PCL Injury
The posterior cruciate ligament (PCL) is the strongest ligament in the knee. Learn about causes, symptoms, and treatment options for PCL injuries.
What is a PCL Injury?
The posterior cruciate ligament (PCL) is located inside your knee, just behind the ACL. It connects your thighbone (femur) to your shinbone (tibia) and prevents the tibia from sliding backward under the femur.
PCL injuries are less common than ACL injuries but can be equally challenging to treat. The PCL is stronger and more robust than the ACL, so significant force is usually required to injure it. Many PCL injuries heal well with conservative treatment, though surgery may be needed for severe tears or combined injuries.
How PCL Injuries Occur
Dashboard Injury
The most common cause—hitting the dashboard in a car accident with a bent knee
Sports Contact
Falling on a bent knee or a direct blow to the front of the knee
Hyperextension
Over-straightening the knee beyond its normal range
Combined Injuries
Often occurs with other ligament injuries in severe trauma
Symptoms
- Pain in the back of the knee
- Swelling that develops within hours of injury
- Stiffness and difficulty bending the knee
- Feeling of instability or "giving out"
- Difficulty walking, especially going downstairs
- Mild to moderate discomfort with activity
PCL vs ACL
PCL injuries often have milder symptoms than ACL injuries:
- • Less dramatic “pop” at time of injury
- • Less immediate swelling
- • May be initially overlooked
- • Often discovered during evaluation for other injuries
Treatment Options
Many isolated PCL injuries can be treated without surgery.
RICE Protocol
Rest, Ice, Compression, and Elevation for initial management
Bracing
Functional brace to support the knee during healing
Physical Therapy
Strengthening quadriceps to compensate for PCL laxity
Surgery
May be considered for complete tears with persistent instability
When Surgery May Be Needed
- • Complete PCL tear with significant instability
- • Combined injuries (PCL with ACL, MCL, or LCL damage)
- • Chronic instability that doesn’t respond to physical therapy
- • Athletes who need to return to high-level sports
- • Avulsion fractures (where ligament pulls off a piece of bone)
Related Conditions
Get your PCL injury evaluated
Schedule a consultation with Dr. Hunter for expert diagnosis and a personalized treatment plan for your PCL injury.