What is the Recovery Time for a PCL Tear?
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The quick answer is the total recovery time for a PCL tear can be up to 6 months. Ligaments are composed of closely packed collagen fiber bundles oriented in a parallel fashion to provide joints stability in the musculoskeletal system.
What is the PCL?
Knee Tendons and Ligaments
PCL stands for Posterior Cruciate Ligament. This is one of the four crucial ligaments in the knee that keeps the shin bone (tibia) moving backward on the thigh bone (femur).
These fiber bundles are stressed when the knee moves in dynamic or rotational motions. These motions challenge these ligaments’ stabilization capacity. When these forces exceed their capacity, the structures can be damaged or torn.
Is PCL Tear worse than ACL?
Even though PCL tears make up less than 20% of injuries to knee ligaments. It is unusual to see isolated tear; usually, they are coupled with injuries to other knee ligaments. One such knee ligament is the ACL which is a more debilitating injury. PCL injuries are often due to a blow to the knee while bent. This includes striking the knee against the dashboard during an automobile accident or falling onto a bent knee. These injuries are common in the following sports: Soccer, Football, Baseball, and Skiing.
Classification of Posterior Cruciate Ligament Injuries:
Ligament sprains can be classified by their severity. The less severe being a grade I.
- Grade I: The ligament has a partial tear in the fibers
- Grade II: The ligament is partially torn and has more laxity than in Grade I
- Grade III: The ligament is completely torn, and the knee becomes unstable
- Grade IV: The PCL is damaged along with another ligament in the knee
Can a PCL Tear Heal on Its Own?
This is dependent upon if the ligament is the only knee ligament that has suffered an injury. In most cases this is not the situation and someone who has a Posterior Cruciate Ligament Tear will require some sort of intervention. This intervention can be either surgical , non- surgical, or a combination of the two dependent upon the severity.
Non-surgical Treatment of a PCL Tear
JOI Physical Therapy for a torn PCL
Grade I or II injuries, may not require surgery if they are the only injured structures in the knee. Also, chronic PCL injuries that are recently diagnosed may not require surgery. This is only when there are no presenting symptoms or other complications. Non-surgical treatment should include physical therapy to gain and maintain range of motion at the knee. It would also strengthen the muscles around the knee to provide stability around the joint.
Physical therapy rehabilitation will progress through exercises targeting specific muscles and progressing the knee’s movement through increasing ranges of motion. The range of motion will be progressed gradually to limit the stresses through the joint during the initial recovery phase. Resistance exercises will be progressed as therapy gradually increases forces through the knee and builds up muscular strength and endurance.
Around 9 weeks post-injury, the patient can initiate a light running program and gradually return to sports activities through week 12.
Criteria to return to sport:
- Absence of pain and swelling
- No detectable laxity within the injured knee
- Strength gains in affected leg equal to greater than 85% of the unaffected side
To learn more about the anatomy of the knee, go to this Knee Anatomy Video.
Surgical Treatment
If the injury is severe enough, creating significant instability in the knee, or if the patient’s personal activities require strong knee stability, surgery will be recommended. Due to poor blood supply at the ligament’s attachment site, it will not spontaneously heal or re-attach to the bone. Surgical repair of a tear includes replacing the ligament with new tissue, either from a deceased donor or from another structure within the patient’s leg.
How Long Does a PCL Tear Take to Heal?
Post-operative treatment should include physical therapy rehabilitation focused on improving range of motion and strength around the knee joint. The patient will be on weight-bearing restrictions for about 5 weeks, using crutches and a knee brace to protect the newly inserted ligament’s healing process. Around week 7 or 8, the knee brace can be removed if the patient shows appropriate quad strength and balance control. The patient can initiate pool running or a walking program at week 12 to increase muscular endurance.
Sport-specific training and running program can be initiated around 4-6 months after surgery as long as the patient reaches established criteria:
- Satisfactory clinical exam
- Quadriceps strength 80% or greater of the unaffected leg
- Hamstring strength 110% or greater of the unaffected leg
- Proprioception testing of 100%
- Functional hop test greater than 75%
The gradual return of full, unrestricted sports occurs around 6-9 months after surgery as long as satisfactory clinical exams continue.
- Physical Therapy Protocol for Ligament Tears
- Ligaments in the Knee
To schedule physical therapy for a PCL injury, please call JOI Rehab at 904-858-7045.
Posterior Cruciate Ligament Tear
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