What is the Recovery Time for a PCL Tear?

Kerri Gilbert, PT, DPT

Total time can be over 6 months is some cases.  Read more here.

The quick answer is that the 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). 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?

anatomy of pcl kneeKnee Tendons and Ligaments

 These fiber bundles are stressed when the knee moves in dynamic or rotational motions. These motions challenge these ligaments' stabilization capacity, and when the forces exceed their capacity, the structures can be damaged or torn.

What Caused My PCL tear? 

PCL tears make up less than 20% of injuries to knee ligaments. It is unusual to see isolated PCL tears; usually, they are coupled with injuries to other knee ligaments. PCL injuries are often due to a blow to the knee while bent, including striking the knee against the dashboard during an automobile accident or falling onto a bent knee. PCL injuries are common in the following sports:

  • Soccer
  • Football
  • Baseball
  • Skiing

Classification of PCL injuries:

  • Grade I: The PCL has a partial tear
  • Grade II: The ligament is partially torn and is looser 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

Non-surgical Treatment of a PCL Tear

Physical therapy will help pcl tear recoveryJOI 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 if 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 and 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 of a PCL Knee Tear

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 PCL's attachment site, it will not spontaneously heal or re-attach to the bone. Surgical repair of a PCL tear includes replacing the ligament with new tissue, either from a deceased donor or from another structure within the patient’s leg.

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 PCL'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.

Related articles: PCL Protocol for Physical Therapy and Ligaments in the Knee.

To schedule physical therapy for a PCL injury, please call JOI Rehab at904-858-7045.

pcl knee injuries affect your exercise routineJOI can get you back on the road to recovery from a PCL knee tear

If you think you have injured your PCL or any other part of your knee, you can book an appointment with one of our knee specialists by calling(904)JOI-2000, schedule online, or clicking BOOK APPOINTMENT below. 

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