What Is a PCL Injury and What Can I Do About It ?? Football Related Knee Injuries !!
The posterior cruciate ligament or PCL is a ligament located in the knee. The strong band of tissues that comprise the PCL serves to connect your tibia to your femur. More commonly people experience an injury to the anterior cruciate ligament (ACL) but it is also possible to experience a PCL injury or tear.
There are a number of things that may cause a posterior cruciate ligament tear. Most commonly a PCL injury happens following some type of fall or other powerful strike to the knee, particularly if the knee is bent during the incident. Certain sports may also have a higher likelihood for PCL tears, for example, soccer, skiing and football.
PCL injuries span a range in severity from less severe to very severe. Typically during a physician's medical assessment for a PCL tear, during diagnosis, a physician may determine the grade of the injury, ranging from the most mild Grade 1 signifying a partial tearing of the PCL to the most severe Grade 4, when the PCL is torn along with other knee ligaments like for example the ACL.
Aside from notable physical pain, other signs of a damage to the posterior cruciate ligament includes swelling in the knee, difficulty walking, and an unstable feeling in the knee. If you think you have a PCL injury or some other knee related injury, it is advisable that you seek medical attention from a qualified doctor. Board certified orthopedic physicians specialize in knee injuries and will be able to offer expert diagnosis and treatment.
If you are getting examined for a knee injury, you may be required to have X-rays to determine whether you have broken or damaged any bones. MRIs are also able to provide information about the location and severity of the injury.
Non-surgical medical treatment for a PCL injury may include rest, ice, compression and the use of crutches to stabilize the knee. Non-steroidal anti-inflammatory medications are also sometimes recommended to relieve inflammation and pain. In addition, physical therapy may be advised as part of the recovery process from a PCL injury.
Sometimes surgery is required to repair a more serious PCL injury. Surgical intervention administered by a board certified orthopedic surgeon for posterior cruciate ligament injuries often involves arthroscopy.
If you are experiencing knee pain and are concerned that you may have a PCL injury, damaged anterior cruciate ligament or ACL injury, or some other type of knee injury, you should seek medical treatment from an orthopedic doctor or another qualified medical professional as soon as possible.
Dr. Stacie L. Grossfeld is a board certified Orthopaedic Surgeon practicing in Louisville, Kentucky. She graduated from the University of Louisville School of Medicine, and completed a fellowship in Sports Medicine at the Fowler-Kennedy Sports Medicine Center. Dr. Grossfeld currently works as a louisville orthopedic surgeon in private practice at Orthopaedic Specialists. Dr. Grossfeld also serves as a clinical instructor in the Department of Orthopaedic Surgery at the University of Louisville. Her special interests are in knee and shoulder reconstruction and sports medicine.
There are a number of things that may cause a posterior cruciate ligament tear. Most commonly a PCL injury happens following some type of fall or other powerful strike to the knee, particularly if the knee is bent during the incident. Certain sports may also have a higher likelihood for PCL tears, for example, soccer, skiing and football.
PCL injuries span a range in severity from less severe to very severe. Typically during a physician's medical assessment for a PCL tear, during diagnosis, a physician may determine the grade of the injury, ranging from the most mild Grade 1 signifying a partial tearing of the PCL to the most severe Grade 4, when the PCL is torn along with other knee ligaments like for example the ACL.
If you are getting examined for a knee injury, you may be required to have X-rays to determine whether you have broken or damaged any bones. MRIs are also able to provide information about the location and severity of the injury.
Non-surgical medical treatment for a PCL injury may include rest, ice, compression and the use of crutches to stabilize the knee. Non-steroidal anti-inflammatory medications are also sometimes recommended to relieve inflammation and pain. In addition, physical therapy may be advised as part of the recovery process from a PCL injury.
Sometimes surgery is required to repair a more serious PCL injury. Surgical intervention administered by a board certified orthopedic surgeon for posterior cruciate ligament injuries often involves arthroscopy.
If you are experiencing knee pain and are concerned that you may have a PCL injury, damaged anterior cruciate ligament or ACL injury, or some other type of knee injury, you should seek medical treatment from an orthopedic doctor or another qualified medical professional as soon as possible.
Dr. Stacie L. Grossfeld is a board certified Orthopaedic Surgeon practicing in Louisville, Kentucky. She graduated from the University of Louisville School of Medicine, and completed a fellowship in Sports Medicine at the Fowler-Kennedy Sports Medicine Center. Dr. Grossfeld currently works as a louisville orthopedic surgeon in private practice at Orthopaedic Specialists. Dr. Grossfeld also serves as a clinical instructor in the Department of Orthopaedic Surgery at the University of Louisville. Her special interests are in knee and shoulder reconstruction and sports medicine.
Football Related Knee Injuries
Ligament Injuries
Football players frequently injure one or more of the knee ligaments. These ligaments include the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL), and the lateral collateral ligament (LCL).
ACL Injury - When an athlete changes direction rapidly, lands wrong from a jump, or simply slows down when running, the ACL could tear. With this injury, knee swelling immediately occurs and walking is painful. The knee may have loss of range of motion and tenderness with an ACL injury. Treatment for this type of injury depends on the degree of tear to the ligament, whether or not there are other associated injuries, and how much physical demand the patient puts on their knee. Sometimes, the orthopedic specialist needs to operate to repair a complete tear of the ACL. Recovery is measured in months, rather than weeks for this type of injury.
MCL Injury - The MCL is generally injured from a direct blow to the outside portion of the knee. The ligament is torn or stretched when the foot is planted firmly on the ground and a sideways force hits the knee. An injured MCL causes pain, difficulty walking, and tenderness. Therapy involves the use of a knee immobilizer, rest, ice applications, compression with a support bandage, and frequent knee elevation. Surgery is only necessary for severe tears of the MCL.
PCL Injury - The PCL is injured when a football player receives a blow to the front aspect of the knee or makes a simple misstep on the turf. Most PCL tears and injuries will heal with conservative treatment. An injured PCL leads to pain with walking, instability, and swelling of the knee. Surgery may be necessary with complete tearing and extensive damage to the PCL.
LCL Injury - The LCL is the least likely ligament to be injured during football activities. When severe force is applied to the inside of the knee, a LCL injury could occur. Symptoms include pain, swelling, weakness, tenderness, and discomfort to the outside of the knee. Treatment involves the RICE method, anti-inflammatory medications, and immobilization. Surgery to reattach the ligament to the bone is sometimes required.
Cartilage Injuries
Torn Cartilage - Most of the time, the meniscus is the cartilage that is torn during a football game. This rubbery, tough structure serves as a shock absorber during athletic activities. The meniscus tears with cutting, decelerating, pivoting, twisting, or from being tackled. Most torn meniscus injuries cause gradual pain and swelling, worse with climbing steps or uphill. Not all meniscus tears require surgery, but frequently the damage can only be repaired through an operation.
Fractures
The patella can break if the football player falls directly onto it or receives a direct blow in that area. If the bone is fragmented, surgery will be required for repair. If the bone is in appropriate position, the orthopedic specialist may prescribe an immobilizer and rest for the injury. The head of the fibula on the outside area of the knee joint is easily fractured from direct blows or as part of an injury to the lower leg. If the bone is not out of alignment, immobilization and conventional therapy will treat the injury. Sometimes, however, the fibula fracture is complex and requires surgical repair. With jumping types of injuries, the tibia bone can be damaged. If the fracture occurs in the tibial plateau, surgery is often necessary.
Bursa Inflammation
Bursa inflammation is also called 'housemaid's knee' or prepatellar bursitis and is the result of repetitive kneeling or crawling on the knees. The space between the kneecap and skin is called the bursa and it becomes irritated and fills with fluid. Bursa inflammation is a common type of knee injury of football players. Treatment includes using anti-inflammatory medications and rest. Occasionally the bursa needs to be drained for resolution of the problem.
Patellar Injuries
The patella can dislocate if it receives a direct blow. The blow can force this bone toward the outside area of the knee. Most dislocations of the patella easily return to normal alignment by simply straightening out the knee. However, some patella dislocations are serious and require surgery. Also, patella-femoral syndrome is inflammation to the underside of the patella. This condition causes localized pain, which is worse with running and walking down stairs. Treatment involves strengthening exercises, the use of ice therapy, and anti-inflammatory medications. Severe cases of this disorder require arthroscopic surgery to remove the damaged cartilage and realign parts of the quadriceps muscle.
Muscle and Tendon Strain
Most strains of the knee are treated with rest, ice therapy, elevation, and compression. Crutches help with walking, and the doctor may order an anti-inflammatory medication. These injuries are often the result of hyper-extension involving the hamstring muscles or hyperflexion causing the quadriceps to be injured. If the patellar or quadriceps tendon is ruptured, there is inability to extend the knee. Surgery is necessary to repair this type of injury.
Posterior Cruciate Ligament - All You Need to Know About PCL Injuries
There are four bones connected to the knee. These are the femur (upper bone/thighbone), tibia (lower bone/shinbone), fibula (strut bone on the outside of the leg) and patella (knee cap).
There are four main ligaments that bind these bones and help in stabilizing the knee. Two of them are collateral ligaments, Media Collateral Ligament (MCL) and Lateral Collateral Ligament (LCL), while the other two are cruciate ligaments, Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL).
The cruciate ligaments, ACL and PCL, attach the thighbone and shinbone. They are named "cruciate" because they pass each other in the middle of the joint forming an "X." There are two functions of the PCL. One is to restrain the traveling of shinbone backwards on the thighbone while the other purpose is to restrict the shinbone from twisting outwards.
As PCL controls the backward movement of the shinbone, if the shinbone moves too far, the PCL can be damaged. This situation occurs due to the direct hit to the front of the knee while it is bent. PCL injury may also result from a car accident, when, due to inertia, the knee strikes the dashboard just below the patella. It can also be injured when someone falls on the bent knee. In both situations, the shinbone is forced to move backwards.
The symptoms of PCL injury may vary with the nature of the injury. In a PCL injury, the knee does not swell up as much. Sometimes patients feel that the knee is slipping or giving out. Pain and swelling may remain from 2 to 4 weeks. There would be positive sign on the "Posterior Drawer Test" and pain when "Reverse Lachman's Test" is performed.
The physical examination is very important to diagnose the deficiency in PCL. It includes three important tests: Posterior Lachman Test, Posterior Sag Test, and Posterior Drawer Test. Mostly the Posterior Drawer Test is conducted by placing the knee and leg in different positions and then applying load to the joint. If there is an unexpected movement of the shinbone, it means that the PCL has been damaged and is not working properly.
MRI, X-rays and sometimes arthroscopy may also be used to diagnose the PCL injury. Arthroscopy uses a small fiber-optic TV camera that is placed inside the knee joint to allow a surgeon to see the whole structure of the knee directly. Exercises and physical therapy may be recommended. Surgery is only recommended when other ligaments are also injured along with PCL.
This article is for information only regarding PCL injuries. For any medical advice and assistance, consult your doctor.
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