Understanding Posterior Cruciate Ligament (PCL) Injuries

Joseph Smith
Aug 26
3 min read

Updated: Sep 26

Have you ever twisted your knee playing soccer or fallen hard while skiing? If so, you might have damaged a vital ligaments in your knee called the Posterior Cruciate Ligament or PCL. Let’s dive into what the PCL does, how it can get injured, and what you can do to recover.

What is the PCL and what does it do?

The PCL is the strongest ligament in your knee. Ligaments are like a tough ropes that connect bones together. The PCL connects the thigh bone (femur) to the shin bone (tibia) and helps keep your knee stable. Its main job is to stop the shin bone from sliding too far backward, as well as stabilising the knee from twisting, especially during sports or other quick movements.

How do PCL injuries occur?

PCL injuries usually happen when a strong force pushes the shin bone backward. For example;

In sports like soccer, rugby, skiing, or football when you fall on a bent knee or someone tackles you.
In a car accident if your knee hits the dashboard hard (this is called a "dashboard injury").
When your knee gets stretched too far (hyperextension).

What does a PCL injury feel like?

When the PCL is injured, you might notice:

Acute - immediate from injury

Pain that feels deep inside the knee or even in the back of the calf.
You can still walk, but it might feel a little uncomfortable.
Swelling may happen, but it’s often less than with other knee injuries.

Chronic - ongoing injury

Pain when walking up or down stairs or hills.
Discomfort when lifting heavy things or walking long distances.
A feeling of weakness or “grumpiness” in the knee after exercise.
Recurrent swelling.

How is a PCL Injury Treated?

Good news! Most PCL injuries don’t need surgery. Your knee can heal on its own with the right care and exercises. Treatment focuses on reducing pain, preventing further injury, and strengthening the muscles around your knee—especially the quadriceps (thigh muscles).

Rest and protect

A brace might be used to keep your knee straight and protect the ligament as it heals.
For more serious injuries, a special PCL brace holds your knee in place and prevents the shin bone from sagging backward.

Recovery

Reduce swelling and pain with ice, rest, and gentle movement to regain knee flexibility.
Simple exercises like tightening your thigh muscles (static quads) and calf pumps can help.

Strength and control

Start with exercises like squats, lunges, and step-downs to rebuild strength.
Balance exercises (like standing on one leg) and coordination drills help your knee feel stable again.
Avoid certain exercises that strain the PCL, like hamstring curls, in the first few months.

Return to sport

After a few months, you may begin running, practicing agility drills, and preparing for sports.
Focus on movements like jumping and landing safely to avoid re-injury.

Prevention

Keep your leg muscles strong and flexible.
Warm up before sports, and gradually return to high-impact activities.

When is surgery needed?

Surgery for a PCL injury is rare. It’s only needed if:

The injury is very severe, and the shin bone moves too far back (called grade 3+ laxity).
There are other injuries, like a torn ACL or damaged meniscus.
The knee stays painful or swollen after months of rehab.

Key tips for recovery

Don’t rush! Healing takes time, and it’s important to follow the rehab plan.
Focus on quad strength—it’s the best way to support your knee.
Avoid exercises that strain the PCL, like bending your knee too far during workouts, for at least 3 months.

Key takeaway

A PCL injury might slow you down, but with personalised care you can return to your favourite activities sooner than you might imagine. Whether it’s running, skiing, soccer, or running after the grandchildren, rest and strength are the keys to success.

Have you or someone you know ever had a PCL injury? Share your experience below!