Understanding PCL Injury
The posterior cruciate ligament (PCL) sits behind the ACL and stops the shin bone sliding backwards. It is injured much less often than the ACL, typically by a direct blow to the front of a bent knee — such as a dashboard injury — or a fall onto a bent knee.
Unlike the ACL, many isolated PCL injuries have some capacity to recover with rehabilitation. Careful grading and a check for associated ligament damage guide whether a brace-and-strengthening approach or reconstruction is needed.
Symptoms to look for
Causes & risk factors
- A direct blow to the front of the shin (e.g. dashboard injury)
- Hyperflexion or a fall onto a bent knee
- Sporting collisions and tackles
How it's diagnosed
Clinical examination including the posterior drawer test.
MRI to grade the injury and identify any associated damage.
Assessment for combined ligament injuries, which change the plan.
What happens if it's left untreated
- Persistent instability if a significant injury is left untreated
- Uneven loading leading to early cartilage wear over time
- Ongoing pain with demanding activity
How we treat it
What to expect
Many isolated PCL injuries recover well with a brace and targeted rehabilitation over a few months. Higher-grade or combined injuries treated with reconstruction recover over 6–9 months.
How to protect yourself
Frequently asked questions
Often not — many isolated injuries do well with rehabilitation. Surgery is reserved for severe, combined or persistently unstable injuries.