PCL injury
An injury to the posterior cruciate ligament (PCL), which helps stabilize the knee and limit backward movement of the tibia. The injury may be partial or complete.
A minor or partial PCL injury may cause local pain and tenderness with limited swelling. Knee function may be relatively preserved.
PCL injuries often occur when the front of the lower leg is forced backward while the knee is bent. In football, this can happen during a tackle or collision where the shin is struck from the front. The injury can also occur with hyperextension or forceful rotation of the knee.
Common situations
- •Tackle or collision to the front of the lower leg
- •Falling onto a bent knee
- •Forceful hyperextension of the knee
- •Twisting of the knee under load
Good leg and trunk strength together with neuromuscular control may help manage loads during tackles, landings and changes of direction.
- •Train strength in the thighs, hips and trunk
- •Develop good control during landing and deceleration
- •Train balance and single-leg control
- •Increase load progressively after periods of low activity
Stop activities that provoke pain and avoid football until the injury has been assessed. Reduce load as needed and monitor symptoms.
Restore mobility and basic function
Focus on mobility, symptom control and gradual loading.
Goals
Normalize daily function and reduce symptoms.
Progression criteria
Able to walk and perform basic exercises without significant pain or increased swelling.
Build strength and control
Progressive strength and neuromuscular control training adapted to knee function.
Goals
Restore sufficient strength and control for running and football-specific training.
Progression criteria
Able to perform single-leg exercises, running and progressively more demanding movements without significant reaction.
- No significant swelling
- Good range of motion
- Adequate strength and balance
- Good control during running and changes of direction
- No significant instability during football-specific movements
The information in the Injury Center is for educational purposes and does not replace professional medical advice. Always consult a qualified healthcare professional for diagnosis and treatment.
PCL injury
An injury to the posterior cruciate ligament (PCL), which helps stabilize the knee and limit backward movement of the tibia. The injury may be partial or complete.
Mild — Mindre skador kan återhämta sig under veckor till flera månader beroende på skadans omfattning och funktion.
Symptoms
A minor or partial PCL injury may cause local pain and tenderness with limited swelling. Knee function may be relatively preserved.
Acute Treatment
Stop activities that provoke pain and avoid football until the injury has been assessed. Reduce load as needed and monitor symptoms.
Rehabilitation
Focus on mobility, symptom control and gradual loading.
Goals
Normalize daily function and reduce symptoms.
Progression criteria
Able to walk and perform basic exercises without significant pain or increased swelling.
Progressive strength and neuromuscular control training adapted to knee function.
Goals
Restore sufficient strength and control for running and football-specific training.
Progression criteria
Able to perform single-leg exercises, running and progressively more demanding movements without significant reaction.
Return to Play
- ☐ No significant swelling
- ☐ Good range of motion
- ☐ Adequate strength and balance
- ☐ Good control during running and changes of direction
- ☐ No significant instability during football-specific movements
Moderate — Återhämtningen kan ta flera veckor till flera månader. Tidsförloppet beror på skadans grad och om andra strukturer är skadade.
Symptoms
More pronounced pain, swelling and reduced function may occur. The player may experience instability, particularly during stairs, running or changes of direction.
Acute Treatment
Stop football activity and seek medical assessment. Avoid loading that increases pain or instability.
Rehabilitation
Restore mobility and gradually increase loading while controlling swelling and pain.
Goals
Good daily function and improved knee control.
Progression criteria
Able to load the leg during daily activities and rehabilitation exercises without significant worsening.
Progressive strength, balance, running and football-specific movements.
Goals
Restore strength, control and load tolerance.
Progression criteria
Able to tolerate running, jumping and changes of direction with good control and without significant swelling or pain reaction.
Return to Play
- ☐ Good range of motion
- ☐ Adequate strength compared with the unaffected side
- ☐ Good balance and single-leg control
- ☐ Able to perform jumping, landing and changes of direction
- ☐ No significant instability during football-specific movements
- ☐ Medical assessment for a confirmed ligament injury
Severe — Mer omfattande PCL-skador och kombinerade skador kan kräva flera månaders rehabilitering. Tidsförloppet är individuellt.
Symptoms
A severe PCL injury may cause significant swelling, severe pain and marked instability or functional loss. Combined ligament injuries may occur after more significant trauma.
Acute Treatment
Stop sports activity and seek medical assessment. Reduce weight-bearing as needed and do not force the knee through painful or unstable movements.
Rehabilitation
The extent of the injury and any combined injuries are assessed. Early rehabilitation focuses on swelling, range of motion, strength and control.
Goals
Restore basic knee function and control symptoms.
Progression criteria
Good range of motion, controlled swelling and sufficient function for continued rehabilitation.
Strength, balance, running, jumping and changes of direction are progressively reintroduced according to an individualized plan.
Goals
Restore the strength and stability required for football.
Progression criteria
Able to complete relevant functional testing and tolerate full training load without pain, swelling or instability.
Return to Play
- ☐ Good range of motion
- ☐ No significant residual swelling
- ☐ Adequate strength and control
- ☐ Good function during jumping, landing and changes of direction
- ☐ No significant instability
- ☐ Medical assessment and individualized return-to-play plan
When to Seek Medical Care
Seek medical assessment after significant knee trauma accompanied by swelling, pain or instability.
- Swelling after trauma
- A feeling of instability
- Inability to bear weight normally
- Persistent pain or functional impairment
- Suspected injury to multiple ligaments
References
- Posterior Cruciate Ligament (PCL) Injuries — American Academy of Orthopaedic Surgeons (https://orthoinfo.aaos.org/en/diseases--conditions/posterior-cruciate-ligament-pcl-injuries/)