NO MATTER HOW STRONG, IT WILL TEAR

The strongest ligament in the knee is the Posterior Cruciate Ligament (PCL).  This ligament connects the tibia bone of the lower leg to the femur bone of the thigh.  The attachments cross behind the patella with the PCL connected to the anterior portion of the femur while attaching to the tibia at the back of the knee.  The main function of the PCL is to prevent the tibia from shifting back beyond the knee capsule.  The PCL provides stability to the knee, allowing the it to bend without the shin bone separating from the thigh.  However, in multiple situations in athletic competition, it cannot be avoided.

During a game or competition, injury to the PCL commonly occurs when the knee is bent and the athlete falls on the bent knee.  The femur shifts back and rolls across the tibia, leading to a tear.  On the ice, a hockey player gets checked.  They are knocked off their skates and land on the hard surface with their knee bent.  In football, when the pigskin is fumbled on the field, players are scramble to recover it.  As it rolls away from them, another player jumps on the ball.  Their knee is the first part of their body to hit the ground.  Again, the mechanism of the injury forces the shift in the femur pulling the ligament apart.

In some cases on the basketball court, a player may plant their foot to prepare for a shot.  The defender jumps out quickly to block and runs into the shin bone of the shooter.  With enough force, as the knee hyperextends, the tibia slides back, stretching the PCL beyond capacity.  One last example is in the MMA ring.  Visualize two fighters on the floor grappling, preparing for their next move.  As they are in a leg lock, fighter #1 goes in and shifts their opponent into an inverted heel hook.  Fighter #1 has the heel off the floor and hooked under the arm diagonal to the locked leg.  He rolls over, bringing his opponent with him and rotates his torso to drive the heel down.  The knee of fighter #2 is hyperextended, basically snapping the PCL in the process.

As with most orthopedic injuries, there are several grades which determine the severity of the injury and if it requires surgical intervention.  With a PCL injury, as long as the other ligaments are in tact, a person can function with the tear while wearing a brace.  After the swelling goes down, intensive rehabilitation is necessary to strengthen the surrounding musculature, not only to support the knee as the PCL heals, but to prevent damage to the other ligaments.  A Grade I and II tear generally do not require surgery.  A Grade III injury is a complete rupture of the tendon which does require surgery.  In some cases, the injury pulls off a bone fragment from the tibia which will require some reconstruction.     

An injury to the PCL does not occur in common, every day movements.  Off the field, damage to the PCL is common in car accidents when the passanger hits their knees on the dashboard in a head on collision.   Comparing the opponent in a sports competition to the impact from a motor vehicle seems unrealistic, but a strong force is required to tear the PCL.

TO PLAY OR NOT TO PLAY…THAT IS THE QUESTION

Written by Lady A  

Read my bio under Contact

Follow me @LadyASNS on Twitter