Nonoperative treatment of PCL injury

Nonoperative Treatment of Posterior Cruciate Ligament Injuries

 D’Amato, Bach

Phase 1

Days 1–7

  • Range of motion (ROM) 0–60 degrees.
  • Weightbearing with two crutches.
  • Electrical muscle stimulation to quadriceps.
  • Exercises
  • Quadriceps sets.
  • Straight leg raise (SLR).
  • Hip adduction and abduction.
  • Mini-squats/leg press (0–45 degrees).

Weeks 2–3

  • ROM 0–60 degrees.
  • Weightbearing without crutches.
  • Progress exercises using weights.
  • Bike (week 3) for ROM.
  • Pool program
  • Leg press (0–60 degrees).

Phase 2

Week 3

  • ROM to tolerance.
  • Discontinue brace.
  • Bike, Stairmaster, rowing.
  • Progress exercises with weights.
  • Mini-squat (0–60 degrees).
  • Leg press (0–60 degrees).
  • Step-ups.
  • Hip abduction and adduction.
  • Toe-calf raises.

Weeks 5–6

  • Continue all exercises.
  • Fit functional brace.
  • Pool running.

 

Phase 3

Weeks 8–12

  • Begin running program.
  • Continue all strengthening exercises.
  • Gradual return to sports activities.

Criteria to return to sports:

  • No change in laxity.
  • No pain, tenderness, or swelling.
  • Satisfactory clinical examination.
  • Functional testing 85% of contralateral knee.
  • Quadriceps strength 85% of contralateral knee.