A posterior cruciate ligament (PCL) injury can significantly impact daily life, sometimes more than people expect. Simple movements like walking, climbing stairs, bending or squatting may suddenly feel uncomfortable or unstable. Even a mild tear can create a sense of weakness in the knee, while more severe injuries may lead to frequent “giving way” episodes that make the joint feel unreliable. Over time, repeated instability can place additional strain on the knee and lead to longer-term issues.
Because symptoms often worsen without proper care, an early evaluation by a specialist is an important first step toward recovery and long-term stability.
By Arete Orthopaedic Centre
Medically Reviewed by Dr Wang Lushun
The PCL is one of the key stabilising ligaments inside the knee, connecting the thigh bone (femur) to the shin bone (tibia). Its main job is to prevent the tibia from sliding too far backwards, especially when the knee is bent.
Most PCL injuries occur after a sudden impact or traumatic event, such as landing forcefully on a bent knee, a sports collision or a car accident. When the ligament is overstretched or torn, the knee loses some of its natural support during movements that load a bent joint. Tasks like walking downhill, going downstairs or rising from a chair may become more challenging.
Since the ligament works closely with the menisci, cartilage and other knee ligaments, damage can sometimes extend to these surrounding structures, making proper assessment and diagnosis even more important.
Pain from a PCL injury often develops at the back of the knee or deep within the joint, sometimes accompanied by swelling and stiffness. Many people describe a sense of looseness or instability, especially when walking downhill, going downstairs or squatting. These movements place added stress on a bent knee and can highlight the loss of support caused by a PCL tear.
Seeking early evaluation can prevent long-term complications and guide appropriate treatment. You should consult an orthopaedic specialist if you experience:
Diagnosis involves a discussion about how the injury occurred and the symptoms you're experiencing during everyday activities. Your orthopaedic specialist will perform a physical examination to assess stability, range of motion and areas of tenderness or weakness.
Imaging tests are performed to confirm the diagnosis and evaluate the extent of the injury:
Combining clinical evaluation with imaging allows for an accurate diagnosis and an appropriate treatment plan.
Management of a PCL injury depends on several factors, including the severity of the tear, whether other knee structures are damaged, your activity level and how much the injury affects daily function. Treatment usually starts with conservative care, but surgery may be recommended for more significant injuries or persistent instability.
Conservative treatment is effective for many partial PCL tears and early injuries.
Surgery is typically considered when the injury is more severe or when symptoms persist despite repeated non-surgical treatment.
Your orthopaedic surgeon may recommend surgery if:
Surgical treatment usually involves PCL reconstruction, where a graft is used to rebuild the ligament. In select cases, a direct repair may be possible if the tear is at the ligament’s attachment site. The choice of technique depends on the injury pattern and your overall knee health.
A thorough discussion with an orthopaedic surgeon will help determine the most suitable approach for long-term stability and function.
Recovery from a PCL injury varies widely and depends on the severity of the tear, whether other structures were injured and whether surgery was needed. A structured rehabilitation plan is essential for restoring stability, strength and confidence in the knee.
Rehabilitation may take several weeks to a few months. The focus is on reducing pain and swelling early on, then gradually rebuilding strength, improving balance and restoring normal movement patterns. Many patients can return to daily activities once strength and control have improved.
Recovery follows an enhanced recovery pathway, especially for those aiming to return to high-level sports. Rehabilitation often spans 6–12 months and follows a phased approach that protects the healing graft, restores full motion and progressively challenges the knee with strength and functional exercises.
Key rehabilitation goals:
Close guidance from a physiotherapist and regular follow-up with your orthopaedic specialist help ensure safe, steady progress throughout recovery.
A PCL injury can affect mobility and daily comfort, but with early diagnosis and proper management, most people recover well. Recognising symptoms and seeking timely treatment is key to protecting long-term knee function. If you have ongoing knee pain or instability after an injury, schedule an evaluation with our orthopaedic surgeon, Dr Wang Lushun . Contact us today to book an appointment.
Mild or isolated PCL injuries without significant instability can often improve with conservative treatment such as bracing and physiotherapy. However, more severe damage may require surgery.
Not necessarily. PCL and ACL injuries differ in how they occur, how they feel and how they are treated. While PCL injuries are less common, each condition requires proper assessment to determine the best management plan.
Your return timeline depends on the severity of the injury, whether surgery was needed and how quickly you progress through rehabilitation. Your orthopaedic surgeon and physiotherapist will guide you with a personalised plan.
Ignoring ongoing pain or instability can place extra stress on the knee, increasing the risk of cartilage damage and additional ligament strain over time. Early evaluation helps prevent long-term complications and supports better outcomes.
MBBS (S’pore), MRCS (Edin), MMed (Ortho), FRCS (Ortho) (Edin)
With over 20 years of experience, Dr Wang Lushun is an orthopaedic surgeon who specialises in treating a wide range of sports injuries and musculoskeletal conditions. He has in-depth experience in minimally invasive surgery and advanced robotic surgery. Dr Wang provides orthopaedic care to athletes and everyday individuals throughout their journey to recovery.
