|
PCL
rehabilitation
Rehabilitation exercises
Alternative
exercises
When can I return to my sport or activity?
Read more about PCL injuries
PCL rehabilitation
As an athlete, your number one concern is getting back to full strength
as soon as possible so that you can return to training and competition.
That is why appropriate rehabilitation is extremely important.
The goals of rehabilitation
are to restore range of motion and to strengthen the quadriceps muscles,
which help stabilize the knee. After surgery, you may have to use crutches
and a knee brace. Exercises such as squats and leg presses are used because
they put less stress on the knee.
Precautions you can
take at home for minor PCL injuries include:
- reduce activity
during the acute phase
- ice injury multiple
times per day
- compression of
the knee with a bandage or wrap
- elevation if the
knee above the level of the heart
- use anti-inflammatory
medications such as ibuprofen to reduce inflammation and speed up recovery
Once swelling subsides,
you will need to follow a program of physical therapy to strengthen your
quadriceps muscle and regain range of motion.
Some patients require
surgery to stabilize the knee. Arthroscopic surgery, which uses small
incisions and pencil-sized instruments, is used to determine and repair
damage to the cartilage in the knee. Avulsion fractures (tearing away)
may need to be fixed with internal screws to ensure proper healing. If
the PCL is completely torn, it may be reconstructed using a portion of
the patellar tendon or some other autograft.
The major objectives of rehabilitation from a PCL injury are to increase
hip and knee flexibility, pain-free range of motion, and strengthen the
thigh muscles. In severe cases, you should avoid activity that causes
knee pain altogether. In these cases, you can still maintain cardiovascular
fitness by swimming or cycling
if allowed by your doctor.
Rehabilitation
exercises
In some of the following exercises, both legs are to be used, which is
intended to prevent the uninjured leg from developing knee pain. (The
uninjured leg is forced to assume some of the workload of the injured
one and so is prone to injury.) These exercises may be done more than
once daily. Three times daily is best, but work up to this amount gradually.
- Front thigh muscle
sets
Sit with legs extended and fully contract the muscles of the front thighs.
Hold contractions for 10 seconds. Repeat 10 times.
- Straight-leg raises
Lie with one leg extended and the other bent at the knee. Lift the entire
leg from the hip so that the heel is about 5 inches above the floor
or ground. Hold this position for 5 to 10 seconds, then slowly lower
the leg. Repeat 10 times for each leg.
- Backward leg raises
Lie on stomach with legs straight. Lift one leg as high as possible
and hold for 5 to 10 seconds. Repeat 10 to 20 times for each leg.
- Half-knee bends
Stand with feet apart at about shoulder width or as the injury improves,
try to stand with feet together. Slowly lower the body weight by bending
the knees. Do not perform a full squat but rather stop at about half
of the full-squat position and then fully extend the knees. If there
is pain before achieving the half-squat position, stop downward travel
at that point. Repeat 10 to 20 times.
Once posterior knee
pain has been minimized, you may be able to swim, cycle, walk, stair climb,
weight train, or jog, as pain allows. These activities will help you to
gradually resume your normal training regimen. Remember that stretching,
strengthening, and range-of-motion exercises must be continued to reduce
the risk of injury recurrence.
Alternative exercises
During the period when normal training should be avoided, alternative
exercises may be used. These activities should not require any actions
that create or intensify pain at the site of injury. They include:
When can I return
to my sport or activity?
The goal of rehabilitation is to return you to your sport or activity
as soon as is safely possible. If you return too soon you may worsen your
injury, which could lead to permanent damage. Everyone recovers from injury
at a different rate. Return to your activity is determined by how soon
your PCL injury recovers, not by how many days or weeks it has been since
your injury occurred. It also depends on how serious the injury is. Instances
where reconstructive surgery is required will obviously create a longer
recovery period than patients with a strain or knee pain.
A good rule is to
allow pain to dictate when you're ready to return to activity. You should
return in moderation, and back off if you feel any pain.
A typical surgery
patient may be able to ride a bike at three months, start running at five
to seven months, and return to competitive sports after eight to 12 months.
Full recovery may take up to two years.
The ultimate goal
of PCL reconstructive surgery is to provide dynamic stability while maintaining
full range of motion, so that athletes can return to competitive or recreational
sports. Progress is assessed by the patient's perception of how stable
the knee feels and by comparing the strength and stability of the injured
and uninjured knees.
You may safely return
to your sport or activity when, starting from the top of the list and
progressing to the end, each of the following is true:
- You have full range
of motion in the injured knee compared to the uninjured knee.
- You have full strength
of the injured knee compared to the uninjured knee.
- You can jog straight
ahead without pain or limping.
- You can sprint
straight ahead without pain or limping.
- You can do 45-degree
cuts, first at half-speed, then at full-speed.
- You can do 20-yard
figures-of-eight, first at half-speed, then at full-speed.
- You can do 90-degree
cuts, first at half-speed, then at full-speed.
- You can do 10-yard
figures-of-eight, first at half-speed, then at full-speed.
- You can jump on
both legs without pain and you can jump on the injured leg without pain.
How long will the
effects of the injury last?
With proper rehabilitation, the first occurrence of pain that is diagnosed
and treated in its early stages with rest, ice, elevation, and compression
usually lasts two weeks. If the injury has recurred several times, full
recovery may take as long as six weeks.
Should poor biomechanics
be the underlying problem, returning to your sport may take longer. Some
athletes with anterior knee pain caused by poor biomechanics of the foot,
knee, or hip, find immediate relief from pain once fitted with appropriate
and effective orthotic devices or patella tracking braces.
Frequent episodes
of PCL injuries may result in a ligament tear. Such a complication may
require surgical treatment, and full recovery under such circumstances
can take up to two years, depending on the severity.
|
