Posterior Cruciate Ligament (PCL) Tears: Causes and Risk Factors

Posterior cruciate ligament (PCL) injuries to the knee are acute and often happen without warning. However, certain situations, activities, and risk factors make some people more likely to experience a PCL injury.

Causes of PCL Tears

PCL tears are commonly seen in contact sports and non-contact sports. They often occur when:

• The knee is hit directly, especially during sports like soccer, rugby, and football
• A person lands on a bent knee, such as during a fall or misstep
• Landing directly on the front of the shinbone, such as when a dancer comes down from a leap and falls
• A person makes cutting or pivoting maneuvers, such as when an athlete plants a foot and shifts directions
• A person lands on one leg, which can happen after a jump in basketball or volleyball

PCL injuries are also caused by car accidents during which the knees hit the dashboard.

Risk Factors of PCL Injuries

While PCL injuries can happen to anyone, there are certain factors that put people at higher risk:

• Participation in certain sports. People who participate in contact sports are at higher risk of injuring the PCL. Contact sports often involve quick and sudden changes of direction, such as soccer, football or basketball. People who participate in non-contact sports, such as dance or skiing, are also at higher risk for a PCL injury.

  See Common Running Injuries: Knee Pain

• Doing manual labor. Certain manual labor jobs, such as construction work and other jobs that require regularly squatting and lifting heavy objects, increase the risk of a PCL tear.
• Injury to other knee ligaments. While PCL tears can occur in isolation, it is common for them to occur alongside other knee ligaments injuries, especially ACL or MCL tears.¹Kim YM, Lee CA, Matava MJ. Clinical results of arthroscopic single-bundle transtibial posterior cruciate ligament reconstruction: a systematic review. Am J Sports Med. 2011 Feb;39(2):425-34. doi: 10.1177/0363546510374452. Epub 2010 Aug 11. Review. PubMed PMID: 20702860.^,2Fanelli GC, Edson CJ. Posterior cruciate ligament injuries in trauma patients: Part II. Arthroscopy. 1995 Oct;11(5):526-9. PubMed PMID: 8534292.

  See Anterior Cruciate Ligament (ACL) Tears and Medial Collateral Ligament (MCL) Tears and Sprains

• Age. PCL injuries are most commonly seen in 18- to 44-year olds, however, older adults are more prone to ligament injury due to general wear and tear.³Bergfeld JA, Graham SM, Parker RD, Valdevit AD, Kambic HE. A biomechanical comparison of posterior cruciate ligament reconstructions using single- and double-bundle tibial inlay techniques. Am J Sports Med. 2005;33(7):976-981.

Research is mixed on whether or not gender plays a role in the occurrence of PCL injuries.

PCL Tear Prevention

Not every posterior cruciate ligament (PCL) injury can be prevented, however, certain precautions can be taken that may help:

• Condition and strengthen the knee area. Improving strength and flexibility around the knee, especially the hamstring, may help decrease the risk of a PCL injury.
• Warmup prior to exercising. The body is less prone to injury if it is properly warmed up and stretched before participating in physical activity.

Some athletes may choose to wear a knee brace that provides support to the area. Current research does not say one way or the other if knee braces are effective in preventing PCL tears.

PCL tears are often the result of one or both knees hitting the dashboard during a car accident. A person should always wear a seatbelt and position the car seat as far back as reasonably possible.