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.