Treatment of posterior cruciate ligament (PCL) injuries has changed considerably in recent years. This article discusses current rehabilitation for PCL disruptions in athletes. The treatment of PCL injuries varies somewhat based on the chronicity (acute vs. chronic) of injury and associated pathologies. The authors provide their treatment algorithm for the acute and chronic PCL-injured-knee patient. Nonoperative rehabilitation is discussed with a focus on immediate motion, quadriceps muscle strengthening, and functional rehabilitation. A discussion of the biomechanics of exercise is provided, with a focus on tibiofemoral shear forces and PCL strains. Surgical treatment is also discussed, with the current surgical approach being either the two-tunnel or the one-tunnel patellar tendon autograft procedure. The rehabilitation program after surgery is based on the healing constraints, surgical technique, biomechanics of the PCL during functional activities, and exercise. With the new changes in surgical technique and in the rehabilitation process, the authors believe that the outcome after PCL reconstruction will be enhanced.
K.E. Wilk is National Director of Research & Clinical Education at HealthSouth Rehabilitation Corporation, Birmingham, AL; he is also affiliated with HealthSouth Sports Medicine & Rehabilitation Center, the American Sports Medicine Institute (ASMI), Marquette University, and the Tampa Bay Devil Rays Baseball Organization. J.R. Andrews is with the University of Alabama at Birmingham, the ASMI, and the Alabama Sports Medicine & Orthopaedic Center (ASMOC). W.G. Clancy, Jr., is with the University of Alabama at Birmingham and the ASMOC. H.C. Crockett and J.W. O'Mara, Jr., are with the ASMI.