02/08/2026
PCL is one of the least common knee ligament injuries, the typical mechanism is a fall on hard ground landing directly on the knee (posterior tibial translation) hence its nickname as the ‘dashboard injury’ due to its common mechanism being knee hitting the dashboard in a motor vehicle collision
Jamie’s presentation was similar, a fall on hard ground and an instant shot of knee pain on landing, clinical presentation main findings were a positive posterior drawer test, pain on resisted hamstring flexion deep in knee and a tibial sag. Boney impact injuries ruled out. MRI diagnosis confirmed PCL partial tear and ACL grade 1 sprain.
We broke rehab down into 4 main stages:
Stage 1: We locked in brace to stabilise knee and allow healing of ligaments. This time was spend focusing on restoring ROM, maintaining upper body strength, nutrition and sleep to promote recovery. Reducing pain and swelling. Any ROM work was done with band assist to stop hamstring working, hamstrings pull your tibia backwards - which will pull on the healing PCL
Stage 2 was focused on strength, once swelling, pain and ROM were controlled, we could begin to load up on the weights and build strength, this was monitored with dynamometery to make sure we are addressing specific weak areas. Lots of single leg control and proprioceptive work was done also. Hamstring strengthening began with hip hinging before working knee flexion once tolerated.
Stage 3 was focused on polymerics, to improve his capacity to tolerate pitch work, running and sprinting. We broke down key movement patterns a midfielder needs - broke them down and through repetition worked on them to ensure he could perform each component of playing well before combining them all together on a pitch - when other distractions are around and he cannot ‘think’ about what his knee is doing. Here is where we drilled these movements in place, so they became subconscious and he was happy accepting weight through the knee
Stage 4 was translating all this to the pitch, combining all the previous hard work to sports specific drills. Non contact first before adding controlled contact
Still can’t beat me in a throw in !
