Diagnose PCL Sprains EASILY [Physical Therapist’s Guide]

By dpope2020

April 11, 2025

dan pope, fitness pain free, football medicine, Knee, knee exam, knee injury, knee pain, ligament injury, pcl, pcl clinical examination, pcl injury, pcl injury clinical examination, pcl injury knee, pcl injury of the knee, pcl injury symptoms, pcl injury test, pcl ligament, pcl reconstruction, pcl tear, physical therapy, physiotherapy, posterior cruciate ligament, posterior cruciate ligament injury, posterior drawer, posterior drawer test, sports medicine

Diagnose PCL Sprains EASILY [Physical Therapist's Guide]

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In today's video we go over: Diagnose PCL Sprains EASILY [Physical Therapist's Guide]

Struggling to confidently assess PCL injuries?

🤔 This video breaks down the key clinical examination techniques you NEED to know. As PTs, we know PCL tears are less common but often complex. Let's sharpen your skills and ensure you don't miss crucial details!

We'll cover:

✅ Common mechanisms of injury (dashboard, sports impacts, falls)

✅ Essential special tests (Posterior Drawer, Step-Off Test, Godfrey's Sign & more!)

✅ How to differentiate PCL injuries from ACL and other knee pathologies.

✅ Practical takeaways for grading severity and when to refer.

Timeline:

  • 0:00 - Intro
  • 0:20 - PCL Background
  • 0:32 - PCL Injuries in Isolation
  • 0:42 - Common Populations
  • 0:50 - Mechanism of Injury
  • 2:10 - Subjective Complaints
  • 3:15 - Joint Effusion
  • 3:41 - Tibio-femoral Step-off Test
  • 4:30 - Grading Injury Severity
  • 5:03 - Posterior Drawer Test
  • 5:37 - Laxity Testing
  • 6:08 - Posterior Sag & Godfrey
  • 6:31 - Quadriceps Active Test
  • 7:08 - Recurvatum Test
  • 7:31 - Differential Diagnosis
  • 9:06 - Practical Take-away

It's a PCL!!

- Dan Pope DPT,OCS,CSCS

Show Notes / Relevant Articles:

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Dan Pope DPT, OCS, CSCS

References: 

  1. Wang D, Graziano J, Williams RJ 3rd, Jones KJ. Nonoperative Treatment of PCL Injuries: Goals of Rehabilitation and the Natural History of Conservative Care. Curr Rev Musculoskelet Med. 2018 Jun;11(2):290-297. doi: 10.1007/s12178-018-9487-y. PMID: 29721691; PMCID: PMC5970122.

  2. Wang SH, Chien WC, Chung CH, Wang YC, Lin LC, Pan RY. Long-term results of posterior cruciate ligament tear with or without reconstruction: A nationwide, population-based cohort study. PLoS One. 2018 Oct 3;13(10):e0205118. doi: 10.1371/journal.pone.0205118. PMID: 30281658; PMCID: PMC6169976.

  3. Pache S, Aman ZS, Kennedy M, Nakama GY, Moatshe G, Ziegler C, LaPrade RF. Posterior Cruciate Ligament: Current Concepts Review. Arch Bone Jt Surg. 2018 Jan;6(1):8-18. PMID: 29430489; PMCID: PMC5799606.

  4. Mariani PP, Margheritini F, Christel P, Bellelli A. Evaluation of posterior cruciate ligament healing: a study using magnetic resonance imaging and stress radiography. Arthroscopy. 2005 Nov;21(11):1354-61. doi: 10.1016/j.arthro.2005.07.028. PMID: 16325087.

  5. Pache S, Aman ZS, Kennedy M, Nakama GY, Moatshe G, Ziegler C, LaPrade RF. Posterior Cruciate Ligament: Current Concepts Review. Arch Bone Jt Surg. 2018 Jan;6(1):8-18. PMID: 29430489; PMCID: PMC5799606.

  6. Agolley D, Gabr A, Benjamin-Laing H, Haddad FS. Successful return to sports in athletes following non-operative management of acute isolated posterior cruciate ligament injuries: medium-term follow-up. Bone Joint J. 2017 Jun;99-B(6):774-778. doi: 10.1302/0301-620X.99B6.37953. PMID: 28566396.

  7. Kopkow C, Freiberg A, Kirschner S, Seidler A, Schmitt J. Physical examination tests for the diagnosis of posterior cruciate ligament rupture: a systematic review. J Orthop Sports Phys Ther. 2013 Nov;43(11):804-13. doi: 10.2519/jospt.2013.4906. Epub 2013 Oct 11. PMID: 24175598.

  8. Rubinstein RA Jr, Shelbourne KD, McCarroll JR, VanMeter CD, Rettig AC. The accuracy of the clinical examination in the setting of posterior cruciate ligament injuries. Am J Sports Med. 1994 Jul-Aug;22(4):550-7. doi: 10.1177/036354659402200419. PMID: 7943523.

  9. Rupp GE, Adrian KMV, Bomar JD, Chau J, Pennock AT, Edmonds EW. Comparison of Outcomes in Pediatric and Adolescent Posterior Cruciate Ligament Injuries With and Without Meniscal Tears: Operative Versus Nonoperative Management. Orthop J Sports Med. 2024 Jan 22;12(1):23259671231222281. doi: 10.1177/23259671231222281. PMID: 38264411; PMCID: PMC10804905.

  10. Wang D, Graziano J, Williams RJ 3rd, Jones KJ. Nonoperative Treatment of PCL Injuries: Goals of Rehabilitation and the Natural History of Conservative Care. Curr Rev Musculoskelet Med. 2018 Jun;11(2):290-297. doi: 10.1007/s12178-018-9487-y. PMID: 29721691; PMCID: PMC5970122.

  11. Paroneto AC, Gomes PS, Carrijo PV, Cohen M, Ramos LA. Outcomes After Posterior Cruciate Ligament Reconstruction With Suture Tape Augmentation and an Accelerated Rehabilitation Protocol: A Retrospective Cohort Study. Orthop J Sports Med. 2025 Feb 6;13(2):23259671241308590. doi: 10.1177/23259671241308590. PMID: 39926586; PMCID: PMC11806459.

  12. Zsidai B, Winkler PW, Naarup E, Olsson E, Horvath A, Moatshe G, Lind M, Musahl V, Hamrin Senorski E, Samuelsson K. Evaluation of Factors Associated With Short-term Failure After Primary Isolated PCL Reconstruction: A Study of Patients From the Swedish and Norwegian Knee Ligament Registries. Orthop J Sports Med. 2025 Jan 3;13(1):23259671241305191. doi: 10.1177/23259671241305191. PMID: 39758146; PMCID: PMC11700431.

  13. Montgomery SR, Johnson JS, McAllister DR, Petrigliano FA. Surgical management of PCL injuries: indications, techniques, and outcomes. Curr Rev Musculoskelet Med. 2013 Jun;6(2):115-23. doi: 10.1007/s12178-013-9162-2. PMID: 23430587; PMCID: PMC3702782.

  14. Pizza N, Di Paolo S, Grassi A, Pagano A, Viotto M, Dal Fabbro G, Agostinone P, Lucidi GA, Monllau JC, Zaffagnini S. Good long-term patients reported outcomes, return-to-work and return-to-sport rate and survivorship after posterior cruciate ligament (PCL)-based multiligament knee injuries (MLKI) with posteromedial corner tears as significant risk factor for failure. Knee Surg Sports Traumatol Arthrosc. 2023 Nov;31(11):5018-5024. doi: 10.1007/s00167-023-07547-0. Epub 2023 Sep 5. PMID: 37668614; PMCID: PMC10598146.

  15. Paroneto AC, Gomes PS, Carrijo PV, Cohen M, Ramos LA. Outcomes After Posterior Cruciate Ligament Reconstruction With Suture Tape Augmentation and an Accelerated Rehabilitation Protocol: A Retrospective Cohort Study. Orthop J Sports Med. 2025 Feb 6;13(2):23259671241308590. doi: 10.1177/23259671241308590. PMID: 39926586; PMCID: PMC11806459.