Address safety, settle excessive irritability and maintain useful movement.
What to do
Protect knee and control effusion
Avoid posterior tibial sag and hamstring loading early when prescribed
Restore ROM and quadriceps activation
Use PCL-specific brace/orthopaedic plan where indicated
Exercise dosage
Quadriceps sets: 3–5 x 10, several times/day
Straight-leg raise if no lag: 3 x 8–12
Progress when
Daily function is stable or improving.
No new red flags or progressive neurological deficit.
Exercise response returns to baseline by the following day.
Phase 2 — Mobility, Strength & Capacity
Restore the specific strength, mobility and control required by the condition.
What to do
Progress quadriceps strength and gait
Introduce closed-chain strengthening within safe ranges
Gradually restore balance and functional control
Exercise dosage
Leg press/shallow squat within protocol: 3 x 8–12
Balance: 3 x 30–45 seconds
Progress when
Target movement and resistance are tolerated with good quality.
Functional capacity is improving without sustained symptom flare.
Progression is based on objective performance and patient goals.
Phase 3 — Functional Restoration & Return to Activity
Rebuild real-world, occupational or sporting capacity.
What to do
Progress running, deceleration and sport-specific drills
Add hamstring loading according to healing stage and specialist protocol
Return only after objective strength and stability review
Exercise dosage
Running and agility only after clearance; 2–4 sets of graded drills
Strength 2–3 days/week
Progress when
Condition-specific return criteria are met.
Full task exposure is completed progressively.
No clinically meaningful deterioration during the following 24 hours.
Manual Therapy — Role & Application
Gentle ROM and patellofemoral mobility may help stiffness.
Avoid posterior tibial mobilisation or hamstring loading that increases posterior sag early.
Modalities — Use / Avoid
Brace and crutches according to injury grade and orthopaedic protocol.
NMES may assist quadriceps activation; passive modalities are adjunctive.
Return / Discharge Criteria
Stable posterior laxity for intended activity
Full ROM and minimal effusion
Quadriceps strength and hop/landing capacity restored
Specialist clearance for high-grade injury
Common Clinical Mistakes
Treating PCL like ACL without posterior-sag precautions
Early aggressive hamstring strengthening
Missing posterolateral corner injury
Clinical Pearls
Quadriceps strengthening is prioritised early in many PCL protocols.
Injury grade and associated structures determine protection and progression.
Continue learning
Connect assessment with management
Use the related PNA learning pathways to explore examination techniques and structured rehabilitation. A test result should always be interpreted alongside the history, full examination and clinical presentation.
Use these sources as a starting point for clinical learning. A reference being listed here does not, by itself, establish that every recommendation on this page is strongly supported. Check the original publication, study design, population and limitations before applying findings to an individual patient.
Educational resource only. Tests and treatment plans must be adapted to the individual patient, irritability, comorbidities, surgical restrictions and local scope-of-practice requirements.
