Posterior Cruciate Ligament Injury

What is PCL injury?

PCL injuries often occur as part of the knee injury and is the least common ligamentous injuries among the four major ligaments of the knee. PCL injuries often occurs in isolation due to the structural positions. Most of the patients able to tolerate the PCL deficient knee and continue their daily activities but there will complications if its left untreated. Studies have indicate good outcomes of non-operative management in terms of returning to high levels of play and functions.

 

Basic Structure and Function of PCL

The Posterior Cruciate Ligament is made of tough fibrous material and function to control excessive motion by limiting joint mobility. The main function of PCL is to limit the posterior translation of the knee, resist hyperextension and provides a rotational axis and stability. It originates from the medial aspect of the medial femoral condyle and branches into two bundles before inserting into the posterior aspect of the tibia.

 

Causes

A PCL tear occur when a direct blow to the front of the knee or leg below the knee and this puts a significant amount of stress on the PCL. When the PCL stretches to the point of mechanical failure which is considered a tear. This commonly happen when someone is tackled in football below the knee from the front and the person lands on the knee forcefully with their knee bend. It can happen in a motor vehicle accidents as well when there is a head-on collision and hard strikes directly against the knee.

 

Non- Operative Rehabilitation

When considering non-operative management for PCL, it’s important to discuss short and long term goals with the patient for optimal decision making.

Basically, to allow ligament to heal in a neutral position, there are a few essential precaution and guidelines to follow:

  1. Avoid hyperextension for 12 weeks
  2. Prevent posterior tibial translation for 12 weeks (no hamstring strengthening)
  3. PCL brace is to be worn x 12 weeks
  4. PCL loading occurs at higher knee angles. It is prudent to use smaller knee angles (0-50 degree) before progressing to larger knee angles (50-100 deg.) because PCL forces generally increase as knee angle increases.
  5. When working on improving the ROM, prescribe exercises from a prone position to limit the effect of gravity.
  6. Limit WB initially to restore joint homeostasis if the injury is accompanied by effusion and joint bleeding.
  7. Limit isolated hamstrings contraction at greater than 15 degrees knee flexion for at least 16 weeks as it was found to increase the load on PCL.

 

When might surgery be required?

Surgery for a ruptured posterior cruciate ligament is often required when other structures in the knee are also damaged. For example, the anterior cruciate ligamentmedial collateral ligament or lateral ligament sprains.

Also, if you have rotational laxity in your knee. This means your lower leg twists more than normal in relation to the upper leg (femur).

 

Post-Surgical PCL Physiotherapy Rehabilitation

Post-operative PCL repair rehabilitation is one of the most important aspects of PCL reconstruction surgery. The most successful and quickest outcomes result from the guidance and supervision of an experienced Sports Physiotherapist.

Your rehabilitation following PCL surgery focuses on restoring full knee motion, strength, power and endurance. While protecting the healing repaired ligament in the early phase. You’ll require proprioception, balance and agility training that is individualised towards your specific sporting or functional needs.

Here in Healthworks, the physiotherapist will perform a thorough assessment regarding your injuries and design a general guidelines and precautions. If there are any queries regarding this article, feel free to contact us at 018-9828539/ 03-6211 7533 or drop us an email at contact@myhealthworks.com.my

Posterior Cruciate Ligament Injury2020-04-07T16:10:03+08:00

How Are You Sitting?

As many are now working from home, it’s important to check if your are sitting correctly in your new work environment.

In order to avoid and reduce back pain and other muscles related soreness, please follow these sitting posture guidelines.

How Are You Sitting?2020-05-03T15:09:24+08:00

The Mummy Tummy (Diastasis Recti) – Part1

It is an exciting day where all moms -to-be are about to meet their babies after a 10 month long waiting period. For most mummies, getting back into shape is probably a struggling concern and for some, regardless of the effort, their ‘mummy tummy’ is just not going away.

Doing specific abs exercises seems to be making it worse not to mention the lower back pain associated with it .

Diastasis Recti is a common post partum condition in which the abdominal muscles are separated by the ligament(linea alba) and it might cause a bulge in the middle of the abdomen where the two muscles separate. Diastasis recti is very common during and following pregnancy.

This is because the uterus stretches the muscles in the abdomen to accommodate your growing baby.  This happens mostly with pregnancy or a larger weight gain which can happen with males or females.

Having Diastasis Recti may cause you to notice the protruding belly and a general feeling of weakness in your core muscles. Other signs of diastasis include incontinence that continues more than eight weeks postpartum (separated abs can often cause pelvic floor dysfunction, which can lead to urine leakage, constipation and pain during intercourse), lower back pain and a four-months-pregnant look.

How do I know if I have a Mummy Tummy?

You can perform an easy test by lying on your back with your knees bent and feet on the floor. Put one hand on your belly, with your fingers on your midline at your navel. Press your fingertips down gently, and bring your head (shoulders stay on the ground) up into a mini crunch-like position. Feel for the sides of your rectus abdominis muscles, and see if and how far they are separated. Separation is commonly discussed in terms of finger widths — for instance, two or three (or more) fingers’ separation.

Stay tuned for Part 2 of this article.

The Mummy Tummy (Diastasis Recti) – Part12020-04-06T12:30:49+08:00

Spinal Health

Stuck at home wondering what can you do to help your spine? Here are some ways you can still give your back the best when you can’t get to your chiropractor, physiotherapist or spinal expert. These are in no way going to replace the importance of healthcare or seeing a specialist. These are just some simple ways you can try to help your spinal health while staying home.

Here’s some food for thought:

Think about what you are eating!
If you have the option, try sticking to plant-based proteins when you can. Things like chia seeds, lentils and beans are good options. They also can keep in the pantry for long and doesn’t rot. You can get a good amount of fiber, vitamins and minerals in the process. Meat based proteins can cause inflammation if you are sensitive. Green leafy vegetables in general are very good to work against inflammation in your body. They contain healthy minerals and can help strengthen your spine.

Try eating foods with healthy Omega-3 fatty acids. This can promote bone and tissue health. It also helps with reducing inflammation. Foods such as salmon, tuna, mackerel and sardines are good providers of these healthy fats. You can also supplement Omega-9 fatty acids with avocados and good olive oil. Salads served with tomatoes and extra virgin olive oil are also good. Healthy nuts such as walnuts and almonds can also serve as healthy snacks and give us good fatty acids.

I’m sure some of us are wondering about dairy products and calcium intake to improve bone health but remember, dairy products also have a lot of cholesterol. Calcium can be found in other food products such as leafy green vegetables. Take some time to shop the fruit section. Look for fruits with high pigments such as strawberries, oranges and blueberries. Just remember that fruits also equal to sugar.

So you would want to balance it out with movement and exercise. As for carbohydrates complex carbs are better in this time. Such as oats and whole meal bread.

Maybe take the time to try cooking a curry! Curries have many herbs and spices: mainly turmeric which helps in repairing damaged tissue. Many curries include ginger and cinnamon as well. This does not exclude western herbs. Herbs like rosemary and basil help fight inflammation and can be easily incorporated into our meals. If you are a fan of tea, you can strengthen you immune system and reduce inflammation by drinking oolong & green teas.

Try avoiding certain types of foods as well especially fast food or overly processed food. Also try to avoid sweet beverages and soft drinks. These types of food are high in sugar and saturated fats and are bad for our overall wellbeing as well as promoting inflammation. With less movement and exercise, we should also be wary of our carbohydrate and white grain intake such as white bread and rice.

Let’s make good healthy food decisions this season while staying home. In fact, these can be made into healthy eating habits that we can follow all year round. This can help us protect our spine as well as keep healthy in addition to exercising and visiting our local spinal experts.

Spinal Health2020-04-06T12:20:18+08:00
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