After weeks of strange knee symptoms, I was finally diagnosed with a PCL tear. Now I'm scheduled for physical therapy. When can I expect to get back to normal?

Posterior cruciate ligament tears are often hard to detect. The symptoms are vague or subtle. The patient doesn't remember a specific trauma or injury to account for the symptoms.

Recommended treatment is conservative care at first. Surgery is done when there is a completely ruptured ligament, knee instability, and/or the patient is a high-level athlete with both.

If the injury is diagnosed early, then bracing, ice, and elevation are used to contain the swelling. The patient may be advised to use crutches and avoid putting weight on the leg for a few weeks while it starts to heal.

For mild (grade one and two) injuries, range of motion and strengthening exercises are started around week two. The physical therapist will guide you in progressing both types of exercises. The rehab program is designed to avoid further damage to the ligament.

At first, the focus is on strengthening the quadriceps muscle. This is the large muscle along the front of your thigh. It inserts all around the knee and helps hold the tibia (lower leg) in place. Without the PCL, the tibia slides backward underneath the femur (thigh bone). A strong quadriceps muscle can prevent this motion and help stabilize the joint.

By the end of six weeks, you will probably be advancing in your rehab program. By now stationary bicycling is an additional part of the program. Between six and 12 weeks, leg presses, half-squats, light jogging, and endurance training will begin.

After 12 weeks, you should be able to return to full activity. This depends on daily compliance with the rehab program.

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