If completely ruptured & minimal intra-articular bleeding/minimal swelling, ACLs are not always painful. When the ACL completely ruptures, the nociceptors (pain/damage sensing nerve fibres) in the ACL are also damaged (thus don't effectively detect pain, & if immediately iced & elevated, the degree of swelling is also markedly reduced further reducing pain in the knee generally.
It looked pretty clear (on TV at least) that there was a positive posterior draw test (for PCL). PCLs can be a 0 week injury (eg Goodsey) but usually a 4-6 week (depending on the initial management & rehab - which professional athletes & medical teams do correctly).
Partial PCL tear/sprain has the potential for healing naturally. Regardless, PCLs are commonly conservatively managed as there is less instability with a PCL injury (compared with an ACL).
The PCL & ACL sit in very close proximity to each other in the middle of the knee joint. "Cruciate" is Latin for cross shaped - the ACL & PCL, in their anatomical position, cross over each other (twisting around each other). The PCL sits behind the ACL in this anatomical arrangement (hence the name Posterior Cruciate). Because of this close arrangement of the Cruciate ligaments, clutching the back of the knee would be of minimal diagnostic value when differentiating between an ACL vs PCL injury.
Time out with a PCL injury will also depend on whether any other structures (eg collateral ligaments, chondral articulate cartilage) was damaged at the same time (hence the MRI he's having tomorrow).
goswannies, is it possible to completely sever the PCL and not require surgery? And wouldn't there be a difference in treatment if it is just a sprain, partial tear or complete rupture?
Love your commentary on the injuries. They are so informative.
Surprised by the negative comments above. I'd much rather a boring win than an exciting loss.
Best part was we did it without Buddy hitting the scoreboard. Mitchell has really freed up our attacking mids (Kennedy, Parker, Hannebery) to rotate forward and score, which is when we are at our best (see 2012) and least predictable. Also good to see Tippett kick a bag.
Decent return from Reid. Was happy to see him tackle and get physical, which what I want to see from him. Jetta also played well.
Lowlights were Shaw and Goodes, who are both on their last legs. And obviously the injury to Heeney.
Since its 345am I'll give the short answer. Yes it is possible. But
- it depends on how effective the rehab is ... it will be intensive & extensive as the quadriceps & hamstrings are required to dynamically compensate for the deficiency of the passive (ligamentous) restraints
- there is increased risk of subsequent structural damage because of the the innate instability of a PCL deficient knee
- it's also dependant on what the person wants to use the knee for ... a desk jockey who doesn't intend to play sport will cope far better than an elite athlete, as the physical demands are considerably less
- a completely PCL compromised knee will likely require missed games to sufficiently rehab the knee
- risk vs reward ... late season injury close to finals a player might risk an early return of conservative treatments vs missing finals with a recon
- bracing - or ar very least taping - will likely be required to help protect the knee, however, the actual benefits of these in proving true & full protection can & have been debated ... just not at 345am
- if there are stability concerns, or resultant injury a reconstruction will be considered
The orthopod will consider all of the above (& more) when advising the patient with a complete (or even partial) PCL rupture.
The long term consequences (ie post football career) of conservative vs surgical management must also be considered.
Most definitely. Quick (& lazy) answer there - I'm sleepy (just woke up, checked in & checking out to go back to sleep ... gotta get up for work in 2 1/2 hours!). For full detail on PCL rehab, do a google search or pop into your local Physio
You're welcome
Last edited by goswannies; 10th May 2015 at 05:38 AM.
I thought our first half was really impressive, that's the best we've kicked the ball in a few weeks. The last quarter and a half fade out wasn't ideal but it needs to be remembered how brutal last week was. To put it in perspective, the Bulldogs stopped to a walk and gave up a 55 point lead to a team coming off a 6 day break...that just simply never happens.
Didn't think Shaw or Goodes were that bad, both serviceable.
Really impressed by Rohan again, his pressure is manic and his kicking deceptively penetrating, as his confidence builds I think he will start to take the game on and hit the scoreboard more often.
Shaky start by Jetta but ended up one of our best, that goal is borderline impossible and loved his work in traffic, his ability to get from inside to outside is unparalleled.
Our structure looks so much better with Reid in the team, he is really important.
Good to see Kennedy, Parker and Jack all find a bit of form, love that they all rotated through the forward line as well, we were really flexible last night. Also thought Hanners fought through the tag well, credit to his running ability that they were forced to use Cross instead of Vince. Mitchell is Mitchell...the kid is on a mission and playing really well...has to stay in the side!.
How dangerous do we look when Tippett is clunking them? Let's hope it turns into a trend.
Buddy was incredibly selfless tonight, geez he covered some km's for a big man to help us out up the field. Enjoyed Pyke hitting the scoreboard too, unlucky not to end up with 2 or 3.
Smith, Laidler, Rampe, Ted all solid defensively and Grundy took some nice marks.
Lloyd was one of our best and on track for another 25+ before he hurt his ankle, hopefully pulls up okay. His similarities to McVeigh are startling, Jarrad also played really well, we look a much stronger unit with him across half back.
McGlynn playing more time forward also makes us better as well I believe, he's comfortably in our best 22. Fingers crossed for Isaac, hopefully he's back for the second half of the season.
Did anyone else think that we played with a bit more mongrel last night? Needs to happen week in, week out.
Bring on the cats!
My elderly Dad was not keen when we first landed Buddy but was happy to change his mind upon seeing him play live in Swans colours last year. He can spend a whole game just studying Buddy's movements during a game. He is convinced Buddy made a conscious effort last night not to shoot for goal for most of the second half. He handballed and passed or tapped to other players even though he was in positions to take shots at goal he would normally kick with ease. Is it possible he is injured or was it a tactic to get the others into the game?
Now that you say it I suspect you're right about that. The five off to Richards was one that he would have taken a set shot for every day of the week. The fact that we saw so many more rotations to full forward ( including Richards) makes me think buddy was under instruction to not take any shots for goal. The second half was essentially used as a training exercise by Longmire. That also explains why Melbourne won the second half because Longmire had a whole lot of guys playing out of position so they could gain match practice out of position for the sake of versatility going forward. I think that's wise. The first half was confidence building the second half was training / match practice
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