Learn how your comment data is processed. Its crucial to know whats best for your path to recovery, and following the next seven tips regarding PCL rehabilitation and exercises might be just the way to get there. Include backward and sideways running drills as well as quick changes of direction. (based on posterior subluxation of tibia relative to femoral condyles with knee in 90 of flexion) Grade I. a partial tear. Anelite personal trainer in Londoncan help you recover from your sports injury fast and safe. Knee Rehab Program For PatellofemularSyndrome, PCL personal trainer rehabilitation specialist in London, Understanding the Scientific Connection Between PCOS and Mental Health, Managing Sciatica Pain During Sleep: Tips and Techniques, Osteoporosis and Ageing: What You Need to Know About Maintaining Strong Bones as You Get Older, Preventing Herniated Discs: Simple Strategies to Keep Your Spine Healthy, 4 PCOS Types & How to Identify & Treat Them. Mobility exercises continue to work on these if full mobility has not been achieved. Sustained rehab over 6-9 months should enable you to get back to full function. Other tests include the posterior sag sign and reverse pivot shift. Eraslan A, Ulkar B. Earlier, we reported that Lance Stroll would be back in the cockpit of the AMR23 this weekend at the season opener in Bahrain. Start with training sessions of 5 to 10 minutes and increase them gradually. p. 204. However, higher grade 2 and grade 3 injuries are often treated with a knee brace to help stiffen the knee. After week 1, the athlete may be able to maintain aerobic fitness with stationary cycling. Cyclist Knee Injuries - mendmyknee.com 6. Generally, I dont recommend surgery for isolated grade 1-2 PCL injuries. These include ice, ibuprofen, compression, and range of motion exercises. If his follow-up radiographs show degenerative changes related to his PCL-deficiency, the changes are likely to be present in which of the following knee compartments? Being able to ride again without worrying about a recurrence of an injury takes time and patience. Take the stretch as far as is comfortable and hold relaxing into the stretch. The following guidelines for rehabilitation of a posterior cruciate ligament injury are for information purposes only. Sports Ligament Injury: Types & Treatment | Banner Health If your knee is still swollen maybe you should take it real easy. The first step is to put the knee joint to rest, accompanied by anti-inflammatory and compresses of ice on the knee, then rehab sessions and exercices. (OBQ09.82) Common cycling injuries which may occur traumatically due to a collision or fall from the bike include:. MCL Tear Slowly and gradually increase the duration of your workouts as well as the pedaling resistance of your stationary bike. A knee sprain causes severe pain in the knee at the time of the trauma or the accident, cracking or tearing, and a feeling of knee instability. The most common way for a PCL to be torn is from high impact to the top part . Physical therapists usually recommend the practice of the exercise bike since it is a gentle, smooth, safe and practical sport to do at home. North American Journal of Sports Physical Therapy. Your LCL (lateral collateral ligament) is a vital band of tissue on the outside of your knee. NEENCA Unloader ROM Knee Brace, Hinged Immobilizer for ACL, MCL, PCL Hi Lucia, Rehab is a key step in the healing process for restoring proper knee coordination and strengthening the muscles that assist and protect the ligaments. In the case of a rupture of the ligaments (severe sprain), a knee surgery can be considered and the ligament replaced by a tendon graft. Just protect your knee from impacts, maybe put a thin knee pad below your normal DH protection. The aim of rehabilitation is to work on knee mobilization, muscle strengthening and neuro-muscular reprogramming in order to recover the joint amplitude. I destroyed mine 9 weeks ago. Inserts superior to the articular margin of the tibia, Deficiency leads to patellofemoral and lateral compartment arthritis, Anterolateral bundle is tight in flexion, posteromedial bundle is tight in extension, Anterolateral bundle is tight in extension, posteromedial bundle is tight in flexion, Anteromedial bundle tight in flexion, posterolateral bundle is tight in extension. However, a posterior cruciate ligament (PCL) injury accounts for up to 20% of acute knee injuries. A severe sprain occurs when a ligament breaks. The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network. This can occur during athletic movements like jumping. (OBQ04.161) In some cases, the forces on the kneecap or the medial compartment increase leading to early arthritis in these joints. PCL Tear Brace. A torn ACL often occurs as a result of sports, particularly when an individual pivots on the knee with the foot in a stationary position or jumps and lands forcefully on the knee joint, according to the American Academy of Pediatrics. Aims To return to sports-specific training and competition. As far as cycling is concerned cycling is a very good exercise ; first because your knee is not bearing any weight . . is the pcl the one that holds in knee cap? don't need for biking though. Normal sports-specific training should now be resumed. ACL tears are a common injury. It has similar symptoms to patellofemoral pain. I ruptured/snapped my PCL a few years ago , did some physio for about a month. PCL injury. Pierce CM, O'Brien L, Griffin LW. A PCL sprain is a tear of the posterior cruciate ligament. They can do this well if given the time to build up with no additonal trauma in the area. These include: a dislocated kneecap a sprain or strain tendonitis a torn. (OBQ07.15) He or she may also move your knee into a variety of positions to assess range of motion and overall function of the joint. Continue to wear for next sports season: ROM Limitation: 0-0-90 prone / assisted: For NWB: 0-0-90 (with R PCL) For PWB: Extension locked: None This website or any of its content or links to third parties does not diagnose, advise, treat or cure any ailments, illness or disease. This knee brace limits movement from 0 to 90 degrees and should only be used in the early stages of rehab. VerticalScope Inc., 111 Peter Street, Suite 600, Toronto, Ontario, M5V 2H1, Canada. Stretching exercises for the lower leg and upper body. The Posterior Cruciate Ligament (PCL) is one of the four major ligaments of the knee joint that functions to stabilize the tibia on the femur. it felt so much better after they had done that. i killed mine at the US open this year, (end of may) and still ahvent had it fixed, complete tear. If you want to rehabilitate your PCL injury safe using a one to one PCL rehab program under the supervision of the best personal trainer in Londonandknee injury rehabilitation specialistcontact Jazz Alessi now by clicking on this link. Experiencing a PCL injury is never fun or certainly doesnt make life easy. Rehabilitation of isolated and combined posterior cruciate ligament injuries. The PCL crosses the ACL in an "X" shaped pattern. Peterson, C. MD, Young, C, MD. Preventing another PCL injury is likely to be another main focus throughout your recovery. Ligament Injuries to the Knee | Johns Hopkins Medicine Recovery following trauma is not only related to joint status and health. Pediatric Emergency Care. Copyright 2021 365 moves. Rebound PCL (day & night); use white shear knob > week 10 - also in case of combined PCL & ACL injury: Rebound PCL during day for +1 month, or activity, or ADL's w/ deep flex, wean off > month 6. It will get better, don't worry about that. Fig 2. A sprain occurs when the ligaments are too stretched: It is in this case a benign sprain. cant kneel on that knee at all, clicks a lot and aches faster than it used to. Ususally, grade 2 injuries should be OK with rehab. Treatment is usually bracing unless there is gross varus instability in which case repair or reconstruction is performed. Place your foot on a table or similar and lean into the stretch, keeping your leg straight and chest up. One of the most common causes of PCL and ACL injuries is experiencing a car accident. ACL Tear: Injury to the anterior cruciate ligament from twisting or force through the knee. Knee pain from cycling can be caused by the improper fit of the bike, anatomical factors, or training issues that put excess strain on the knees or leg muscles. Hours spent curled over the handlebars mean that one of the most common injuries cyclist suffer with is lower back pain Add in that many of us have jobs that require more sitting and bending. The aim is to restore strength, balance, and control before restarting running and sports-specific training. It is still really painful, and hurts when I tweak it or bend my knee too much. Often, a cruciate ligament injury does not cause pain. Adjust the gears to a low level that allows for a minimum of 90 repetitions per minute in the beginning. Lance Stroll reveals full extent of injuries after cycling crash, including broken toe. Is the exercise bike advised? It is mandatory to procure user consent prior to running these cookies on your website. Avoid using ankle weights or putting stress on the knee when bent over 70 [3]. If you feel that the exercise is too demanding, rest for a day before resuming your exercises. [ 10] PCL Injury and Reconstruction. It's only by strengthening your muscles that you can relieve your knee joint durably and prevent relapses. The exercise bike is also recommended after an ankle sprain because the ankle hardly moves when pedaling (always make sure not to have the leg too tense while pedaling) and does not have to bear the weight of the body. A 23-year-old collegiate soccer player sustained a right knee injury 6 months ago. The most common mechanism of injury is when a force hits the front of the tibia, forcing the tibia backward and tearing the PCL. The Posterior Cruciate Ligament (PCL) is a paired ligament in the middle of the knee. Repeat 10 to 20 times. Knee Ligament Injuries: Assessment and Management | Doctor Traumatic Stress, Depression, and Recovery: Child and Parent Responses After Emergency Medical Care for Unintentional Injury. While no fractures were identified, the patient was found to have a tense effusion and bruising on the anterior aspect of his knee. Try This Technique To Help With Piriformis Pain - YouTube He has been writing about fitness and giving workout tips and advice since 2016. Cycling, only on a stationary bike where control settings can be made, can be initiated as early as four weeks post-surgery or post-injury [3]. As soon as you can walk again and your physiotherapist allows you, you can practice self-rehab at home. cycling with pcl injurymg+2hcl=mgcl2+h2 is an example of which type of reaction. Recovery following injury hinges upon expectation and hope. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. As you can see in this study [10] many times PCL injuries occurs because your hamstring muscle fails to effectively do its job, and this is usually caused by overextension or overexertion. When the PCL is injured, the pain level is often classified as mild to moderate. The ligaments are very strong and elastic fibrous tissues which connect the bones to each other in the joint and ensure their stability. Copyright 2023 Lineage Medical, Inc. All rights reserved. People who engage in activities that involve repetitive hip rotation, such as running, cycling, or rowing, may be more susceptible to piriformis pain. S. Alberto Bettiol crashed hard at Strade Bianche but got up to ride, with his helmet saving from far more serious injuries. However, the PCL injury usually occurs with sudden, direct impact, such as in a car accident or during a football tackle. bestlla nytt krkort; lammskinn gotland grdsbutik; mta blodsocker utan att sticka sig; Otherwise, progress onto more usual stretching exercises as long as they do not cause pain in the knee. Typically, the knee brace pushes the shin bone forward, allowing a torn PCL to heal. The PCL is comprised of a bundle of ligament fibers attaching the back of the tibia (shinbone) to the femur (thigh bone) in the knee. i did a LOT of research into knee injuries and surgeries and finally decided to go with a hot shot surgeon-to-the-stars and have my PCL replaced (it was a complete tear). Palpating the injured area, or surgical incision if one is present, 5-10 minutes a day can help with this break down [4]. Bicycling With a Torn ACL | livestrong For example, the anterior cruciate ligament, medial collateral ligament, or lateral ligament sprains. Knee Taping for Stability: Meniscus Tear, ACL Strain and - YouTube Other low-impact exercises can be introduced two months post-surgery or post-injury. Pedal slowly at the start with a low or average resistance that you can gradually increase over time. May 2008. Start at 50% of maximum speed and increase each session to 90% of maximum speed. Strengthening the quadriceps muscles is an important aspect of your knee rehab [10]. (OBQ06.99) Lie on your back and bend the knee ensuring the foot stays in contact with the floor. Physical exam reveals 10 varus alignment when standing and a varus thrust with walking. There are some fantastic alternative ways to alleviate knee pain and increase rehabilitation recovery. PCL Tear. Does Stationary Bike for Knee Rehab after torn ligaments help? - 365 MOVES The most common mechanism of injury of the PCL is the so-called "dashboard injury." 1 This occurs when the knee is bent, and an object forcefully strikes the shin backward. This can be developed to increase range of movement if needed by using a towel or similar to pull on the leg further than it would normally go. With a combined instability (multiple torn ligaments) even after surgery many people still need a brace when participating in sports that have lots of side to side stress, pivoting, etc. The Ulnar Collateral Ligament (UCL) is the most common injury in the elbow. Negative psychological experiences usually occur after an unplanned injury [5]. Some therapists recommend holding stretches for up to 40 seconds or more. Posterior Cruciate Ligament Injury - Healthline He has no instability complaints but at age 18, he sustained a Grade 1 PCL injury that was treated non-operatively. Mike is creator & CEO of Sportsinjuryclinic.net. Usually associated with knee instability. The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user. Sit on the floor with your injured leg extended and your other leg bent. This website uses cookies to improve your experience while you navigate through the website. Therefore, we advise to rehabilitate your knee injury by working closely with a long term personal trainer rehabilitation expert. Normal knee anatomy. So what is a Knee PCL tear, and how do we treat it? PCL injuries are traumatic knee injuries that may lead to posterior knee instability and often present in combination with other ipsilateral ligamentous knee injuries (i.e PLC, ACL). Relax for about 3 seconds and repeat 10 to 20 times. The PCL, posterior cruciate ligament, is similar to the ACL where it helps connect your thigh bone to your shin bone. Knee Surg Sports Traumatol Arthrosc. The frequency of application can be gradually reduced over the next few days to no less than 3 times a day and always after mobility or strengthening exercises. They are cause by either a direct blow (more severe tear) or a non-contact injury (less severe). Then lift the . Which of the following mechanisms is most likely to have caused this injury? Cyclist Syndrome / Pudendal Nerve Entrapment Treatments The treatment after a knee injury mainly depends on the severity of the injury and therefore the type of sprain. Oct 2012. Car Accident: Dashboard injuries, where the knee is bent and the shin hits the car dashboard pushing the knee into hyperflexion is the most common cause of PCL tears Fall: Falling onto a bent knee with the foot pointing downwards is the most common sporting PCL injury Sporting Tackle: sometimes the posterior cruciate ligament can be injured during an awkward tackle when the knee is bent Apr 2015. Lance Stroll reveals full extent of injuries after cycling crash The Pudendal nerve (nerve that causes cyclist syndrome) is a combination of 3 nerves that form a single nerve. i did have my doctor prescribe a set of custom knees braces, cause the torn pcl is in the same knee that i previously blew out my ACL in (that got fixed) and my rigth collarboen is no longer attatched at oen end, so i have an issue blowing ligaments. For cases of non-surgical treatment, rehabilitation to establish range of motion for the knee joint is also necessary. Wydra FB, Frank RM. People with a PCL injury may have pain, swelling and other symptoms. This can benefit both respiratory health, and also ROM. Did you know that current rehab research discussed in details by the best personal trainer in Londonand theknee injury rehabilitation expert Jazz Alessi shows that a posterior cruciate ligament (PCL) injury mostly happens when the posterior aspect of your knee joint is strained? Aims To control swelling, maintain the ability to straighten and bend the leg, and begin strengthening exercises for the leg muscles when possible. Is There Any Way I Can Start Biking With a Partially Torn Medial These cookies do not store any personal information. I am in PT, and see my doctor again on Nov. 8th. Tibial subluxation is a major aggravating PCL risk factor. This can also be corrected by completing strength exercises for the quadricep muscles, ensuring good posture, and keeping equal weight distribution between your legs. In general, an isolated high-grade PCL injury only needs surgery if you have co-existing instability (giving way). What is the best treatment option to allow this patient to return to competitive athletic activity? 23 2015. Bend the front leg to lean forwards and return to standing. You have to take care of yourself, though. One study indicated that glucosamine supplementation does provide slight benefits in joint health and pain reduction [11]. Conceptual framework for strengthening exercises to prevent hamstring strains. It originates from the anterolateral aspect of the medial femoral condyle in the area of the intercondylar notch and inserts onto the posterior aspect of the tibial plateau. Elbow Ligament Injuries. I have a grade 3 PCL tear. Lateral Collateral Ligament (LCL)Tear: What Is It, Causes & Treatment Posterior cruciate ligament (PCL) injury / tear. The aim here is to get a little bit of elasticity to the healing tissue, not increase flexibility. Use crutches, ice your knee and follow your healthcare . Will I be able to do this again if the PCL is not surgically repaired? Additional symptoms may include a popping sound at the point of injury, pain and swelling in the affected joint, according to Mayo Clinic. A PCL injury leads to greater forces on the kneecap and medial (inside) compartment. Among the isolated lesions, bone avulsions were nine (10.6%). You also have the option to opt-out of these cookies. You must in any case talk to your physiotherapist about when you can start it and what you can do. After a knee sprain injury, you have difficulty in walking and feel pain as soon as you try to move or bend your knee. Fig 1. The knee joint is supported by the quadriceps, the muscle at the front of the thigh, and the hamstrings at the back of the thigh. Kassam-Adams N, Bakker A, Marsac ML. A fall while skiing, a football tackle, the knee tilts in and the foot goes outwards, it is the sprain of the knee or what we also call a twisted knee. The posterior cruciate ligament (PCL) connects your upper leg to your lower leg. strength is 2500 to 3000 N (posterior) minimizes posterior tibial displacement (95%) Classification. A PCL injury occurs when the ligament is stretched or torn. These injuries are relatively uncommon. What do you need to know about rehabilitation or self-rehabilitation? A knee sprain is a damage of the ligaments in the knee joint. Pain, inflammation the cruciate ligaments of the knee have relaxed or torn and it will be necessary, whether or not there is operation, to immobilize the knee and then undergo rehabilitation! It is called a 'dashboard injury' because this can be seen in car collisions when the shin forcefully strikes the dashboard. Read more: Gym Leg Workouts for ACL Recovery. 5. Once you feel confident, you can vary your workouts a little bit by performing accelerations for example or by increasing the resistance of the bike for a few seconds (which is good for improving the strength of the muscles in your legs and thighs) and repeating these exercises several times. Step down . (OBQ07.4) Bent leg hamstring stretch on the back targets the muscle fibres closer to the hip whereas the straight leg hamstring stretch targets the fibres nearer the knee. Calf stretches, hamstring stretches, ankle mobility, and pain-free knee mobility exercises. Treatments include both non-surgical and surgical options. Iphone | Android. Never force! If so, push surgery to the Oct/Nov time frame, when you'd likely be off your bike much more anyways for the winter. The movement of pedaling a bike has a lower impact on the knees than running or walking. The technical storage or access that is used exclusively for anonymous statistical purposes. 2. Strengthening of what muscle group most effectively counteracts the deficit that results from the damaged structure? Alberto Bettiol crashes hard at Strade Bianche but avoids serious injury Slight discomfort may be felt but not pain. Which of the following rehabilitation principles is true regarding non-operative treatment of a grade II PCL tear? In the case of a benign sprain (partial tear of the ligament), a non-operative treatment is generally prescribed. By the end of this phase, the athlete may be able to do proper cycling or light swimming. Apply cold therapy and compression as soon as possible following injury and for 15 minutes every 2 hours for the next 24 to 48 hours. Non-impact exercise like cycling, elliptical training, and swimming might be less stressful to the knee. The pain goes away soon but I'm guessing your whole quad/knee area has gotten a little smaller/weaker. A qualified Sports Injury Therapist with a degree in Physical Education, Sports Science and Physics, and a Postgraduate Certificate in Education. Avoid full weight bearing on the affected knee joint (especially during first 1-2 weeks). As soon as you feel confident (you must at least be able to walk properly without crutches) and your physiotherapist allows you, you will be able to do some exercises on your exercise bike at home (if you don't have a stationary bike, the DKN AM-3i is very well adapted to rehab). Both injuries can occur from a sporting mish. Curr Rev Musculoskelet Med. Lippincott Williams & Wilkins. Dr. Masci is a specialist sport doctor in London. Grade 3 refer to a completely torn ligament. In the initial statement, it was revealed he'd had minor surgery on one of his wrists and when he arrived at the paddock this morning, he came wrapped up in a little plaster and sporting some quite obvious bruising. Beware the insufficiency fracture of the knee, Advanced hydrodistension for frozen shoulder, Distal Clavicular Osteolysis (weightlifters shoulder), a grade 3 injury with symptoms of instability, a grade 3 injury with other injuries such as posterolateral corner or LCL tear. Depending on the extent of the injury, you may need surgery to correct this condition. PCL Injuries: Sprains and Tears A PCL injury occurs when the ligament is overly stretched or torn by an unusual movement or force. Once this is achieved, apply cold after every training session. Cycling is frequently used as a rehabilitation exercise modality after knee injury or surgery as well as part of the management of chronic degenerative conditions such as osteoarthritis. Generally, we use X-ray and MRI to confirm the diagnosis of a torn PCL and rule out other damage to ligaments and cartilage. PCL Injury? | Mountain Bike Reviews Forum He has been treated with rest and rehabilitation but is unable to play at his previous level due to his knee "giving way." PCL is the primary restraint to posterior tibial translation, functions to prevent hyperflexion/sliding, isolated injuries cause the greatest instability at 90 of flexion, combined PCL and posterolateral corner (PLC) injuries, posterior tibial sulcus below the articular surface, strongest and most important for posterior stability at 90 of flexion, reciprocal function to the anterolateral bundle, lies between the meniscofemoral ligaments, ligament of Humphrey (anterior) and ligament of Wrisberg (posterior), originate from the posterior horn of the lateral meniscus and insert into PCL substance, minimizes posterior tibial displacement (95%), based on posterior subluxation of tibia relative to femoral condyles with knee, ibia remains anterior to the femoral condyles, complete injury in which the anterior tibia is flush with the femoral condyles, a combined PCL + capsuloligamentous injury, tibia is posterior to the femoral condyles and often indicates an associated ACL and/or PLC injury, differentiate between high- and low-energy trauma, hyperflexion athletic injury with a plantar-flexed foot, ascertain a history of dislocation or neurologic injury, often subtle or asymptomatic in isolated PCL injuries, laxity at 30 alone indicates MCL/LCL injury, patient lies supine with hips and knees flexed to 90, examiner supports ankles and observes for a posterior shift of the tibia as compared to the uninvolved knee, the medial tibial plateau of a normal knee at rest is 10 mm anterior to the medial femoral condyle, an absent or posteriorly-directed tibial step-off indicates a positive sign, with the knee at 90 of flexion, a posteriorly-directed force is applied to the proximal tibia and posterior tibial translation is quantified, isolated PCL injuries translate >10-12 mm in neutral rotation and 6-8 mm in internal rotation, combined ligamentous injuries translate >15 mm in neutral rotation and >10 mm in internal rotation, attempt to extend a knee flexed at 90 to elicit quadriceps contraction, positive if anterior reduction of the tibia occurs relative to the femur, > 10 ER asymmetry at 30 only consistent with isolated PLC injury, KT-1000 and KT-2000 knee ligament arthrometers, used for standardized laxity measurement although less accurate than for ACL, may see avulsion fractures with acute injuries, medial and patellofemoral compartment arthrosis may be present with chronic injuries, apply stress to anterior tibia with the knee flexed to 70, asymmetric posterior tibial displacement indicates PCL injury, contralateral knee differences >12 mm on stress views suggest a combined PCL and PLC injury, confirmatory study for the diagnosis of PCL injury, quadriceps rehabilitation with a focus on knee extensor strengthening, surgery may be indicated with bony avulsions or a young athlete, extension bracing with limited daily ROM exercises, immobilization is followed by quadriceps strengthening, isolated Grade II or III injuries with bony avulsion, isolated chronic PCL injuries with a functionally unstable knee, primary repair of bony avulsion fractures with ORIF, allograft is typically utilized with multiple graft choices available, options include - Achilles, bone-patellar tendon-bone, hamstring, and anterior tibialis, good results achieved with primary repair of bony avulsions, primary repair of midsubstance ruptures are typically not successful, results of PCL reconstruction are less successful than with ACL reconstruction and residual posterior laxity often exists, successful reconstruction depends on addressing concomitant ligament injuries, no outcome studies clearly support one reconstruction technique over the other, consider medial opening wedge osteotomy to treat both varus malalignment and PCL deficiency, when performing a high tibial osteotomy in a PCL deficient knee, increasing the tibial slope helps reduce the posterior sag of the tibia, shifts the tibia anterior relative to the femur preventing posterior tibial translation, posteromedial portal is placed 1 cm proximal to the joint line posterior to the MCL, avoid injury to branches of the saphenous nerve during placement, posteromedial corner of the knee is best visualized with a 70 arthroscope either through the notch (modified Gillquist view) or using a posteromedial portal, transtibial drilling anterior to posterior, fix graft in 90 flexion with an anterior drawer, results in knee biomechanics similar to native knee, biomechanical advantage with a decrease in the "killer turn" with less graft attenuation and failure, screw fixation of the graft bone block is within 20 mm of the popliteal artery, arthroscopic or open techniques may be utilized, biomechanical advantage with knee function in flexion and extension, clinical advantage has yet to be determined, may be advantageous to perform with combined PCL/PLC injuries for better rotational control as PLC reconstructions typically loosen over time, avoid resisted hamstring strengthening exercises (ex.