Posterolateral Corner Injury

john miller physiotherapist

Article by John Miller

posterolateral corner injury

What is a Posterolateral Corner Injury?

Injuries to the posterolateral corner of the knee (PLC for short) are most commonly associated with athletic traumas, motor vehicle accidents and falls. PLC injuries account for 16% of all knee ligament injuries and often occur in combination with other cruciate ligament injuries.

PLC provides both static and dynamic stabilisation to the knee joint. The static structures include the lateral collateral ligament (LCL or FCL), popliteus tendon, the popliteofibular ligament and the posterolateral capsule. Together these structures prevent varus collapse at the knee and external rotation of the tibia on the femur. Dynamic structures of the PLC play similar roles as the static structures but through movement. These structures include the popliteus muscle, iliotibial band, bicep femoris and the lateral gastroc tendon.

Your PLC is the area on the outside of your knee that extends from the bottom of your femur (thigh bone) to the heads of the tibia and fibula (lower leg bones) immediately below the outside of your knee.

Ligaments and joint capsules surrounding the joint offer more stability during movement and weight bearing.

Importantly, the common peroneal nerve (a nerve that supplies the lower leg and toes) wraps around the top of the fibula and can also be implicated if there is an injury to the PLC of the knee.

What Causes a Posterolateral Corner Injury?

The posterolateral corner of the knee is most commonly injured following a combined hyperextension and varus force to the knee. An example of how this could be sustained would be a posteromedial angled blow to the extended leg. Other mechanisms include coupled hyperextension and external rotation of the tibia or external rotation of the tibia and a heavy varus force.

What are the Symptoms of a PLC Injury?

Injuries affecting the PLC may or may not occur in conjunction with injuries to other structures in the knee. Symptoms of a PLC injury commonly include:

  • Pain and/or swelling over the posterolateral surface of the knee
  • Pain which is aggravated by weight-bearing activities, especially those involving high loads going through the lower limb such as walking up a hill, quick direction changes or jumping
  • Feeling of weakness or ‘giving way’ around the knee

If you have an injury to the PLC and the peroneal nerve is affected, you may also experience pins and needles and/or numbness in the lower leg and foot. You may also experience foot or ankle weakness.

How is a Posterolateral Corner Injury Diagnosed?

On examination, your physiotherapist or sports doctor will look for signs of a PLC injury. Palpation and a series of knee ligament stability tests on physical examination will be utilised to confirm or deny injury to the PLC and will be graded accordingly based on severity. An MRI may be required to confirm the diagnosis.

What is the Treatment for a PLC Injury?

Physiotherapy

Most patients with a mild posterolateral injury start to recover within a few weeks of the injury with the appropriate rehabilitation.

Your physiotherapy treatment will aim to:

  1. Reduce pain and inflammation
  2. Normalise joint range of motion
  3. Strengthen the muscles of your lower limb
  4. Improve patellofemoral (knee cap) alignment
  5. Normalise your muscle lengths
  6. Improve your proprioception, agility and balance
  7. Improve your technique and function with walking, running, squatting, hopping and landing
  8. Minimise your chance of reinjury

We advise that you discuss your knee injury with a knee injury specialist such as a sports physiotherapist, sports physician or knee surgeon. This will provide you with the most accurate information regarding your specific injury and rehabilitation program.

Surgery

Most grade I PLC injuries resolve completely with conservative treatment. In severe cases, and depending on the number of structures within the PLC involved, surgery may be required. Risks of surgery include infection, persistent instability and pain, stiffness, and difficulty returning to previous level of activity. Surgery is determined case by case and severity of the injury.

Functional instability is a problem with PLC injuries. Your return to sport should be professionally guided by your sports physiotherapist, sports doctor and/or knee surgeon.

Post-Surgical Rehabilitation

Post-operative knee rehabilitation is one of the most important, yet too often neglected aspects of knee surgery. The most successful and quickest outcomes result from the guidance and supervision of an experienced physiotherapist.

Your rehabilitation following knee surgery focuses on restoring full knee motion, strength, power and endurance. You will also require balance, proprioception and agility retraining that is individualised towards your specific sporting or functional needs.

Your physiotherapist has extensive knowledge in this field. We suggest you contact them for the best advice in your circumstances.

How to Prevent a Posterolateral Corner Injury?

There are a number of things you can do to reduce your risk of sustaining a PLC injury.

These include:

  • Correcting poor biomechanics of the knee and/or ankle joints
  • Adequate warm-up and stretching program before and after exercise
  • Correcting muscle imbalances in the lower limb
  • Adequate footwear during exercise
  • Avoid sudden increases in training frequency and/or intensity
  • Strengthening muscles of the lower limb

Return to Sports with a PLC Injury

If a suitable rehabilitation regime is not undertaken, athletes often experience difficulty when returning to sport after sustaining a PLC injury. It is important to complete your specialised rehabilitation program as prescribed by your physiotherapist in order to return to sport as quickly and safely as possible.

Where to from here?

If you require more information or are interested in discussing your PLC injury please don’t hesitate to contact us:

Call PhysioWorks

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Posterolateral Corner Injury Treatment Options

  • Early Injury Treatment
  • Avoid the HARM Factors
  • Soft Tissue Injury? What are the Healing Phases?
  • Acupuncture and Dry Needling
  • Sub-Acute Soft Tissue Injury Treatment
  • Closed Kinetic Chain Exercises
  • Active Foot Posture Correction Exercises
  • Gait Analysis
  • Biomechanical Analysis
  • Balance Enhancement Exercises
  • Proprioception & Balance Exercises
  • Agility & Sport-Specific Exercises
  • Medications?
  • Orthotics
  • Real Time Ultrasound Physiotherapy
  • Soft Tissue Massage
  • Brace or Support
  • Electrotherapy & Local Modalities
  • Heat Packs
  • Joint Mobilisation Techniques
  • Kinesiology Tape
  • Prehabilitation
  • Running Analysis
  • Strength Exercises
  • Stretching Exercises
  • Supportive Taping & Strapping
  • TENS Machine
  • Video Analysis
  • Yoga
  • FAQs about Posterolateral Corner Injury

  • Common Physiotherapy Treatment Techniques
  • What is Pain?
  • Physiotherapy & Exercise
  • When Should Diagnostic Tests Be Performed?
  • Massage Styles and their Benefits
  • What Causes Post-Exercise Muscular Pain?
  • Barefoot Running: Your MUST READ Guide to the Pro's and Con's.
  • Can Kinesiology Taping Reduce Your Swelling and Bruising?
  • Heat Packs. Why does heat feel so good?
  • How Can You Prevent a Future Leg Injury?
  • How Much Treatment Will You Need?
  • Post-Run Soreness: Should You Be Concerned?
  • Runners: How to Reduce Your Knee Stress
  • Sports Injury? What to do? When?
  • What are the Common Massage Therapy Techniques?
  • What are the Early Warning Signs of an Injury?
  • What Can You Do To Help Arthritis?
  • What is a TENS Machine?
  • What is Chronic Pain?
  • What is Nerve Pain?
  • What is Sports Physiotherapy?
  • What's the Benefit of Stretching Exercises?
  • When Can You Return to Sport?
  • Why Kinesiology Tape Helps Reduce Swelling and Bruising Quicker
  • Call PhysioWorks

    Book Online

    Helpful Products for Posterolateral Corner Injury

    Patellofemoral Pain Syndrome

    Knee Pain

    Common Causes

    knee pain

    Knee Ligament Injuries

    Knee Meniscus

    Knee Tendonitis

    Muscle Injuries

    Children's Knee Conditions

    Other Knee-Related Conditions

    Knee Surgery

    Call PhysioWorks

    Book Online


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    Last updated 18-Jan-2018 05:57 PM

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