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 outside of your knee that extends from the bottom of your femur (thigh bone) to the heads of your tibia & fibula (lower leg bones).
Ligaments and joint capsules surrounding the joint provide 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. It can become compromised if there is an injury to the PLC of the knee.
What Causes a Posterolateral Corner Injury?
A combined hyperextension and varus force to the knee can injure the posterolateral corner of the knee. An example this could be, a blow to the inside of your knee with a straight knee.
Other mechanisms include coupled hyperextension and external rotation of the tibia or external rotation of the tibia and a large 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 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 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 confirm or deny damage to the PLC. They will be graded accordingly based on severity. An MRI may be required to confirm the diagnosis.
What is the Treatment for a PLC Injury?
Most patients with a mild posterolateral injury start to recover within a few weeks of the damage with the appropriate rehabilitation.
Your physiotherapy treatment will aim to:
- Reduce pain and inflammation
- Normalise joint range of motion
- Strengthen the muscles of your lower limb
- Improve patellofemoral (knee cap) alignment
- Normalise your muscle lengths
- Improve your proprioception, agility and balance
- Improve your technique and function with walking, running, squatting, hopping and landing
- Minimise your chance of reinjury
We advise that you discuss your knee injury with a knee injury practitioner such as a sports physiotherapist, sports physician or knee surgeon. Twill provide you with the most accurate information regarding your specific injury and rehabilitation program.
Most grade I PLC injuries resolve entirely 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 the previous level of activity. Operations are determined case by case and severity of the injury.
Functional instability is a problem with PLC injuries. Your sports physiotherapist, sports doctor or knee surgeon should professionally guide your return to sport.
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 individualised balance, proprioception and agility retraining 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 several things you can do to reduce your risk of sustaining a PLC injury.
- Correcting poor biomechanics of the knee 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 or intensity.
- Strengthening muscles of the lower limb
Return to Sports with a PLC Injury
An inadequate rehabilitation regime often renders the athlete to experience difficulty when returning to their sport after sustaining a PLC injury. It is crucial to complete your specialised rehabilitation program as prescribed by your physiotherapist to enable a return to competition as quickly and safely as possible.
Common Causes - Knee Pain
Knee pain can have many origins from local injury, referred pain, biomechanical issues and systemic issues. While knee pain can appear simple to the untrained eye, a thorough assessment is often required to ascertain the origin of your symptoms. The good news is that once a definitive diagnosis is determined, most knee pain quickly resolves with the correct treatment and rehabilitation.
Knee Ligament Injuries
- Knee Ligament Injuries
- ACL Injury
- PCL Injury
- MCL Sprain
- LCL Sprain
- Posterolateral Corner Injury
- Superior Tibiofibular Joint Sprain
Knee Meniscus Injuries
- Chondromalacia Patella
- Fat Pad Syndrome
- Patella Dislocation
- Patellofemoral Pain Syndrome
- Osgood Schlatter’s Disease
- Sinding Larsen Johansson Syndrome
Knee Tendon Injuries
- Corked Thigh
- Thigh Muscle Strain
- Hamstring Strain
- ITB Syndrome
- Popliteus Syndrome
- Muscle Strain (Muscle Pain)
- DOMS – Delayed Onset Muscle Soreness
Children’s Knee Conditions
Other Knee-Related Conditions
- Runner’s Knee
- Plica Syndrome
- Stress Fracture
- Overuse Injuries
- Restless Legs Syndrome
For specific information regarding your knee pain, please seek the assistance of a healthcare professional with a particular interest in knee condition, such as your physiotherapist.
What is Physiotherapy Treatment?
Physiotherapists help people affected by illness, injury or disability through exercise, manual joint therapy, soft tissue techniques education and advice. Physiotherapists maintain physical health, help patients to manage pain and prevent disease for people of all ages. Physiotherapists help to encourage pain-relief, injury recovery, enabling people to stay playing a sport, working or performing activities of daily living while assisting them to remain functionally independent.
There is a multitude of different physiotherapy treatment approaches.
Acute & Sub-Acute Injury Management
Hands-On Physiotherapy Techniques
Your physiotherapist's training includes hands-on physiotherapy techniques such as:
- Joint Mobilisation (gentle joint gliding techniques)
- Joint Manipulation
- Physiotherapy Instrument Mobilisation (PIM)
- Minimal Energy Techniques (METs)
- Soft Tissue Techniques
Your physiotherapist has skilled training. Physiotherapy techniques have expanded over the past few decades. They have researched, upskilled and educated themselves in a spectrum of allied health skills. These skills include techniques shared with other healthcare practitioners. Professions include exercise physiologists, remedial massage therapists, osteopaths, acupuncturists, kinesiologists, chiropractors and occupational therapists, just to name a few.
Your physiotherapist is a highly skilled professional who utilises strapping and taping techniques to prevent and assist injuries or pain relief and function.
Alternatively, your physiotherapist may recommend a supportive brace.
Acupuncture and Dry Needling
Many physiotherapists have acquired additional training in the field of acupuncture and dry needling to assist pain relief and muscle function.
Physiotherapists have been trained in the use of exercise therapy to strengthen your muscles and improve your function. Physiotherapy exercises use evidence-based protocols where possible as an effective way that you can solve or prevent pain and injury. Your physiotherapist is highly-skilled in the prescription of the "best exercises" for you and the most appropriate "exercise dose" for you depending on your rehabilitation status. Your physiotherapist will incorporate essential components of pilates, yoga and exercise physiology to provide you with the best result. They may even use Real-Time Ultrasound Physiotherapy so that you can watch your muscles contract on a screen as you correctly retrain them.
- Muscle Stretching
- Core Exercises
- Strengthening Exercises
- Balance Exercises
- Proprioception Exercises
- Real-Time Ultrasound Physiotherapy
- Swiss Ball Exercises
Biomechanical assessment, observation and diagnostic skills are paramount to the best treatment. Your physiotherapist is a highly skilled health professional. They possess superb diagnostic skills to detect and ultimately avoid musculoskeletal and sports injuries. Poor technique or posture is one of the most common sources of a repeat injury.
Aquatic water exercises are an effective method to provide low bodyweight exercises.
Sports physio requires an extra level of knowledge and physiotherapy skill to assist injury recovery, prevent injury and improve performance. For the best advice, consult a Sports Physiotherapist.
Women's Health Physiotherapy is a particular interest group of therapies.
Not only can your physiotherapist assist you in sport, but they can also help you at work. Ergonomics looks at the best postures and workstation set up for your body at work or home. Whether it be lifting technique improvement, education programs or workstation setups, your physiotherapist can help you.
Plus Much More
Your physiotherapist is a highly skilled body mechanic. A physiotherapist has particular interests in certain injuries or specific conditions. For advice regarding your individual problem, please contact your PhysioWorks team.
ACL TearAn ACL (Anterior Cruciate Ligament) tear most often occurs during sporting activities when an athlete suddenly pivots, causing excessive rotational forces on the ligament. Individuals who experience ACL tears describe a feeling of the joint giving out, or buckling. You'll commonly hear a "pop."
Signs You May Have Sustained an ACL Tear:
- Sudden giving way of the knee
- Hearing a 'pop' at the time of injury
- Sudden swelling of the knee joint
- Pain in the knee when walking
How is an ACL Tear Diagnosed?A well trained Sports Physiotherapist, Sports Physician or Orthopaedic Surgeon will generally be able to confirm the diagnosis of an ACL tear within the clinic and from your injury history. An MRI scan can confirm your ACL tear and identify other knee injuries that may have occurred when your ACL was ruptured. These accessory injuries commonly include meniscal tears, bone bruising and collateral ligament injuries. Confirmation of an ACL tear is essential since the treatment differs from a common knee ligament strain or a meniscus tear.
What to do if have a Ruptured ACL?Please be guided by your trusted healthcare practitioner for an ACL tear. Successful rehabilitation options vary depending on your age, activity level and extent of the injury. For specific advice, please consult your physiotherapist, knee surgeon or doctor.
Why are ACL Tears Such a Big Problem?When an ACL injury occurs, the knee becomes less stable. The ACL injury is a problem because this instability can make sudden, pivoting movements difficult, and it may make the knee more prone to developing arthritis and cartilage tears. If your knee is unstable, a common complaint of a sensation that the knee will 'give out' from under them. When this giving way sensation is because of an ACL injury, the knee joint is sliding too much. Joint sliding can be a problem because each episode of instability (the 'giving way' sensation) can cause damage to the knee cartilage. Therefore an ACL injury makes patients more prone to developing arthritis and meniscus tears. Athletes often have particular difficulty once they have sustained an ACL injury. Many sports require a functioning ACL to perform common manoeuvres such as cutting, pivoting, and sudden turns. These high demand sports include, but are not limited to:
- Hockey (Ice and Field)