Thursday, June 19, 2008

PCL Injuries in Roller Derby

Molly Python, in the process of tearing her PCL.
Photo by L.J. McAllister, posted on the Jet City Rollergirls Flickr site.
Having a PCL tear has been an interesting experience as a patient because it is apparently not a very common injury. My original doctor had never seen one before and was pretty pleased with himself for diagnosing it correctly (later confirmed by the MRI). He's still talking about it. The orthopedist I was referred to gave me a little pamphlet entitled "You and your knee injury" or something similar, where the only line in it about the PCL is that it is injured much less frequently than the ACL. Not too helpful. He only gave it to me for the drawing in it that showed where the PCL was located. When I went to my physical therapist, he called in his student to check it out because she wasn't likely to get another chance anytime soon. Which I find fascinating because it seems to be fairly common in roller derby.

Apparently people tear their PCLs mostly from being in car accidents (when they're shins hit the dashboard) or playing football (when they are tackled from the front while planting their feet). How common it is in the general populace is not really known, but studies of National Football League (NFL) pre-draft physical examinations showed 2% incidence of PCL injuries where the football player didn't even know he had ever torn his PCL. PCL injuries which were known about, operated on, or combined with other ligament injuries ranged from 3.5-20%. That seems fairly high to me, but we're talking about professional-level football players, so it doesn't seem ridiculous.

What about roller derby? WFTDA conducted an injury survey last year whose results are available on the WFTDASafetySquad Yahoo Group. Here's a bunch of disclaimers: This is in no way a scientific study. Responding was voluntary. I have only skimmed the surface of these results and could easily have made mistakes. That being said, I think there are some interesting trends to be found:
  • Out of 1070 respondents, 574 (~54%) reported an injury that kept them from participation on one or more occasions.
  • Of those 574, 262 (~46%) report a knee injury (more than any other type of injury by far)
  • Of those 262, 36 (~14%) specifically mention the PCL in their description of their injury. This does not count all the people (20) who said they had injured their knee ligaments but were not specific as to which ligaments, or the many others who said they had injured their knee in some unspecified manner.
that's a pretty high percentage.

Can we do anything to prevent them? I'll save that for another post.

14 comments:

Crime Minister (ARRG) said...

What were your syptoms? I think I have a PCL tear that has not yet been diagnosed. I have been playing derby for 2 years and have chronic back of the knee pain now in both knees. It is very severe on impact. Any info would be helpful.

RIDIN' DIRTY said...

Had surgery a month ago to reapir a torn PCL in my right knee. My symptoms while skating were: behind the knee pain and severe pain on impact (even single knee touch n goes ), it would swell a little. Instability in the turns. But after a few days of rest and it was fine so I attributed it to just being worn out....you should get it checked out, it could lead to other(more serious)injuries if it goes untreated. Hope this helps

Anonymous said...

Our derby girls had an abundance of knee injuries as well until we started the PEP Program which is a set of exercises designed to build the mucsles that support the knee to help prevent the injuries in the first place. Apparently these injuries are common because of the way women are built. Makes sense! Anyway, the knee injuries have decreased significantly and existing problems have ceased to exist. It's a great program and I recommend it for all women athletes.
http://www.aclprevent.com/pepprogram.htm

Anonymous said...

I just completely tore my PCL, tore my ACL, and have a Grade II sprain to my MCL. My doctor was amazed by how I injured my knee too. He mentioned that this type of injury only usually happens in car accidents and well he has heard of it when a man name Steve Yzerman did it awhile ago:D My doc said that I should be up and skating in 4-6 months and that is without surgery just rehab!!!

Laura said...

Uggg. I can not wait t start that PEP program, thanks so much for sharing!

I tore my PCL completely, 5 days ago. I'll know more tomorrow as to the MRI results, but it's looking like some meniscus damage as well. All I did to earn my first "major" is take a routine rock-star fall and apparently do it the wrong way!

How did it feel? For me it felt loose, right away. Weird, loose and just icky. Initially it was not painful unless I tried to move, as it swelled it became more and more painful. I could not push back with my lower leg, as if it was just not happening because my business was cut! ;D

Request an MRI right away, not through an ER, but through a doctor who listens. The sooner you can immobilize the injury and start treatment the faster you will be on skates again!

Anonymous said...

I just got my MRI back. I have a tear in my PCL. It was from a roller derby fall on the right knee. Doctor was surprised and said it was kind of rare. The pain is behind the knee cap at the bone joints and it's hard to squat down on it. When I fall on it I get a sharp pain through my entire leg. After that there is major swelling! I go to another doctor next week to see what needs to be done.

Anonymous said...

Funny to hear this... Mine was from Derby as well... I've not had my MRI yet but my PT gal says she's sure that is what my injury is... I had no idea that it wasn't too common until it happened... and I'm slowly finding out that it is a REALLY common derby injury... thanks for spreading the word... http://www.athleticadvisor.com/injuries/le/quad_strengthening.htm... this is helpful prevention and rehab...

zimmer nexgen cr flex said...

Consider taking lessons to learn the proper technique for sports. Have a trainer or person who is familiar with sports equipment check your equipment to see if it is well suited for your level of ability, body size, and body strength.

Beth said...

I was awesome enough to rupture my PCL during a basic falling drill. I'm braced up and getting prepped to start rehab...no suergery here thankfully.

When I hit the concrete I knew right away I jacked my knee somehow...it swelled right awy to the point that I couldn't even bend my leg enough to get my skates off! Now that the swelling is down my only symptoms are 'looseness' in the knee and if I move it a certain way I get a sharp pain. They have me braced up ala Forrest Gump in order to keep my knee from bending backwards and blowing my ACL.

I should be back on skates in a week or two (with my brace which is designed for sports)but won't be allowed any contact or fall drills for 6 weeks or so.

Caitlin said...

Beth,

I would be really curious to hear more about the specifics of your injury-was your ligament torn all the way? only partially? was anything else torn as well? I had a similar experience at my last bout (fell and just knew right away something was wrong). I saw an othropedist days later who says he believes the PCL is probably torn (completely) and that I would be extremely LUCKY if the ACL and the meniscus was not also torn...we will find out after MRI today. I CAN walk around and only certain things hurt, but my shin does slide back past my knee a bit (very ominous! lol).

My question to you is, if it was totally torn, why did your doc to decide to forgo surgery? I am reading that some doctors do not want to reconstruct a PCL, but my doc said that if we did not do surgery you can PROBABLY not expect to going back to the same level of ativity, i.e. derby. The knee could get strong again with rehab, but it would always be weaker and "iffy" and it would be a big gamble to go back to competition level activity....

I guess I'm just wondering how it is that you were able to go back after your torn PCL. What is your secret?!

Thanks!

Zierra said...

Oh today i found out that i have torn my now right pcl. Tore my left 6 months ago. Also tore my meniscus in the right knee. So now 2 Crap knees. I love derby but do you continue if you are apparently prone to hurt yourself?

kamikazikelli said...

I tore my PCL two years ago, when I first started roller derby and never knew. I'm pretty tough and stubborn, so I kept going. I was a newbie and didn't want to stop. The pain was constant and I reinjured it several times. I took a leave of absence last year, due to moving. I had constant pain in my knee every day. I finally went to see a PT for the other knee, and she found the symptoms for the tear. I'm scheduled to have surgery at the end of December. If not, I can't return to the sport.

Rich66 said...

Found this blog searching the net to find out what I did to my knee. I first injured it a few months ago while skating. I fell forward onto my knee and I'm not sure if my skate was wheels-to-floor or laces-to-floor but the back of my knee felt pulled in the direction that it's not supposed to bend. I continued to skate and never saw a doctor because it wasn't too bad. After that, when I would kneel on something I felt pain, not on my kneecap, but in the outer side of the knee...nothing terrible. Tonight I fell again while skating...I continued to skate because it feels better to try and "work it out". Now that I'm home it's elevated and I'm icing it...and searching the internet to learn more about it. I'm pretty sure it's a PCL injury...the pain is the outer side and back of my knee. I love to skate and I just know I'll be told to stop. Easier said than done when it's something that you love doing.

Gaz said...

About two months ago I tore my PCL and damaged the cartilage under my knee cap in our end of season bout. I now have a PCL deficient knee, whatever that means. Listening to what our league physio has said and seeing other league members with PCL injuries hasn't been encouraging when it comes to me skating again. Is it even possible to get back anywhere near 100% without surgery? Because while I'm happy to rehab, I'm too scared to put my skates back on.