Actually a pcl problem not acl; the importance of PCL on the knee joint

Dear Ask The Doctor: I actually injured my pcl. completely tore it it is no longer attached the doctor advised that i not have the surgery because they aren't as comfortable with it as they are the acl. my problem is that now both of my knees are constantly hurting and the one that i tore the pcl on seems like it falls apart and kind of locks and I can barely walk until i find out which way i need to turn and or stretch it to get it to pop back together. I no longer have medical insurance and cant afford it I have been unemployed for 2 years now. sometimes I don't know how I could work a full time job anymore. If I sit down too long my knee cramps and I have to stretch it out and move around if i am standing or walking sometimes I just about collapse or have to catch myself on something and now my other knee hurting as much as it does I don't remember doing anything to injure it so I am thinking it is just fatigued or something from me relying on it so much more than the other one. is there something I can do to help the pain that doesn't involve drugs? I go to the gym 5 or 6 times a week and approximately every 4th time at the gym is leg day never anything very strenuous I don't even lift my own body weight and it hurts too much to run or jog on the tread mill even and stairs are out of the question i do use the bike and elliptical so is there something I should be doing different or that i should stop doing?

Dear Spencer: Both ligaments ACL and PCL are very important to stabilize the knee joint backwards and forwards, the lateral ones stabilize it side to side, the menisci give cushion between femur and tibia, and the synovial fluid lubricates all the surfaces minimizing the friction during the movements, so as you can see every element is important for the correct function of the knee joint. According to the description of your problem, it might be important to rule out a Meniscus lesion. The menisci are C-shaped wedges of fibro cartilage located between the tibia and femur, and very close related to knee ligaments and attached also to the joint capsule. They are susceptible to get injured with leg rotation movements or rotational forces applied to them, and the lesion produced can be partial or complete tear. Meniscus injuries are common in active people as you, who are involved in sporting or physical activities. Pain along with locking or buckling are common symptoms after a meniscus lesion develops. Locking usually occurs at 20-45° of joint extension. If a torn fragment has been trapped within the joint, extension may feel limited against a rubbery resistance. Joint inflammation or capsular involvement also may resemble locking. A more reliable indicator of meniscus lesion is a click, pop  or snaps after the joint unlocks, it can be or not associated with pain. A sensation of giving way may occur when the loose fragment becomes lodged for a moment in the knee joint, causing a sense of buckling. This finding should be distinguished from the sensation of giving way due to joint instability (eg, ACL tear) or buckling secondary to decreased activity of the quadriceps femoris muscle. On the other hand, knee pain is the most common presentation of patellofemoral syndrome. The pain typically is located behind the kneecap and often shows during activities that require knee flexion and forceful contraction of the quadriceps (ei, during squats, bicycle, ascending/descending stairs, jogging or pendants). Pain may be worsen by sitting with the knee flexed for a long period of time, such as while watching a movie, hence leading to the terms "theatre sign" and "movie-goer's knee." The suggested strategy for conservative treatment should be as follows: Physical therapy program (exercises and pain control with TENS, ultrasound, ice packs after exercises), anti-inflammatory medication (i.e.: “Aleve”, “Advil”), education  so  you understand which activities avoid because those can aggravate patellofemoral syndrome. Also, and very important, remark the need for extended adherence to the exercise regimen. The physical therapist should educate you about a home exercise program.