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Cahill's Injury causes Club v Country Row

Monday 8th May 2006

Tim CahillTim Cahill’s knee injury has opened up a club versus country row in the run up to the World Cup. The Australian damaged a Posterior Cruciate ligament during a Premeirship match against Birmingham two weeks ago and the initial prognosis was that he would be out for six weeks.

The Socceroos face Japan in their opening World Cup match on 12 June and Cahill is desperate to be fit. However, reports from Australia claiming that Cahill would be back in full training next week have angered Everton manager David Moyes.

The Toffees’ boss declared, "Tim will be back when we say he is fit and ready, and not when the witch doctors in Australia say he is. Tim is looking much better, but there is no miracle cure in Australia. If there was, I am sure they would send Wayne Rooney there. He can make an impact in the World Cup and we hope he gets there."

The Posterior Cruciate Ligament (PCL) is larger and stronger than the Anterior Cruciate Ligament (ACL). It passes backwards and downwards from the bottom of the femur (thigh bone) to the top of the tibia (shin bone). Its main purpose is to prevent the tibia slipping backwards on the femur.

Regardless of the specific cause of a PCL injury, the mechanism of injury is almost always a blow to the front of the upper shin. During football, a PCL injury can occur when a player falls to the ground on a bent knee, causing the upper shin to strike the ground first.

One study estimates that PCL injuries make up as many as 20\% of all knee ligament injuries, but the diagnosis is often missed. This is due to the fact that many people can function normally without a PCL. However, detection of PCL injury is important because untreated PCL ruptures will lead to significant degeneration (i.e. osteoarthritis) of the knee and disability in later life.

The gold standard treatment for partial tears of the PCL is physiotherapy that includes aggressive quadriceps (thigh muscle) strengthening and full knee range-of-movement maintenance. Patients may return to sports when quadriceps and hamstring strength reaches 90\% of the opposite side. This typically takes 4-6 weeks.

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