PHASE I (0-2 WEEKS):
Goals:
- Control inflammation
- Minimize effects of immobilization
- Protect graft fixation
- Achieve full extension
- Achieve 90° flexion
- WBAT
Exercises:
- Heel slides/wall slides
- Quad sets
- Hamstring sets
- Patellar mobilization
- Non-weight bearing gastrocnemius and hamstring stretches
- Sitting assisted flexion hangs
- Prone leg hangs (for extension)
- SLR all planes
Functional Training:
- UBE/ well leg cycling for aerobic conditioning
- Active/passive jt positioning
- Balance exercises
- Stable platform: eyes open & eyes closed
- Seated ball throwing and catching
PHASE II (2-4 WEEKS):
Goals:
- Restore normal gait
- Restore full ROM
- Improve strength, endurance, & proprioception to prepare for functional activities
Exercises:
- Mini squats: 0°-30°
- Stationary bike (start with high seat and low tension)
- Closed-chain extension: leg press 0°-30°
- Toe raises
- Continue stretches & progress to WB gastrocnemius stretches
- Add weight to prone hangs
Functional Training:
- Stair training
- Unstable platform: eyes open & eyes closed
- Mini-tramp standing
- Standing ball throwing and catching
PHASE III (6 WEEKS-4 MONTHS):
Goals:
- Protect joint
Exercises:
- Advance CKC strengthening:
- One-leg squats
- Leg press 0°-60°
- Stair stepper/elliptical stepper
- Cross-country skiing machine
Functional Training:
- Stair jogging
- Box jumps (6”-12”)
- Straight ahead jogging: progress to running
- Figure 8 patterns
- Large circles: walking or slow jogging
- Lateral slide board
- Ball throwing/catching on uneven surface
PHASE IV (MONTH 4):
Goals:
- Return to unrestricted activities
Exercises:
- Continue and progress flexibility & strengthening
Functional Training:
- Agility:
- Shuttle run
- Lateral slides
- Carioca cross-overs
- Cutting drills
- Reaction drills
- Sport specific drills
- Advance box jump heights
PHASE V (RETURN TO SPORTS):
Goals:
- Safe return to athletics
- Maintenance of strength & endurance
- Patient education concerning any possible limitations
Exercise:
- Gradual return to sports participation
- Maintenance program for strength & endurance
- Agility and sport specific drills progressed
References:
Brotzman SB, Wilk KE. Clinical Orthopaedic Rehabilitation. 2nd ed. Philadelphia, PA: The Curtis Center; 2003.
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