Acute Phase I: (0-2 weeks)
Goals:
- Alleviate acute pain and swelling
Plan:
- Weight bearing as tolerated with crutches and brace locked in full extension when up
- Passive ROM 0-90 when seated
- Begin SLR in brace locked in full extension immediately
- ICE and elevate
- *Start PT around 1 week*
- Sub-Acute Phase I: (2-6 weeks)
Goals:
- Decrease swelling
- Full ROM
- Straight leg raise against gravity
Plan:
- Continue Phase I exercises
- WBAT in brace and crutches
- Full Passive and Active ROM as tolerated
- Aquatic therapy after incisions healed
- Hamstring and gastroc stretching
- Hamstring and quadriceps co-contraction
- 4-Quad (hip flexion, abduction, adduction, extension)
- Modalities for pain and edema control
- Stationary bike with elevated seat, no resistance, as tolerated
- EMG Biofeedback
Phase II: (6-10 weeks)
Goals:
- Promote independent ambulation w/o assistive device
- Full ROM (pain free)
- Increase Quad strength
Plan
- Continue Phase II exercises
- WBAT remove brace with good quad control
- Stationary bike
- Gait training
- Begin closed chain activities
- Full ROM
- No running/jumping sports
- Proprioceptive and balance training BAPS and trampoline
- Calf and hip PRE’s
Phase III: (10-14 weeks)
Goals:
- Maintain full ROM (pain free)
- Symmetric Quad girth and strength
Plan
- Continue Phase II exercises
- Advance strengthening
- Closed chain only
- No running/sports/jumping
- Muscle endurance activities
Phase IV: (14+ weeks)
Goals:
- Sports specific activities
Plan
- Continue Phase III exercises
- Ok to begin jogging
- Begin agility and plyometrics program
- Cardiovascular conditioning
- Return to Sports: Usually @ 4 months
- 1->80% strength vs. opposite leg
- 2- >90% hop test
- 3- cutting/running/jumping confidence
- 4-physician clearance