Download as PDFPhase I – Inflammatory Phase:

  • Modalities to control inflammation
    • Prescription anti-inflammatories
    • Ice
    • Clinical modalities as needed
  • Evaluate and treat lumbar, sacral, and pelvic dysfunction
  • Evaluate for corrective orthotics
  • Implement appropriate, selective stretching
    • Iliotibial band
    • Hamstrings
    • Quadriceps
    • Gastrocnemius/soleus
    • Piriformis
  • Apply appropriate patella mobilizations
    • Evaluate lateral retinaculum and apply patellar tilt mobilization when indicated
  • Begin early VMO/quadriceps strengthening
    • Quad setting
    • Multi-plane straight leg raising
    • Open kinetic chain multi-plane hip strengthening
  • Cardiovascular exercise
    • Stationary bike
    • Modify weight bearing activities
  • Initiate aquatic exercise and walking program at chest level water progressing to waist level as tolerated

Phase II – Subacute and Early Strengthening Phase:

  • Continue with appropriate Phase I activities progressing as tolerated
  • Advance strengthening program
    • Proprioception
    • Use caution with closed kinetic chain exercise

Phase III – Advanced Strengthening:

  • Continue with consistent stretching and phase I/II exercise program
  • Begin gym strengthening as appropriate
  • Advance light weight bearing cardiovascular exercises (walking/elliptical trainer)

This protocol is intended to provide a general guideline to treating degenerative joint disease of the knee. Progress should be modified on an individual basis.

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