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.
