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The following is Dr. Lind’s non-operative protocol. The main emphasis focuses on:

  1. Reducing inflammation
  2. Restoring full range of motion
  3. Restoring quadriceps function

Phase I – Inflammatory Phase:

  • Modalities to control inflammation
    • Prescription anti-inflammatories
    • Ice
    • Clinical modalities to control inflammation
  • Cardiovascular Exercises
    • Stationary bike-focus on restoring range of motion
    • Pool program as indicated
  • Begin range of motion exercises
    • Seated flexion/extension off of table
    • Wall slides
    • Heel slides
  • Begin VMO and quadriceps strengthening
    • Quadriceps setting
    • Multi-plane straight leg raising
    • Open kinetic chain multi-plane hip strengthening
  • Gait training; protected weight-bearing as instructed

Phase II – Subacute and Early Strengthening:

  • Continue with appropriate Phase I activities
  • Continue to work toward full range of motion
  • Advance strengthening program
    • Proprioception exercises
    • Closed kinetic chain squat program
    • Closed kinetic chain unilateral squats, dips, and step-up progression
    • Closed kinetic chain multi-plane hip strengthening
  • Advance intensity and duration of stationary biking program. May add treadmill walking as swelling permits, avoid running and impact activity.

Phase III – Advanced Strengthening:

  • Advance closed kinetic chain strengthening as appropriate
  • Begin gym strengthening, avoid leg extensions and lunges
  • Begin running and multi-directional functional drills

Phase IV – Return to Sport Phase:

  • Re-evaluation with physician and sports test for return to play

This protocol is intended to provide a general guideline to treating an MCL sprain. Progress should be modified on an individual basis.

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