- Ice and modalities as needed to reduce pain and inflammation
- Use crutches ____% weight bearing x _____ weeks
- Emphasize patella mobility and full extension
- Full active/passive knee range of motion exercises
- Quadriceps setting focusing on VMO function
- Multi-plane open kinetic chain straight leg raising
- Gait training
- Stationary bike immediately Post-operative with Low Resistance
- Dyna-splint or JAS splint as indicated
Phase II – Progressive Stretching and Early Strengthening (Weeks 2 to 6):
- Passive and active range of motion; work toward full range
- Dyna-splint or JAS splint as indicated
- Lower extremity stretching
- Aggressive patella mobility
- Open/Closed kinetic chain multi-plane hip exercises
- Proprioception drills emphasizing neuromuscular control
- Pool program when incisions are fully healed
- Stationary bike, treadmill walking or elliptical trainer
Phase III – Advanced Strengthening and Proprioception (Weeks 6 to 12):
- End range stretching flexion and extension
- Continue patella mobility
- Bilateral closed kinetic chain strengthening progressing to unilateral as tolerated
- Advance time and intensity on cardiovascular program-no running
- Functional cord resistance program
- Initiate gym strengthening program as appropriate
- Outdoor biking – easy gears
Phase IV – Return to activity (Week 16):
- Follow-up examination with the physician
- Gradually increase intensity of lower extremity strengthening, stretching, and cardiovascular training
- Sports test – may be modified on and individual basis
