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Considerations
POST-OPERATIVE ASSESSMENT:
Treatment:
SITTING:
STANDING:
Week 1-2
ON PLINTH:
SITTING:
Minimum swelling
90 of active flexion
Almost full extension
Fair quadriceps control
STANDING:
TO FINISH:
RICE + ankle pumps: 15 minutes
Week 2 4
ON PLINTH ADD:
Scar mobilisation
Bilateral bridging (3x10)
Isometric hamstring contraction against PT shoulder (3x10x6
sec hold) mid-outer range
Prone knee bends with thera-band resistance (3x10)
CKC leg press with sports cord (3x10)
SITTING:
STANDING:
EXERCISE MACHINES:
Rower: for ROM (low resistance)
Multi-hip 4 directions with resistance above knee (3x10)
Abductor/adductor: (3x10)
Hamstring curl: isometric > concentric (3x10) DAPRE
Leg press: isometric > isotonic (bilateral > unilateral (3x10)
DAPRE (increase repititions)
Calf Press (3x10) bilateral > unilateral
PROGRESSION CRITERIA:
1. Independent gait
2. Good patella mobility
3. Full passive and active extension
4. 2/3 flexion
5. No pain through available range
6. Minimal knee swelling
7. Fair quadriceps control: quadriceps lag <5 degrees
8. Do not require 1:1 assistance
ADD:
6 Weeks +
ADD:
Stair-climber
Unilateral proprioception progression: involved leg (AP)
Unilateral squats (3x5) progress repetitions
Unilateral wall squats with swiss ball: 3x10
(add proprioception, low load)
Lateral step down (3x20)
Lateral squats (uninvolved > involved > step): 3x10
Dynamic lunge: 3x10
8-12 Weeks
ADD:
Hydrotherapy Phase 3
Lateral squat down with proprioception (3x10)
Unilateral proprioception (lateral)
Profitter: lateral sliding (3x20)
Hamstring strengthening in eccentric mode
PROGRESSION CRITERIA:
Transfer the patient to the advanced ACL group or into Phase 4 when
the following criteria are achieved:
No swelling
Full pain free ROM (limitation of flexion acceptable)
Good muscle control
A normal gait pattern
No complications: patella tendinopathy, PFPS.
Biodex isokinetic test (CON/CON 60:180:300 degrees/sec):
involved leg 70% strength of uninvolved.
GOALS
Physiotherapy 5 x week
BCM:
Hydrotherapy Phase 4
16-24 weeks
Subjective
Lysholm score
Objective
RUNNING PROGRESSION
12 16 WEEKS
(3 x Week)
1. Jogging on spot
Knees back
Knees up