ACL Reconstruction

Nine weeks’ post-surgery

  • Able to jog on a trampoline under control
  • Progress to functional, non-contact, activities

 

Twelve weeks’ post-surgery

  • Able to jog on a normal surface
  • Open kinematic chain quads with minimal weight
  • Progress to functional non-contact activities
  • Progression to contact sport is dependent upon the sport

 

Acute Stage

  • C.P.M. 0 – 60 degrees
  • Full passive extension – 5 minute stretches (x 5 daily)
  • Pain relief – Ice, drugs
  • Partial weightbearing – use of crutches for comfort
  • Isometric quadriceps exercises in full extension
  • Muscle pump exercises
  • Simple closed kinetic chain exercises (eg: heel raises, mini squats, weight transference)

 

Seven Days

N.B. Check that full extension is achieved

  • Continue with extension stretches
  • Progress to F.W.B. (if this has not already been achieved)
  • Check wounds – gentle friction to reduce scar sensitivity
  • Commence patellar mobilisations
  • R.O.M. exercises – aim to regain full movement equal to opposite leg by 3 weeks
  • Progress closed chain exercises (eg: low step-ups)
  • Proprioceptive training – balance, etc.

Progression

To include such things as:

  • Cycling (free at first)
  • Step-ups and step-downs
  • Bouncer
  • Single leg balance and exercises
  • Cliniband – terminal extension
  • Abductor and adductor exercises
  • Open chain hamstring exercises
  • Check scar tissue
  • Light jogging
  • Isokinetic assessment* (at physiotherapist’s discretion)

* When isokinetic assessment is 80% of uninvolved side begin more advanced specific training A return to sports specific training, non-contact sport and contact sport is dependant on the individual’s progress and assessment results.

Posterior Cruciate Ligament

The general progression would be as for ACL repair, but avoiding open chain hamstrings in the early stages. Open chain quadriceps exercises are acceptable.

 

Anterior Cruciate Ligament