Jun
30

ACL Rehab Protocol

Author sgalley    Category Knee Brace     Tags

ACL Rehab Protocol

ACL Rehab Protocol

Phase I of ACL Rehab Protocol
( Approximately weeks 1 – 2)

MD to do day 1 post-op change of dressing and examine home program.

ACL Rehab Protocol

Nurse go to at day 14 for suture elimination and check-up.

ACL Rehab Protocol

Icing and elevation as much as able to reduce edema and promote healing.

ACL Rehab Protocol

If required, use of a CPM in your home for 4 – 6 hours a day.

ACL Rehab Protocol

Gait training to promote highest of gait with the least amount of assistance.

ACL Rehab Protocol

Passive and active variety of movement exercises.

Balance/proprioception workouts in a protected environment.

Well-leg fixed cycling, upper body conditioning, and core conditioning.

Soft tissue treatments to posterior musculature, quads, and infrapatellar pouch.

Substantial patellar mobilizations, superior/inferior glides and patellar tipping.

Passive range of motion must be 0 ° or hyperextension to 90 ° flexion, minimal pain and edema, and unassisted excellent, quality gait prior to moving onto Phase II.

Phase II of ACL Rehab Protocol
( Approximately weeks 2 – 4) – Moderate defense phase:.

MD visit at 4 weeks.

Patient still needs to be somewhat peaceful with low influence on knee, should raise and ice daily.

Walking for workout limited to 15 – 20 minutes daily if no swelling or limping.

Continue with range of movement, gait training, soft tissue treatments and balance exercises.

Include practical exercises/eccentrics (i.e. squats, bridging, extreme core training, and 2″ action downs).

Leg weight machines PRE’s (i.e. leg press, hamstring curls, calf raises, abduction/adduction).

Aerobic exercises as tolerated (i.e. bilateral stationary cycling, UBE, Elliptical).

Pool workouts including deep water running, waist-high quick walking in all directions.

Variety of movement need to be equivalent, extension bilaterally to 120 ° flexion, regular gait without help, single-leg balance ability, and no considerable edema before moving to Phase III.

CPM can be terminated if ROM goals reached.

Phase III of ACL Rehab Protocol
( Approximately weeks 4 – 6) – Return to work/ reinforcing phase:.

Continue any required soft tissue mobilization needed.

Highlight self stretching of both lower extremities.

Increase the strength of practical workouts (i.e. biking, roadway cycling, boost resistance in workouts, approximately 1 hour strolling for workout, include stairs, climber or VersaClimber, increase difficulty of proprioceptive training and eccentric workouts (i.e. 4 – 6″ action downs). All workouts still in a regulated environment.

Greater emphasis on single-leg strength workouts such as leg press and single leg squats.
Clients must have complete hyperextension and 80 – 90% of full flexion, able to do 4″ single-leg step down, and bike with minimal resistance for 20 – 30 minutes prior to relocating to Phase IV.

Phase IV of ACL Rehab Protocol
Approximately weeks 6 – 10 – Progressive activity stage:.

Include lateral training exercises (i.e. lateral lunges, lateral step-ups, action overs).

Begin to integrate sport-specific training (i.e. volleyball bumping, easy hiking, functional training workouts in ALL aircrafts of movement). No cutting or pivoting.

Focus on great, quality eccentric strength and continue to enhance obstacle and complexity of proprioceptive exercises.

All activities should be pain totally free without swelling, coming down stairs should be smooth and pain free, single-leg squatting for 30 seconds ought to be of excellent quality and pain totally free before relocating to Phase V.

Phase V of ACL Rehab Protocol
Approximately weeks 10 – 16 – Training for sport phase:.

MD visit at 3 months and functional test.

Incorporate bilateral, low-level leaping workouts. Look for compensatory patterns with take-offs or landings.

Development to running if able to demonstrate excellent mechanics and proper strength at 12 weeks.

Include suitable dexterity training with progressive complexity and obstacle still mindful with cutting and rotating.

Patients must be weaned into a house program with workouts particular to their particular activity/sport; aggressive roadway biking is encouraged.

Fit for practical knee brace if requested by MD
. Single-leg squat test for 1 minute must be at least 80% of uninvolved leg, moderate resistance cycling for 30 minutes need to be quickly tolerated, client should be positive with all ADL’s and independent in an appropriate fitness center and outdoor training program prior to transferring to Phase IV. Client ought to be well informed on preventing cutting sports.

Conditioning should be highlighted in this phase instead of playing a sport.

acl rehab protocol

Phase VI of ACL Rehab Protocol
( Approximately months 6 – 12) – Return to sport stage:.

MD check out and sport test.

Progression of program of enhancing intensity to return to sports, enhancing plyometric training with suitable development and emphasis on type.

Client needs to be effectively informed of greater danger activities and instructed on appropriate training for most safe progression to those particular activities such as snowboarding, basketball, and soccer.

Client should pass sport test and MD examination prior to being launched to complete athletics.

Practical test at 12 weeks.

Contrast of included and uninvolved leg in the following tests:.

Single-leg squat for 1 minute; contrast of repetitions accomplished in 1 minute.

Lateral Excursion Test: Patient to base on test leg attempt to tap (touch toe only) as far out laterally as possible with opposite leg. Distance recorded and compared for 3 attempts on each side.

Posterior Excursion Test: Same as above however with client tapping toe posteriorly.

Cariocas: Patient to demonstrate excellent, quality movement and control with 1/2 speed cariocas over 40′.

Lateral Leaps: Patient to leap laterally at 1/2 speed touching markers set 3 – 4′ apart for 1 minute with excellent control and type.

Sport test at 6 months and 1 year.

3/4 to full speed cariocas over 40′ with excellent control and type.

Single-leg contralateral reach downs: Patient to base on test leg, with contralateral hand to touch flooring at test leg’s ankle. Repeat over 1 minute and compare number of successful touches to uninvolved side.

Forward Leap: Patient to leap forward (stepping) with alternating legs over 40′ to see quality and willing of single leg push-off and landing.

Lateral Leap with Resistance: Same test as 12 Week but with added resistance cable around waist in line with instructions of leap.

At one year:.

Include test of single leg hop for range; 3 hop trials per leg.

Add Change of Direction Drill: Patient to begin running forward and on command, reverse instructions to in reverse run; on next command, turn and run right; on next command turn and run left, etc. for 1 minute. Assess quality and control of movement.

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