ACL Rehab Protocol
This program should not be accelerated unless specifically intructed to do so!
Regain full passive ROM
Optimize lower extremity strength (quad,ham,calf isometrics).
Cardiovascular conditioning (UBE).
Post-op week 1
Ice, modalities, EMS.
ROM: active 20 – 90 , passive 10 – 90. Perform “heel slides” for 10 minutes, 5X / day (If meniscus was repaired, defer to the ROM and weight-bearing guidelines for “meniscal repair”)
Brace set @ 10 – 90 (removed for bathing only)
Weight bearing: (crutches) toe touch X10 days. Progress to full weight bearing @ 14 days post-op as tolerated.
Strength: Quad, hamstring, calf isometrics (multi-angle)
Conditioning: upper-body ergometer
Post-op week 2 – 3
Ice, modalities, EMS.
ROM goals@ 3 weeks AROM 10 – 90, PROM 10 – 110
Brace set @ 10 – 110
Weight bearing: Progress to full weight bearing at the end of the 2nd week as tolerated
Strength: Continue phase 1 exercises, progress to 1/2 squats (no added weight). Closed-chain quad exercises only. Hip Flex, Ext,Ab,Add exercises with knee extended
Post-op week 4 – 6
ROM: @ 6 weeks 0 -130 (DO NOT PERMIT KNEE FLEXION > 130 degrees!!!)
Weight bearing : full
Strengthening: Continue exercises as above. Progress closed-chain exercises (sport cord)
Isotonic PSEs (begin gentle slow controlled reps). PNF patterns. Ambulate backwards on treadmill.
Proprioception: Exercise Bicycle (no resistance, maintain 80 rpms). Stairclimber (begin low demand, short range). Side to side weight transfers. Forward, lateral step-ups/stepdowns (4″). Sport cord. Forward, lateral, sideways walking
Conditioning: UBE, gradual progressive increased resistance on exercise bicycle
Post-op week 7 – 16
Strength: Progress phase 3 closed-chain exercises (sport cord). PNF patterns. Isotonic quad/ham PREs (begin gentle slow controlled reps).
Proprioception: Slow progression to 16 weeks.Slideboard, walking on 2 X 4, double leg hops.
Forward, lateral, sport cord. Forward,lateral, sideways lunges. Plyometric step-down step-ups (4-8″). Conditioning: UBE, staionary cycling, stairclimber
Function: begin jogging on treadmill at 12 wks (slowly progress duration)
Post-op week 16 – 24
Strength: Continue PREs on an independent basis. Single – leg squats, begin plyometrics
Proprioception: begin walk/jog program. progress to backward and figure of eight running, and agility training; begin light, sport-specific drills
Conditioning: Single-leg jump up/ jump down (forward & lateral). Jump rope, cycling, stairclimber
Post-op > 24 weeks
Strength and conditioning continue to improve speed and endurance including advanced plyometrics and sport specific training.