ACL ReconstructionRehab Protocol

Phase 1 (0-4 weeks)

• WBAT with crutches
• Knee brace
  • locked in extension all times through week 1 then may remove for sleep and PT
• ROM
  • as tolerated
• Exercises
  • heel slides, patella mobilization, heel cord stretches, quad/hamstring sets in brace until quad control returns, hip and core exercises 

Phase 2 (4-12 weeks)

• Full weight bearing
• Knee brace
  • May discontinue at 1 month or after once protective quad control returns (can perform straight leg raise without lag)
• ROM
  • full extension, progress work on flexion 
• Exercises
  • toe raises and active heel cord stretches 
  • closed chain extension and hamstring curls
  • stationary bike
  • step ups

Phase 3 (12-16 weeks)

• Full weight bearing with normalized gait
• Knee brace
  • None
• ROM
  • Full
• Exercises
  • advance closed chain
  • advance proprioceptive
  • may begin elliptical, stair master, straight running
  • hip and core exercises
  • aquatic

Phase 4 (16-24 weeks)

• Full weight bearing
• Knee brace not required
• Full ROM
• Exercises
  • running to sprinting may begin week 20, backward running
  • plyometrics
  • sports functional assessment for athletes

Phase 5 (24 weeks and beyond)

• full return
• maintenance program