NO OPEN CHAIN QUADS EXERCISES FOR FIRST 12 WEEKS
STAGE 1 : Approx first 2 weeks
Adequate analgesia
Swelling management
Gait re-education and mobility
Stretches as required
Exercises : static bike with minimal resistance, Knee ROM exercises, strengthening of knee stabiliser muscles (OKC exercises for hamstrings allowed)
Manual Therapy: Soft tissue and Joint mobilisations as appropriate
Hydrotherapy / Electrotherapy: If available and thought appropriate
Goals required to progress to next stage:
ROM 0-120 degrees
Full quadriceps activation
Minimal joint effusion in morning
Full weight bearing (with aids if required)
STAGE 2: Approx 2-6 weeks
As stage 1 plus:
Increased resistance on static bike
Swimming may be introduced (but not breaststroke leg kicks)
Strengthening muscles with therabands and weights as appropriate
Proprioceptive / balance exercises
Core stability and gluteal control work
Goals required to progress to next stage:
Full range of active movement
Minimal activity related effusion
CKC single leg squat
Single leg stance as good as unoperated side with eyes open
STAGE 3: Approx 6-12 weeks
As stage 2 plus:
Rowing machine / stepper /cross trainer may be introduced
Review lower limb biomechanics and intervene as required
Goals required to progress to next stage:
Bilaterally equal single stance proprioceptive tests, including on uneven surface
Bilaterally equal strength of hamstrings, adductors, abductors and gastrocnemius
STAGE 4: Approx 12 weeks onwards
As stage 3 plus:
May start jogging/ sports specific drills
