STAGE 1:  Approx 0-4 weeks


Achieve full extension to 90 degrees flexion

Minimal morning joint effusion

Closed kinetic chain quadriceps exercises only

Full weight bearing (with aids if required)



Adequate analgesia

Swelling management

Gait re-education

Stretches of tight structures

Strengthening of muscles stabilising the knee (open chain allowed for hamstrings)

Manual therapy – soft tissue and joint

Hydrotherapy / electrotherapy: if available and thought to be appropriate


STAGE 2: Approx 4-12 weeks

Aims / restrictions

Avoid jogging / impact exercise

Optimise normal movement

Improve strength and balance / proprioception



As stage 1 plus:

Educate patient to avoid activities that provoke significant shear forces or impact

Strengthening – increasing resistance work with weights / therabands

Core stability work

Balance – double to single leg stance, eyes open and closed


STAGE 3: Approx 12 weeks onwards


Normal movement and muscle strength

Hopping / cutting with good control

Return to sport from 6 months



As stage 2 plus:

Increased dynamic work : hopping, cutting etc

Balance/proprioception: Wobble boards, trampette, gym ball etc

Sports/occupation specific drills once balance/proprioception allows


Have a knee problem?