ACL Protocol


This is for soft tissue (hamstrings) AUTOGRAF...BTB auto may WBAT immediately and will use CPM...with recent focus on a more anatomic position of the tunnel positions, there are increased concerns that accelerated rehab may place the graft at increased risks, not experienced by more "traditional" graft positioning techniques

0 - 2 weeks

PWB to 2 weeks, WBAT for BTB auto

Home CPM for BTB auto

  • Ice 15 - 30 minutes/hour
  • Brace WBAT in extension, may drop lock for sitting
  • Supine and prone sustained extension stretching
  • Soft tissue patella and scar mobs
  • Supine wall slide
  • Seated hamstings (carped drags), prone hamstring curls,
  • Stationary bicycle for ROM, no resistance
  • Isometric quads
  • 4-way SLR without lag
  • Isometric quads contractions at 0 and 65 deg with and w/o stim
  • Modalities

Week 2 - 4

  • Progress to WBAT, wean to 1 crutch, goal d/c brace @ 4 weeks
  • Bilateral mini-squats (0 - 40)
  • Bilateral leg press, minimal weight, 0 - 40
  • Calf raises
  • May unlock brace for ambulation week 4
  • d/c brace @ night when extension easily maintained
  • step-ups
  • walking on heels

Weeks 4 - 8

  • Short-arc quads
  • Wall sits
  • Unilateral leg press with eccentrics
  • Lateral steps
  • Profitter/slide board
  • Full arc quads (week 6)
  • Increase resistance on stationary bicycle

Weeks 8 -12

  • Single leg hops
  • Increased height of step up/downs
  • Bosu step-ups
  • Unilateral mini-squats

Weeks 12 - 16

  • Begin plyometrics, jump landing training
  • Light jogging (4 months)
  • Jumping rope
  • Lunges sideways, forwards, backwards

Weeks 16 - 6 months

  • Begin cutting, light agility drills
  • Reactive jumping

RETURN TO SPORT - advance to full activity if <10% strength deficit, single leg hop test >80% uninvolved LE...patience and caution with the realistic goal to return to high-intensity cutting sports (soccer, football, hockey, basketball, skiing, etc.) @ 9 - 12 months. Consider bracing for return to sport <12 months



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