Knee protocols

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Author:
jaystutz
ID:
177644
Filename:
Knee protocols
Updated:
2012-10-14 20:21:03
Tags:
knee ACL injury exercise protocols
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Description:
Knee exercise protocols
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  1. ACL repair post surgery:
    Maximum protection phase goals
    • Timeframe - 1-4 weeks
    • 1. Protect ligament - brace w/ WB, appropriate ex, avoid quad contractions
    • 2. Regain motion - 0-90 by 1st wk, 0-125 by end of stage, use gravity positions to "stretch"
    • 3. Strengthen hams - low level ex into knee flex
    • 4. Quad control - co-contractions w/ hams, 4-way SLR in brace
    • 5. Normalize gait & WB
    • 6. Decrease pain & inflammation (may be #2 if pain/inflam limits exercises)
  2. ACL repair post surgery:
    Early Max protect phase exercises
    • Co-contractions - hams before quads
    • CKC w/ brace (prob wk 2) - mini squats - SLS
    • NO SAQ/LAQ
  3. ACL repair post surgery:
    Late Max protect phase exercises
    • Co-contractions - 4-way SLR out of brace - progress w/ weight above knee
    • Mini squats
    • SLS
    • Active knee extension 90-60 no resistance
    • Weight shifts & low step-ups in brace
  4. ACL repair post surgery:
    Moderate protect phase goals
    • Timeframe - 5-10 weeks
    • 1. Protect graft (graft is especially fragile ~4-6 wks p.o. & pt is feeling better...not a good combination!)
    • 2. Gain full ROM & flexibility - HS, quads, IT bad
    • 3. Improve strength - 1) HS, 2) hip & ankle, 3) quads
    • 4. Improve proprioception & balance - helps to normalize gait
    • 5. Dynamic control of joint - thru CKC
  5. ACL repair post surgery:
    Mod protect phase begins with...
    • 1. ROM is 0-120
    • 2. Full WB gait (brace may still be used)
    • 3. Ability to control knee with quads and hamstrings
    • 4. Controlled pain & swelling
    • 5. Tests show no increased joint instability
  6. ACL repair post surgery:
    Mod protect exercises
    • Brace may be used up to 2-3 months for CKC, gait, etc
    • OKC 4-way hip strengthening
    • LAQ no resistance - progression to resistance on prox tib
    • Continue w/ CKC, make more dynamic
    • Strong HS strengthening - stool scoots
    • SLS w/ no external support
    • Stabilization exercises - walking against resistance of cables
    • Proprioception/balance - BAPS board (late mod)
    • Avoid CKC strengthening & PRE's
    • Avoid resisted OKC ext 60-0 (TKE)
    • Avoid CKC squats 60-90 (deep knee flexion)
    • Knees no farther forward than toes during squats
  7. ACL repair post surgery:
    Minimum protection phase begins with...
    • 1. Full ROM & flexibility
    • 2. Strength 75%-80% or normal
    • 3. Normalized FWB gait
  8. ACL repair post surgery:
    Min protect phase
    • Increase strength, power, endurance, dynamic stability
    • Continue LE stretching program
    • Advance with CKC & pylometrics, proprioceptive training, jogging, running, jumping

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