as needed. If using e-stim for quad/VMO activity, do in conjunction with functional quad
exercises such as single leg stance lunge, squat etc.
WEEK 2:
• (Patient will recheck with Dr. Bruner at 2weeks, 2months, 4 months, and 6months)
• PROM: full extension- 110° flexion
• AMB: Should begin weaning off crutches by now unless problems with pain, swelling,
quad control, or limping.
• EXERCISE: Progress same type of exercise: balance, proprioception, reaches, strength,
control, all three planes (sagittal, frontal, transverse) but still limiting range and speed as
patient can control. Continue to emphasize good technique with exercises. As exercise
intensity increases, monitor any increase in patellofemoral or pes anserine pain, and
slow down if indicated. Continue good stretching program for LE musculature.
• SPECIAL ACTIVITIES: Pay close attention to soft tissue, with adding massage to portals
and possibly to patellar tendon incision if healing well.
WEEK 3-6:
• PROM: full extension- 120° at 4 weeks and full flexion at 6 weeks.
• ABM: should be off crutches if ambulatory with no limp.
• EXERCISE: Okay to progress to fitness center workouts including cardiovascular
equipment. (NO RUNNING) and weight equipment if patient is ready with appropriate
strength, pain control, decreased swelling. Typically, patients are ready for the squat
rack (¼ to ½ squats) unilateral leg press, hamstring curl, free weights, lunges with
handheld weights, but no power cleans, clean and jerk, leg extensions with weight.
Continue to focus on balance/proprioception, and stimulation of functional activities,
but taking care to avoid hard impact/landing. Emphasize total body control with
dumbbell activities for combination work of strength/balance/proprioception.
• SPECIAL ACTIVITIES: Still no running, jumping, or sport activity of any kind.
WEEK 6-10:
• PROM: Should have full range by approx. 6-8 weeks out.
• EXERCISE: Continue advancing cardiovascular work outs, and strength training for all
muscle groups, in combination with proprioception, increased range, increased load/
demand, simulation of functional activities including return to sport positions/reaches.
Continue dumbbell workout, such as matrix lunge pattern. At the 9-10 week mark,
advance to low level “step and sticks” to work toward bent-knee landing in preparation
for running.