!"#$%&'()*"+,$&-&./01231.4
562789*2.*:;.82&<=>&?@20&A/26BB/8&C69D.9&<72.E8/F2&561.9G28712@.9&
A8.2.1.B!
- Osseous!healing!of!the!bone-to-bone!tunnel!occurs!at!approximately!8!weeks!Post-Op!
- Graft!revascularization!80%-90%!at!6-8!weeks!post-op-!Clancy!et!al.!JBJS!1981!
- Flexion!angles!for!exercises!would!be!most!comfortable!to!the!patient!between!45°!and!60°!
- Be!aware!of!any!forces!that!affect!the!patellar!tendon.!If!patellofemoral!type!pain!does!arise,!treat!like!
Patellofemoral!Pain!Syndrome!with!modalities,!taping!techniques,!myofascial!release!techniqu e s,!N MES!for!
quad!strength!regeneration!
o Also!evaluated!the!entire!kinetic!chain,!look!for!dysfunctional!patterns!along!the!chain,!especially!in!the!
hip,!ankles,!SI,!and!Lumbar!spine!
§ Kinetic!Chain!Ripple!Effect-!everything!is!connected!
o Functional!movement!is!through!all!3 !p lan e s ,!an d !th e re !is!a !mobility!an d !st ab ilit y!c o m p o n e n t!a t!e ac h !
joint!and !w it h !ea c h!muscle!fo r!p ro p e r!movem en t !
§ HI/4;B6J!Gluteus!Maximus,!is!classified!a s !an !e xt en d e r!o f!th e !h ip ,!h owever,!if!you !lo o k !at !th e !
alignment!of!the!muscle!fibers,!it!is!just!as!much!a!hip!abductor!and!external!rotator.!Which!
means!it!acts!as!a!prime!mover!and!a!stabilizer!at!the!same!time.!Moving!in!one,!while!stabilizing!
in!the!oth e r!t w o ,!d ep e n d ing !o n !th e !p o sitio n !o f!t h e!jo in t!a n d !th e !m o v e m e n t!t he !a th le te !is!
performing!
§ All!muscles/movements!have!to!be!train!for!both!strength!and!stability!
• You!need!to!look!at!soft!tissue:!they!are!all!connected!fascially!and!interact!for!true!
functional!m o vement!
• HI/4;B6J!SLR=!Strain!on!multiple!tissues,!not!just!the!hamstring!
o ITB,!ipsilateral!lum bar!fascia,!A c h ille s!te n d o n ,!c o n tr ala te ra l!lu mbar!fas cia ,!and!
plantar!fascia!in!descending!percentages&
*!This!protocol!is!a!criterion-based!protocol,!with!a!goal!of!maximizing!healing!and!strength!recovery,!while!
minimizing!risk!of!re-injury,!so!t he !a th le te !ca n !re tu rn ,!a s!q u ick ly!a n d !sa fe ly !as !p o ss ible ,!to !a th le tic !ac tiv itie s!a t!
the!pace!that!ea ch !individ ua l!progre sses .!!
K446 D @/ 26 BL &A . G2*M;68/2@N6&A0/G6J!!O66P &,Q&/ ;; 8. I 3&D/ LG&, *R&;.G2*.;68/2@N6BL%!
Goals!of!this!phase!are:!
- Restore!full!passive!knee!extension,!and!gradually!!!knee!flexion!to!90°!
- Diminish!joint!swelling!and!pain!
- Restore!patellar!mobility!
- Re-establish!quadriceps!control-!active!quadriceps!contraction!with!superior!patellar!glide!
- Impro ve !a m b ulation!to !F WB/!¯! assist ive !d ev ic e!u s e!
C86/24692GJ!A68F.84S@9186/G6&974T68&/9D&D78/[email protected]&.F&6I681@G6G&/G&2.B68/26D!
- Gait!Training:!
o Patient!is!WBAT!in!full!locked!extension!brace!with!bilateral!crutches!!
- Exercises:!
o Ankle!Pumps!to!¯!swelling/edema !
o Ankle!resistance!band!open!chain!exercises-!all!4!directions!
o Patellar!mobilization!in!all!directions!
o Quadriceps!isometric!setting,!with!VMO!self!biofeedback!
o Gluts!sets!
o Hamstring!stretches!for!hamstring!re-length en in g !
o Straight!Leg!Raises!(all!4!directions)!
!"#$%&'()*"+,$&-&./01231.4
o Gastrocnemius/heel!cord!stretching!for!re-lengthenin g !
o Active!and!Passive!knee!flexion!exercises!to!tolerance,!not!pushed-!(to!90°!by!days!5-7)!
o Wall!slides!(supine!with!foot!on!wall/window)!for!increasing!knee!flexion,!or!seated!AAROM!!
o Gentle!overpressure!into!full!extension!(PT!or!pt.!actively)!
o Weight!Bearing:!weight!shifts!in!full!extension!brace!
o Standing!Hamstring!concentric!&!eccentric-!90°Û40°!
- NMES:!
o !Can!and!should!be!used,!if!contraction!deficit!is!present,!during!active!muscle!exercises!
- CP!with!full!Extension,!could!also!use!Kinesio!Tape!(basket!weave!technique)!or!dry!needling!technique,!
to!control!swelling/ ed em a !
- Patient!Education:!What!to!expect,!Goals!of!the!phases,!contraindicated!movements/activities,!etc.-!
=.92@976D&208.7E0.72&/BB&;0/G6G&.F&206&;8.2.1.B!
- Home!Exercises!Program-!See!attached!HEP!for!Immediately!Post-op!Phase!
H/8BL&A.G2*M;68/2@N6&A0/G6J&&
Criteria!for!entering!this!phase!is:!
1- Quadriceps!voluntary!initiation!with!quad!set!and!SLR!
2- Full!passive!knee!extension,!Knee!A!+!PROM!of!0°-90°!!
3- Good!patellar!mobility!
4- Minimal!joint!effusion!
5- Indepe n d e n t!a mbulatio n!
Goals!of!this!phase!are:!
- To!maintain!full!passive!and!active!knee!extension!
- To!gradually!increase!knee!flexion!to!110°-120°!
- To!diminish!swelling!and!pain!
- Increase !muscula r!tr a in in g!
- Restore!proprioception!
- Maintain!patellar!mobility!
- Use!a!recumbent!cycle!without!difficulty!
- Perform!a!SLR!with!no!extension!lag!
- Reciprocal!stair!climbing!
- KOS-ADL!Score!of!>65%!
C86/24692J&&
- Gait!Training:&WBAT,!with!a!goal!of!discontinuing!use!of!crutches!by!day!10-14!post-op-!continue!brace!
until!voluntary!quad!control!is!demonstrated,!*U/L&T6&G7TV612&2.&10/9E6&TL&UW!
- Exercises:!(1.92@976S;8.E86GG&/BB&6I681@G6G&F8.4&;[email protected]&;0/G6%!
o Continue!NMES!with!quadriceps!exercises,!if!needed,!&!Quad!Sets!
o SLR!in!all!SLR!in!all!4!directions-!progression!with!1#!weight/week!(*A8.I@4/B&B./D@9E)!
o PROM!0°!to!110°-120°,!OKC!–Knee!Extension!90°!to!40°! eccentric!
o Mini!Squats!0°-30°!DL!(BW!only)!Progress!to!unstable!surface!such!as!tilt!board!(Med./Lat.!&!
Ant./Post.)!or!foam!with!3-5!second!holds!XY.8?/8D&2879P&2@B2*&86187@2&ZS:&[&79B./D&<=>,!Wall!
Squats/Sits!to!45°-60°!
o Overpressure!into!Full!Knee!Extension,!Prone!Knee!Hangs!if!lacking!full!extension!
o Hamstring!Curls!
o Weight!Shifts-!Medial/Lateral!&!Diagonal!Patterns,!Balance!Weight!Shifting-!progressing!with!
balance!board,!BOSU!
o Forward!&!Lateral!Mini!Lunges!(30°-40°!of!flexion)-!@F&;/2@692&0 / G&E . . D &\ 7 / D 8 @16 ; G &1 . 9 28. B !!
o Step-Ups!in!pain!free!range-!Front!&!Lateral!
o Lateral!Step!Over:!Cones,!Hurdles-!XK9G28712&2.&8/@G6&P966&2.&B6N6B&.F&0@;!
o DL!Leg!Press-!Sub!Maximal!
o Stationary!Bicycle!(if!ROM!permits)!
!"#$%&'()*"+,$&-&./01231.4
- Manual!Treatments:!
o Patellar!Mobilization!(if!limited),!Scar!Mobs!(when!skin!is!healed),!TFM/MFR!to!any!tight!tissues!
in!the!hip ,!b ac k,!a n d !lo w e r!e xtr emity!
- Continue!to!control!swelling:!Ice,!elevation!if!needed&
K92684 6 D @/ 26 &A . G2*M;68/2@N6&A0/G6J&!
Criteria!for!entering!this!phase:!
1- P!&!AROM!knee!flexion!to!³!110°!
2- Quadriceps!&!Hamstring!strength!≥60%!of!the!non-injured!leg!( D yn a momet ry) !
3- Minimal!to!no!effusion!!
4- No!joint!line!or!patellofemoral!pain!
5- Mild!laxity!on!clinical!examine,!or!+1!or!less!with!the!KT-2000!test!(*if!available)!
a. Week!4!!&!6:!KT-2000!test!at!20!&!30!lbs!anterior!and!posterior!
Goals!of!this!phase!are:!
- Quadriceps!strength!to!≥75%!of!the!non-injured !leg ,!H / S!≥ 7 5 % !n o n -injured!leg !
- Restore!knee!ROM!to!0°-125°,!o r!k n e e !R OM!to!within!1 0°-15°!of!non-inju re d !leg !
- Impro ve !lo wer!extre m it y!s tre n g th!
- Enhance!proprioception,!balance,!and!neuromuscular!control!
- Impro ve !muscula r!e n d u ra n c e!
- Restore!limb!confidence!and!function!
- KOS-ADL!score!or!>75%!
- Get!an!Post-Op!score!for!IKDC!or!KOOS!(age !ap pro pria te!vers ion ) !
Treatments:!!
- Gait!Training:!Unlocked!brace,!discontinued!use!if!sufficient!quad!strength!is!present.!Retrain!with!
normal!walking!gait!pattern!
- Exercises:!(=.92@976S;8.E86GG&/BB&6I681@G6G&F8.4&;[email protected]&;0/G6G&/G&2.B68/916S/G&966D6D %!
o Knee!concentric!and!eccentric!90°<->40°!
o Front!&!Lateral!step!down!exercises!
o Standing!heel!raises!(raising!up!onto!toes)!
o Progress!lateral!stepping!exercise!
o Squats!with!forward!tilt!to!decrease!ACL!strain!
o Perturbation!training!-!DL®SL!Balance-!Tilt!Board!(stabilized!to!level!position),!BOSUÒ,!Ai re x Ò-!
progress!with!ball!toss!&!catch/reaching!(UE!&!LE),!external!tapping!on!hips!and!trunk-!XO@20&
P966&GB@E02BL&FB6I6D!
o Pool!exercises!if!available:!forward!&!backward!walk/run!!XF.8?/8D&/2&?6 6P &]#%,!hi p !&!leg!
exercises-!at!slow!speeds!of!mvmt.!(Graft!protection)!
o Begin!testing/training!for!proprioception!on!the!BiodexÒ!Stability!System!(or!other!system)-!X@F&
/N/@B/TB6Q&.8:!Balance!Error!S c o rin g !S y st em!Test,!F u n ct io n a l!R ea c h !T es t,!T a n d e m!Walkin g !te sts-!
See!attached!sheets!
o Progress!bike!and!walking-!min!of!10!minutes,!increasing!10min/wk!(walk)!
o Stair-stepper!machine!for!minimum !of!10!minu tes!to!increase!enduran ce-!X@F&/N/@B/TB6!
o Core!stabilization/strengthening-!Bridging!(Progress!with!ball!squeeze®!unstable!surface®!
hamstring!curl!with!physioball)!
- Manual!Treatments:!
o Continue!patellar!and!scar!mobilization!if!needed!
o Tibiofemoral!mobilization!with!rotation!for!ROM!if!joint!mobility!is!limited!
>/26&A.G2*M;68/2@N6&A0/G6J!!
Criteria!for!entering!this!phase:!
1- Active!knee!ROM!0°-!³125°!
!"#$%&'()*"+,$&-&./01231.4
2- Quadriceps!Strength!&!Girth!³75%!of!non-injured!le g !(d yn a m o metry!&!t ap e !measure ),!H amstring!
Strength!≥75%!of!non-injured!leg!(d yn a mometr y) !
Goals!for!this!phase:!
- Restore!full!knee!ROM!
- Continue!to!improve!lower!extremity!strength,!balance,!proprioception,!neuromuscular!control,!
muscular!endurance!
- Knee!effusion!to!trace!or!less!
- Quadriceps!strength!to!>80!%,!Hamstring!Strength!>80%!of!the!non-injured !leg !
- Normal!gait!pattern!
- Minimal!laxity!on!clinical!exam,!or!2mm!or!less!on!the!KT-2000!test!
- Get!a!baseline!FMS®!and!Y-Balance™!score!at!≥"!weeks!post-op-!when!appropriate-!Begin!with!the!SFMA!
(no!pain!with !the!a sse ssm e nt)!w ill!de term in e!rea din es s!for!FMS®!and!Y-Balance™!Test!
- Patient!is!tested!with!the!Landing!Error!Scoring!System!(LESS):!:66&<22/106D&:0662GJ&*&C6G2&/2&A/2@692^G&
@9D@N@D7 / B&4/I&N68 2@1 / B&V7 4;&06@E 0 2Q&9 . 2 &G2 /9 D / 8 D &46/G78 6 &. 9 &20 6 &> H ::*&4/L&T6&2..&0@E0&.8&2..&B.?&F.8&
/1178/26&@9D@N@D7/B&V74;&/GG6GG4692&G1.86Q&9.&G..968&20/9&,$&?66PG&;.G2*.;&
o Excellent!Score!is!</=!4!
o Good!Score!is!>4!and!</=5!
o Moderate!Score!is!>5!and!</=6!
o Poor!Score!is!>6!
- Perform!hop!testing!at!no!sooner!than!,$!weeks!post-op:!:66&<22/106D&:0662G!!
o 2!practice!trials!on!each!leg,!then!2!timed!or!measured!trials!an!each!leg;!measure!and!average!
to!compare !injure d!to!n on-injure d!le g s !
o 1-!Single-leg !h o p!f or !d ista n c e!
o 2-!Triple!hop!for!distance!
o 3-!Single-Leg!Crossover!triple!hop!
o 4-!6-Metered!timed!hop!!
Treatment:!&
- Exercises:!(=.92@976S;8.E86GG&/BB&6I681@G6G&F8.4&;[email protected]&;0/G6G&/G&2.B68/916S/G&966D6D%&
o Progress!exercises!in!intensity!and!du ra tio n!
o Perturbation!training!continues!
o Dynamic/Plyometric!Leg!Press!(Begin!at!³10!Weeks-!To!learn!technique!and!control!ground!
reaction!forces,!“lan d !softly!on !toe s!w ith!kn ees !slightly!flexe d” !for!dissip atio n!of!fo rce!a nd !to!
avoid!hyperextension)!
o Progress!lateral!stepping!and!lateral!step-down!exercises!with!resistance!bands!on!the!distal!
femur!creatin g!a!m e dia l!pull!(bila teral!w ith !step pin g,!SL!w ith!late ral!ste p-down)!
o Advance!core!stabilization!exercises!
o Isokinet ic!e x er cis es !a t!(9 0°-40°)!(120°/s-240°/s)!
o Begin!training!on!Athletic!Dynamic!Stretching!Program-!:66&:0662G!
<DN/916D&<12@N@2L&A0/G6J&&
Criteria!for!entering!this!Phase:!
1- Full!knee!AROM,!with!No!pain!or!effusion!!
2- Quadriceps!Strength!&!Girth!>80%!of!the!non-injured!leg,!knee !fle xo r -extensor!ratio!of!70%!to!75%,!
Hamstring!Strength!>80%!of!the!non-injured !leg !!
3- No!laxity/instability!on!clinical!exam,!or!KT-2000!test!of!2mm!or!less!compared!to!the!non-injured!sid e!
4- Hop!Tests!(80%!of!non-injured !leg ),!LS I-Limb!Symmetry!Index!of!≥80%!!
5- IKDC!(u se !for!co n co m itan t!injurie s)-!score!of!80%!or!higher,!or!the!KOOS!(use!with!AC L!alone)!score!of!
³80!
6- Score!of!³“Good!“!on!the!LESS!to!be!able!to!begin!Plyometric!Training!Protocol!
Goals!for!this!phase:!
- Normalize!lower!extremity!strength!
!"#$%&'()*"+,$&-&./01231.4
- Increase !muscle!p o w e r !and!endurance!
- Maintain/Gain!Hamstring!&!Quadriceps!Strength!and!Girth!of!80%!or!greater!
- Hop!Tests!to!>!90%!of!the!non-injured!leg!
- Continue!to!improve!neuromuscular!control!
- Begin!selected!skill!drills!
- KOS-sports!score!of!>!70%!
- FMS®!(goal!of!³14/21!points!with!no!0/3,!1/3,!or!asym m e tries)!an d!Y-Balance™!score!(goal!statistically!
symmetrical!to!non-in ju red !le g )!
- Subjective!Knee!score!(Cincinnati!Knee!Rating!System)!of!80!points!of!higher!
C86/24692GJ&
- Exercises:!(=.92@976S;8.E86GG&/BB&6I681@G6G&F8.4&;[email protected]&;0/G6G&/G&2.B3S966D3%!
o Agility!exercises-!side!shuffling,!cariocas,!zigzags!
o Advanced!core!&!hip!stabilization!exercises!
o Begin!walk®run!protocol,!tow a rd!th e!en d!o f!pha se,!w he n!p atien t!is!able !to!pe rform !a !con trolled !sing le!leg!
squat!(injured!leg)!to!60°!of!knee!flexion-!G66&/22/106 D&G0662G!!
o Begin!Plyometric!Training!Protocol-!when!appropriate!according!to!LESS,!Hop!Tests,!and!no!increase!in!
patient’s!symptoms-!:66&/22/106D&G0662G!
o Isokinet ic!e x er cis es !(1 8 0°/s),!if!available!
o CKC!exercises!may!be!progressed!to!75°-90°!of!flexion!
o Eccentric!exercises!for!all!lower!extremity!muscles!
o Continue!Athletic!Dynamic!Stretching!Program-!:66&:0662G!
[email protected]/B&<GG6GG4692GJ!
- FMS®!and!Y-Balance!Assessment™!/2&T6E@99@9E&/9D&69D&.F&20@G&;0/G6!
- Repeat!the!4!Hop!Tests!from!the!previous!Phase!/2&T6E@99@9E&/9D&69D&.F&;0/G6!
Core!Testing:!
- Segmental!Multifidus!Test!
- Trunk!Curl!Up!Test!
- Double-Leg!Lowering!Test!
- Side!Bridge!Test!
- Prone!Bridge!Test!
- Supine!Single-Leg!Bridge!Test!
- Extensor!Endurance!Test&
562789&2.&<12@N@2L&A0/G6J&!
Criteria!for!entering!this!Phase:!
1- Full!ROM!
2- A!score!of!³14/21!on!the!FMS®!Assessment!Screen,!with!_.!0/3=!pain!on!any!of!the!7!fundamental!
movement!patterns!
3- No!statistical!asymmetries!and!on!the!Y-Balance!Assessment™!
4- Hop!Tests!(90%!or!higher!compare d!t o !n on-injured !le g )!
5- Limb!Symmetry!Index!(LSI)!of!90%!or!greater!on!hop!tests!
6- IKDC!Sc o re !³!85%,!or!the!KOOS!score!of!³85!
7- KOS-Sports!Score!90%!or!greater!
8- Cincinnati!Knee!Rating!System!score!of!290!points!or!higher!
9- No!change!in!knee!laxity!(clinical!exam!or!!</=2mm!on!KT!2000!test)!
10- Isokinet ic!t es tin g :!(if!a v aila b le )!
i. Quadriceps!(80%!or!greater)!compared!to!non-injured!leg!
ii. Hamstring!(100%-110%)!compared!to!non-injured!le g !
iii. Hamstring-Quadriceps!Ratio!(70%!or!greater)!
!!!!!!!
!
!"#$%&'()*"+,$&-&./01231.4
Goals!of!this!Phase:!
- Achieve!maximal!strength!and!endurance!
- Normalize!neuromuscular!control!
- Progress!to!skill!training!
- Gradually!return!to!sport!specific!training!
C86/24692GJ&
Exercises:!
- Continue!strengthening!exercises!
- Continue/Advance!core!training!exercises!
- Continue!Neuromuscular!control!exercises!
- Begin!Sport!Specific!Dynamic!Stretching!program-!:66&:0662G!
- Continue!plyometric!exercises!
- Progress!running!program!
- Begin!agility!and!skill!training!exercises:!
o Continue!cariocas,!zigzags,!side-shuffling!
o Begin!sudde n !sta rt !an d !s to p s,!fig u re -8’s,!45°!and!90°!cutting!drills,!box!jumps!(progressing!&!
varying!heights!up!to!20cm)!
[email protected]/B&<GG6GG4692J&
- FMS®!and!Y-Balance!Assessment™!/2&206&69D&.F&20@G&;0/G6!
- Repeat!the!4!Hop!Tests!from!the!previous!Phase,!Plus!Hop!to!Stop!Test!/2&206&69D&.F&20@G&;0/G6!
[email protected]/B&C6G2@9EJ&F.8&;[email protected]&2.&G;.82*G;61@F@1&28/@9@9E*&!_.&G .. 96 8&20 / 9&+ (*`#&O66PG%&*X=/9&T6&;68F.84&
.N68&47B2@;B6&D/LG*&:66&<22/106D&:0662G!
Strength!and!Power!Testing:!!
- Single-Leg!Squat!Test/!Single-Leg!Squat!Test!!
- Vertical!Jump!Test!
- Figure-8!Hop!Test!
- Up-Down!Test!
- Hexagon!Test!(DL),!Modified!Hexagon!Hop!Test!(SL)!
Speed,!Agility,!and!Quickness!Testing:!
- T-Test,!or!Modified!Agility!T-Test!(MAT)!
- Three-Cone!Drill!Test!
- Slalom!Test!
- Backward!Movement!Agility!Test!
- Zigzag!Run!Test!
- Lower!Extremity!Functional!Test!(LEFT)!
Core!Testing:!
- Segmental!Multifidus!Test!
- Trunk!Curl!Up!Test!
- Double-Leg!Lowering!Test!
- Side!Bridge!Test!
- Prone!Bridge!Test!
- Supine!Single-Leg!Bridge!Test!
- Extensor!Endurance!Test!
Function!and!Balance!Testing:!
- FMS®!Assessment!Screen!
- Y-Balance!Assessment™!
- Vail!Sport!Test™!
&
&
&
!"#$%&'()*"+,$&-&./01231.4
X562789*2.*:;.82&A8.2.1.B*&:66&:;61@F@1&:;.82&562789*2.*:;.82&A8.2.1.BG&
Criteria!for!Return-to-Sport!Specific!Protocols:!
- A!score!of!³16/21!on!the!FMS®!Assessment!Screen,!with!no!pain!or!asymmetries,!6G;61@/BBL&?@20&K9B@96*
B79E6,!a n d !2 !or!greate r!on!all!7!fu n damen t a l!movement!pa tt e rn s!
- Y-Balance!Test™-!No!asymmetries!and!passing!score!when!compared!to!peers!with!data!analysis!through!
the!Move 2Pe rofo rm !so ftwa re= !a!composite!score!as!close!to!100!as!possible!
- Limb!Symmetry!Index!(LSI)!0f!³95%!on!hop!tests!
- LEFT!Score:!≤!117!seconds!(females),!≥105!seconds!(males)!!
- Vail!Sport!Test™:!≥!46/54!points!
- Isokinet ic!t es tin g :!(if!a v aila b le )!
o Quadriceps!(90%!or!greater)!compared!to!non-injured!leg!
o Hamstring!(100%-110%)!compared!to!non-injured!le g !
o Hamstring-Quadriceps!Ratio!(80%!or!greater)!
- IKDC!sc o re !o f!³85%,!or!KOOS!score!of!³90!
- Knee!Outcome!Survey-Sports!Activities!Scale!(KOS-SAS):!³!95%!
- Cincinnati!Knee!Rating!System:!Score!³350!
- SL!Hop!tests!³100%!compared!to!non-injured!leg!
- No!discomfort!or!swelling,!and!passing/statistically!equal!to!normative!values!(if!available)!with!above!
Functional!Tests!
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Adams!D,!Logerstedt!D,!Hunter-Giordano!A,!Axe!MJ,!Snyder-Mackler!L.!Current!Concepts!for!Anterior!Cruciate!
Ligament!Reconstruction:!A!Criterion-Based!Rehabilitation!Progression,!J"Othop"Sp orts"P hy s"Th er.!2 01 2 ;!7:6 01 -
614.!
!
Angelozzi!et!al.!Rate!of!Force!Development!as!an!Adjunctive!Measurement!for!Return-to-Sport!Decisions!After!
Anterior!Cruciate!Ligament!Reconstruction.!J"Othop"Sports"Phys"Th er.!2012;!9:772-780.!
!
Beynnon!et!al.!Accelerated!Versus!Nonaccelerated!Rehabilitation!After!Anterior!Cruciate!Ligament!
Reconstruction:!A!prospective,!Randomized,!Double-Blind!Investigation!Evaluating!Knee!Joint!Laxity!Using!
Roentgen!Stereophotogrammetric!Analysis.!Am"J"Sports"Med.!2011;!12:2536 -2548.!
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Brumitt!et!al.!Lower!Extremity!Functional!Tests!and!Risk!of!Injury!in!Division!II!Collegiate!Athletes.!Inter"J"Sports"
Phys"Ther.!2013;!8(3):216-227.!
!
Christensen,!JC,!Goldfine,!LR,!West,!HS.!The!Effects!of!Early!Aggressive!Rehabilitation!on!Outcomes!After!
Anterior!Cruciate!Ligament!Reconstruction!Using!Autologous!Hamstring!Tendon:!A!Randomized!Clinical!Trial.!
Journal"of"Spo rts"R eh ab ilitation .!20 1 3;!2 2:1 91-201.!
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Cook,!Gray.!Movement:"Functional"Movement"Systems!(book).!2010;!ON!Ta rge t!Pub lica tion s. !
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Davies!GJ,!Zillmer!DA.!Functional!Progression!of!a!Patient!Through!a!Rehabilitation!Program.!Ortho"Phys"Ther"
Clin"N"Am.!2000;!9(2):103-117.!
!
Dunn!et!al.!Which!Preoperative!Factors,!Including!Bone!Bruise,!are!Associated!with!Knee!Pain/Symptoms!at!
Index!A n te r io r!C ru c ia te !Lig a ment!Rec o n s tru c tio n!(ACLR) ?!A !Multicen t er !O rt h o p a ed ic !O utcome s !N e tw ork!
(MOO N )!ACLR!Cohort!Study.!Am"J"Sports"Med.!2010;!9:1778-1787.!
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Eitzen!I,!Mosksnes!H,!Snyder-Mackler!L,!Risberg!MA.!A!Progressive!5-Week!Exercise!Therapy!Program!Leads!to!
Significant!Improvement!in!Knee!Function!Early!After!Anterior!Cruciate!Ligament!Injury,!J"Ortho"Sports"Phys "
Ther.!2010;!11:70 5 -721.!
!
Garrison!et!al.!The!Reliability!of!the!Vail!Sport!Test™!as!a!Measure!of!Physical!Performance!Following!Anterior!
Cruciate!Ligament!Reconstruction.!Inter"J"Sport s"P h y s"T h e r."2012;!7(1):20-30."
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Goulbourne,!Shaun.!Sports-Related!Injuries!in!the!Young!Athlete!(book!from!training!course).!2011;!Cross!
Country!Education,!LLC.!
!
Hewett!TE,!Stroupe!AL,!Noyes!FR.!Plyometric!Training!in!Female!Athletes.!Decreased!Impact!forces!and!
Increase d !H a mstring!T o rq u e s .!Am"J"Sports"Med.!1996;!2:765-773.!
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Lentz!et!al.!Return!to!Preinjury!Sports!Participation!Following!Anterior!Cruciate!Ligament!Reconstruction:!
Contributions!of!Demographic,!Knee!Impairments,!and!Self-Report!Measures.!J"Orthop"Sports"P hy s"Th er.!2 01 2 ;!
11:893-901.!
!
Myer!GD,!Paterno!MV,!Ford!KR,!Quatman!CE,!Hewett!TE.!Rehabilitation!After!Anterior!Cruciate!Ligament!
Reconstruction:!Criteria-Based!Progression!through!the!Return-to-Sport!Phase.!J"Orthop"Sports"Phys "Th er.!
2006;!6:385-402.!
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Narducci!E,!Waltz!A,!Gorski!K,!Leppla!L!Donaldson!M.!The!Clinical!Utility!of!Functional!Performance!Tests!
Within!One-Year!Post-ACL!Reconstruction:!A!Systematic!Review.!Inter"J"Sports"P h ys "T h er.!20 1 1;!4 :33 3 -342.!
!
Padua!et!al.!The!Landing!Error!Scoring!System!(LESS)!is!a!Valid!and!Reliable!Clinical!Assessment!Tool!of!Jump-
Landing!Biomechanics:!The!Jump-ACL!Study,!Am"J"Sports"Med.!2009;!10:1996-1002.!
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Paterno!et!al.!Biomechanical!Measures!During!Landing!and!Postural!Stability!Predict!Second!Anterior!Cruciate!
Ligament!Injury!After!Anterior!Cruciate!Ligament!Reconstruction!and!Return!to!Sport,!Am"J"Sports"Med.!2010;!
10:1968-1978.!
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Paterno!MV,!Rauh!MJ,!Schmitt!LC,!Ford!KR,!Hewett!TE.!Incidence!of!Contralateral!and!Ipsilateral!Anterior!
Cruciate!Ligament!(ACL)!injury!After!Primary!ACL!Reconstruction!and!Return!to!Sport.!Clin"J"Sport"Med.!2012;!2:!
116-121.!
!
Reiman,!Michael!P.,!Manske,!Robert!C.!Functional"Testing"in"Human"Performance:"139"tests"for"sport,"fitness,"
and"Occupational"Settings!(book).!2009.!Hum an !Kine tics. !
!
Ross!MD,!Langford!B,!Whelan!PJ.!Test-retest!Reliability!of!4!Sing le-Le g!Horizontal!Hop!Tests.!J"Stength"Con d"
Res.!2002;!4:617 -622.!
!
Schmitt!LC,!Paterno!MV,!Hewett!TE.!The!Impact!of!Quadriceps!Femoris!Strength!Asymmetry!on!Functional!
Performance!at!Return!to!Sport!Following!Anterior!Cruciate!Ligament!Reconstruction.!J"Orthop"Sports"Phy s"
Ther.!2012;!9:750 -759.!
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Spindler!et!al.!Prognosis!and!Predictors!of!ACL!Reconstructions!using!the!MOON!Cohort:!A!Model!for!
Comparative!Effectiveness!Studies.!J"Ortho"Res.!2013;!1:2-9.!
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Stearns!KM,!Pollard!CD.!Abnormal!Frontal!Plane!Knee!Mechanics!During!Sidestep!Cutting!in!Female!Soccer!
Athletes!After!Anterior!Cruciate!Ligament!Reconstruction!and!Return!to!Sport.!Am"J"Sports"Med.!2013;!4:918 -
923.!
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Van!Ginckel!A,!Vedonk!P,!Victor!J,!Witvrouw!E.!Cartilage!Status!in!Relation!to!Return!to!Sports!After!Anterior!
Cruciate!Ligament!Reconstruction.!Am"J"Sports"Med.!2013;!3:550-559.!
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Wilk!KE,!Macrina!LC,!Cain!EL,!Dugas!JR,!Andrews!JR.!Recent!Advances!in!the!Rehabilitation!of!Anterior!Cruciate!
Ligament!Injuries.!J"Othop"Sports"Phys"T he r.!20 12 ;!3:!1 53 -171.!
!
Yabroudi!MA,!Irrgang!JJ.!Rehabilitation!and!Return!to!Play!After!Anatomic!Anterior!Cruciate!Ligament!
Reconstruction.!Clin"Sports"Med.!2013!165-175.!
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