Anterior Cruciate Ligament Rehabilitation Protocol

Stage I: 0 to 2 Weeks
Goals
   Full knee extension ROM
   90-degree knee flexion ROM
   Good QS
   Emphasize normal gait pattern
Assisted Weight Bearing 50% to 75% with crutches progressing to Weight Bearing as
Tolerated
Stage II: 2 to 4 Weeks
Goals
   Knee ROM 0 to 120 degrees
   Full Weight Bearing without crutches, no limp
Stage III: 4 to 6 Weeks
   Progress to full ROM by 6 weeks
   Stairmaster (forward and backward)
   Aquatic exercises
Stage IV: 8 to 10 Weeks
   Slow-form running with sport cord (forward and backward)
Isokinetic quadriceps work at different speeds (60, 90, 120 degrees
  
per second)
   Begin lunges
Stage V: 12 to 16 Weeks
   Knee extension machine with low weight/high repetitions
   Lateral sport cord drills (slow, controlled)
   Progress isokinetic quadriceps to full extension by 16 weeks
Stage VI: 16 to 18 Weeks
Begin plyometric program with shuttle, minitrampoline, jump rope if quadriceps strength 65%,
  
no effusion, full ROM, stable knee
   Begin jogging program if quadriceps strength is 65%
Stage VII: 5 to 6 Months
   Agility training
   Sport-specific drills (e.g., carioca, 45 cutting, figure-of-eight)
   Retest quadriceps if necessary
Stage VIII: 6 Months
Return to sport if:
   Motion >130 degrees
   Hamstrings >90%
   Quadriceps >85%
   Sport-specific agility training completed
   Maintenance exercises 2 to 3 times per week
QS, quadriceps setting; ROM, range of motion
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