ACL Reconstruction Rehabilitation Program - Gundersen Health ...
ACL Reconstruction Rehabilitation Program - Gundersen Health ...
ACL Reconstruction Rehabilitation Program - Gundersen Health ...
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Treatment<br />
Recommendations<br />
• Active warm-up: Bike, Elliptical Runner, Nu Step, Treadmill walking<br />
• Continue with stretching and flexibility exercises as needed<br />
• Strengthening and endurance exercises: Advance as tolerated with emphasis<br />
on functional strengthening. Avoid dynamic valgus during strengthening and<br />
functional activities.<br />
Total leg strengthening<br />
Hip strengthening<br />
Heel raises<br />
Hamstring full ROM isotonics<br />
Quadriceps isotonics 30-90 if minimal chondrosis<br />
CKC exercises: Leg press, multiple direction lunges and step-ups, squats,<br />
sideshuffle with T-band<br />
Gastroc soleus exercise<br />
Isokinetic quadriceps/hamstrings 30-90 if minimal chondrosis<br />
Stairmaster, Euroglide<br />
• Dynamic balance exercises<br />
• CV conditioning and core stability<br />
• Ice<br />
Testing • wk 12 (3 months): Linea, Biodex 30-90 deg at 180 and 300 deg/sec, KT 1000<br />
• wk 16 (4 months): Linea, Biodex, 30-90 deg at 90, 180, 300 deg/sec, KT 1000<br />
• wk 20-24 (5-6 months): Linea, Biodex 0-90 deg at 60 or 90, 180, 300 deg/sec,<br />
KT 1000, Functional testing<br />
Return to sport /<br />
work guidelines<br />
• wk 12 (3 months): Return to running program if MD clearance, no pain or<br />
effusion, strength scores on Linea of 75%<br />
• wk 16 (4 months): Plyometrics, agility drills, pivoting and cutting maneuvers<br />
• wk 20-24 (5-6 months): Return back to sports based on MD approval, minimal<br />
pain at rest or with activity, no knee joint effusion, full pain-free ROM, isokinetic<br />
strength and functional testing at 90 % compared to uninvolved side, good<br />
performance on functional testing (90% compared to normative data or<br />
contralateral extremity) and adequate performance on sport-specific drills<br />
<strong>ACL</strong> <strong>Reconstruction</strong> <strong>Program</strong> References<br />
Accelerated <strong>Rehabilitation</strong> Following <strong>ACL</strong> <strong>Reconstruction</strong> using Ipsilateral Patellar Tendon Graft<br />
Protocol printed from SportsMedRx.com, 2003<br />
Beynnon BD, Johnson RJ. Anterior cruciate ligament injury rehabilitation in athletes. Biomechanical<br />
considerations. Sports Medicine, 1996; 22(1): 54-64<br />
Brandsson S, Faxen E, Kartus J, et al. A prospective four to seven year follow-up after arthroscopic<br />
anterior cruciate ligament reconstruction. Scand J of Med and Science in Sports, 2001; 11(1):<br />
23-27<br />
Davies GJ, Heiderscheit B, Clark M. Open kinetic chain assessment and rehabilitation. Athletic Training:<br />
Sports health care perspectives, 1995; 1(4): 347-370<br />
Davies GJ, Zillmer DA: Functional progression of exercise during rehabilitation in Knee Ligament<br />
<strong>Rehabilitation</strong>, Ellenbecker, 2000; 345-360<br />
Delay BS, Smolinski R, Wind WM, Bowman DS. Current practices and opinions in <strong>ACL</strong> reconstruction<br />
and rehabilitation: Results of a survey of the American Orthopaedic Society for Sports
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