Early NWB pain free ROM encouraged starting day after procedure
Restrictions:
Patellar Tendon:
Week 1 0-30°
Week 2 0-60°
PWB on crutches x 7 days (knee/hip)
WBAT in walking boot x 7 days (foot/ankle)
May d/c crutches/boot when able to walk pain free without a limp
Do not walk barefoot (foot/ankle)
Goals
Control swelling
Restore ROM
Muscle activation
Functional test to progress to the next phase:
Normal/symmetric gait pattern (no assistive device)
Pain free passive ROM (ankle dorsiflexion/knee and hip flexion)
Phase 2: 2-6 Weeks
Special Considerations:
Pain < 3/10 with all activities
Restrictions:
Patellar Tendon:
Week 3 0-90°
No running, jumping, cutting, pivoting
Goals
Neuromuscular control
Proprioception
Gentle muscular strengthening
Functional test to progress to the next phase:
Foot/Ankle: at least 1 unilateral SL heel raise through full ROM
Knee/Hip: Single leg squat through partial ROM
Phase 3: 6-12 Weeks
Special Considerations:
None
Restrictions:
Monitor load progression (as discussed at the end of the protocol)
Goals
Progressive strengthening
Sport/region specific RTP preparation
Functional test to progress to the next phase:
Lunge walk x 10 steps
Pain free jogging prior to formal return to run progression
10 single leg hops
Phase 4: 12+ Weeks
Special Considerations:
Not applicable for all patients
Restrictions:
Monitor load progression (as discussed at the end of the protocol)
Goals
Full unrestricted return to sport/work
Transition to maintenance program (S&C, personal trainer, self-directed HEP)
Functional test to progress to the next phase:
Specific to demands of sport/position
Guided by AT and S&C staff
To be used as a general guide based on biologic tissue healing. This timeline does not consider the location and extent of diseased tissue as well as other intrinsic patient factors that may impact time to clinical healing.
Basic load progression principles: Pain level < 3/10 with activity. Any pain associated with the activity should not persist into the following day. If pain persists then the load needs to be decreased
