Phase 1- Initial Rehabilitation (0-8 Weeks Post-op):

Goals:
  • Protection of the repaired tissue.
  • Restore ROM within guidelines.
  • Prevent muscular inhibition and gait abnormalities.
  • Diminish pain and inflammation.
Precautions:
  • Brace: T-scope hip.
  • Patients will be 25% weight-bearing for 6-weeks post-op.
  • Do not push through pain.
ROM Guidelines:
  • Full passive knee ROM. Hip flexion 0-45 flexion for 2 weeks, 0-90 at 4 weeks, as tolerated without pain after 4 weeks. Full abduction, extension, and rotation at 2 weeks post-op.
  • No AROM knee flexion and hip extension until 6 weeks post-op.
  • No hamstring stretches until 8 weeks post-op.
Initial Exercises (0-6 weeks post op):
  • Flexibility calf, quad, hip flexor, groin.
  • Ankle Pumps, gluteus sets, quad sets, pelvic tilts, heel slides, submaximal abduction and adduction isometrics, ankle strengthening, prone quad flexibility, active hip abduction progressing from supine to standing to sidelying.
6-8 weeks post op
  • Start active knee flexion in prone.
  • Start active hip extension in standing progressing to prone as tolerated.
  • Stationary bicycle no resistance.
  • Progress gait WBAT.

Phase 2 – Intermediate Rehabilitation (8-10 Weeks Post-op):

Goals:
  • Protection of the repaired tissue.
  • Restore full hip ROM.
  • Restore normal gait attern.
  • Progressive strengthening of hip, pelvis, and LE’s.
Precautions:
  • No forced (aggressive) stretching.
Phase 2: Intermediate Exercises
  • Discontinue T-scope hip brace.
  • Gait training FWB.
  • Start gentle hamstring flexibility.
  • Initiate supine SLR.
  • Begin light resisted knee flexion and hip extension.
  • Begin resisted knee extension.
  • Core strengthening.
  • Initiate closed chain strength and proprioception (i.e. wall squats, step ups, leg press, single leg balance, double leg balance board).

Phase 3 – Advanced Strengthening (10-12 Weeks post-op):

Criteria for progression to Phase 3:
  • Full ROM
  • Non antalgic gait pattern
Goals:
  • Restoration of full muscular strength and endurance.
Precautions:
  • No contact activities.
  • No forced (aggressive) stretching.
Phase 3: Exercises
  • Initiate dynamic flexibility.
  • Begin aerobic stepping.
  • Continue strength and proprioception .

Phase 4- High Impact Activity (12-16 Weeks post-op):

Criteria for progression to High Impact Training:
  • Successful completion of 12 week functional test.
Phase 4 Training
  • Initiate jogging.
  • Initiate double leg plyometrics uniplanar.
  • Initiate agility drills.
  • Continue strength and proprioception .

Phase 5- Return to Full Function (16-24 Weeks post-op):

Criteria for progression:
  • Successful completion of 16 week functional test.
Phase 5 Training
  • Sport specific drills.
  • Single leg plyometrics uniplanar.
  • Double leg plyometrics multiplanar.
  • Advanced agility drills.
  • Continue strength and proprioception.
Return to sporting activities is permissible when final functional testing is successfully completed. Similar to an ACL reconstruction, this will typically occur between 6 and 9 months.

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