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.
