PT Protocols
Quad Tendon Repair
Post-op Program:
POD 1
- Ankle pumps: 20-25 per hour
- Strict NWB. Brace locked in extension at all times unless performing exercises.
- Gait with crutches
- Patellar mobilizations
- Polar care/ cryotherapy
- Dressing change
- Quad sets in brace
POW 1-6
- Continue as above
- Start SLR’s: start standing, then sitting, then supine in brace
- May use e-stim to promote quad recruitment
- Encourage full extension
- Progress ROM 10 deg per week beginning week 4 to achieve 90 deg by 8 weeks
- Gait training with assistive device
- Begin WBAT with brace locked in extension at 4 weeks
- Start the following open chain exercises
- Side lying hip abduction and adduction
- Sitting hip flexion
- Ankle theraband
- Encourage upper extremity strengthening for overall conditioning
POW 6-12
- Continue as above
- Be sure to advance knee to full ROM starting at 8 weeks
- Unlock brace at 8 weeks to ambulate
- D/C brace at 10 weeks
- Aquatic therapy may start at 8 weeks for LE strengthening
- Stationary bike with low resistance and seat up high to avoid hyperflexion
- Standing terminal knee extension with theraband.
- May increase resistance on stationary bike at 10 week
POW 12-16
- Begin closed chain knee exercises
ENCOURAGE PROPER TECHNIQUE AT ALL TIMES.- Single leg stance: level to unlevel surfaces
- Therakicks: progress resistance, speed, arc of motion
- Walking forward, retro, and sidestepping
- Standing calf raises, wobble board
- Wall slides
- Leg press with very light weights at 12 weeks
- Stationary bike
- Jog Progression
- Fast walk
- High knee march
- Figure 8
- 4 way reaction drill
- Jog
- Continue modalities
- Encourage upper extremity strengthening for overall conditioning
POW 16-20
- Continue as above
- Progress exercises for building strength and endurance
- 4-6 sets of 15-20 reps
- Progress from double to single leg and concentric to eccentric
- Emphasis on closed chain activities only
- Squats, leg press
- Lunges (front/side/back)
- Step-ups
- Leg curls
- Hip strengthening
- Resisted walking
- Exercises for balance and proprioception
- Progress from local to whole body
- Mini-tramp
- Sport cord
- Slide board
- Swiss ball
- Exercises for endurance
- Bike
- Stairmaster
- Elliptical trainer
- Treadmill walking
- e. Aquatic exercise
POW 20: Return to sport
- Progress jump roping to line jumps, then box jumps, and then distance jumps
- Begin sport specific drills
- Progress speed and intensity of above activities
Return to Athletics Criteria
- Satisfactory clinical exam
- <10% isokinetic strength deficit (Leg Press)
- Completion of sport replication activity
- Single leg hop test