PT Protocols

Knee Arthroscopy

Post-op Program:

POW 1-2

  1. Patellar Mobilizations
  2. Cryotherapy
  3. Quad sets
  4. SLR’s: supine
  5. May use e-stim to promote quad recruitment
  6. Progress ROM to full actively and passively
  7. Teach gait training
    1. Emphasize heel-toe, good quad isolation, normal knee flexion and push-off
  8. Start the following open chain exercises
    1. Side lying hip abduction and adduction
    2. Sitting hip flexion
    3. Ankle theraband
    4. Standing hamstring curls to tolerance
  9. Begin closed chain knee exercises
    ENCOURAGE PROPER TECHNIQUE AT ALL TIMES
    1. Single leg stance: level to unlevel surfaces
    2. Therakicks: progress resistance, speed, arc of motion
    3. Walking forward, retro, and sidestepping
    4. Standing calf raises, wobble board
    5. Wall slides
    6. Leg press
    7. Stationary bike
  10. Encourage upper extremity strengthening for overall conditioning
  11. Continue modalities

POW 2-4

  1. Continue as above
  2. 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
    1. Leg press
    2. Squats
    3. Lunges (front/side/back)
    4. Step-ups
    5. Leg curls
    6. Hip strengthening
    7. Resisted walking
  3. Exercises for balance and proprioception
      • Progress from local to whole body
    1. Mini-tramp
    2. Sport cord
    3. Slide board
    4. Swiss ball
  4. Exercises for endurance
    1. Bike
    2. Stairmaster
    3. Elliptical trainer
    4. Treadmill walking
    5. Aquatic exercise

POW 4-6

  1. Continue as above but slowly progress weight and decrease reps (8-10)
    1. Increase load
    2. Decrease time and increase power
  2. Progress walking to a fast walk then walk/jog on treadmill
    1. High knee march
    2. Figure of “8”
  3. Begin jumping rope.
    1. Shuttle

POW 6-return to sport

  1. Progress jump roping to line jumps, then box jumps, and then distance jumps
  2. Begin sport specific drills
  3. Progress speed and intensity of above activities

Return to Athletics Criteria

  1. Satisfactory clinical exam
  2. <10% isokinetic strength deficit (Leg Press)
  3. Completion of sport replication activity
  4. Single leg hop test