ACL Reconstruction NoHip Strengthening Rehabilitation Program

Exercises should be gradually progressed based upon the patient's ability to perform correctly and without an increase in pain.

Phase 1 (0 to 4 weeks) ‐

Goals: Control of pain and swelling

Restoration of Patellar Mobility

Emphasis on full extension

Increased quadriceps isometric strength

Normalized gait/Weight Shifting

Specific Exercises:

Patellar Mobilizations (superior‐inferior‐medial‐lateral; anterior interval, suprapatellar pouch)

Quad Sets (with NM E‐stim) – if patient is unable to perform a straight leg raise without an extension lag

*initiated during 1st week and continued through 4 weeks if necessary

Heel slides

Gastrocnemius Stretch

Isometric hamstring contractions

Straight leg raise (SLR) – hip flexion

Dynamic Warm‐up

Short Arc Quads (SAQ) – range of 90° to 40°

Mini‐Squats – range of 0°to 30°

Weight shifts (body weight) – progress to single leg balance

Double Leg Dead Lift (shortened range of motion with gradual progression)

Bilateral Shuttle Leg Press

NOTE: Prior to progressing into Phase 2: Full knee range of motion Minimal complaints of pain and swelling in the involved knee Complete 3 sets of 20 repetitions of a straight leg raise with no extension lag Perform single leg balance of the involved limb on a solid surface for 1 minute.

Phase 2 (5 to 12 weeks) ‐

Goals: Improving single leg strength and neuromuscular control

Developing strength and stability in all planes of motion and under various proprioceptive conditions

Maximizing cardiovascular fitness and muscle endurance

Specific Exercises:

increase repetitions/weight of Phase 1 exercises, plus:

Single Leg Dead Lift (Progression: Sagittal → Transverse)

Shuttle (Progression: Bilateral → Unilateral → Bilateral Jumps → Unilateral Jumps)

Lunge (Progression: Forward → Backward → Lateral → Transverse)

Balance Board (Progression: Sagittal → Frontal → UE manipulation w/ balance board)

Step‐ups (Progression: Sagittal → Frontal → Transverse → UE manipulation with step‐ups)

BW double/single leg squats (progress depth and resistance with sport cord as hip/knee control improves)

Forward + Backward Jogging/Lateral agility (Progression: no weight → green sport cord → black sport cord)

*Must demonstrate shuttle jump control prior to F/B jogging/lateral agility activities

*Participants are allowed to begin hip strengthening exercises (below) after 8 weeks of rehabilitation.

Sidelying Hip Abduction *

Prone Hip Extension *

Clam Shells *

Double leg Bridges *

Single leg bridges *

Quadruped Arm/LE lift *

Side Bridge (Plank) *

Standing Hip Abductions *