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. 2021 Dec;41(2):82–90.

Table 2.

Criterion Based Rehabilitation Progression Following Ultrasound Guided Tendon Debridement of the Lower Limb

Rehabilitation Phase Estimated Timeline† Special considerations Restrictions Goals Functional test to progress to next phase
1 0-2 weeks Early NWB pain free ROM encouraged starting day after procedure

  1. PWB on crutches x 7 days (knee/hip)

  2. WBAT in walking boot x 7 days (foot/ankle)

  3. May d/c crutches/boot when able to walk pain free without a limp

  4. Do not walk barefoot (foot/ankle)

  1. Control swelling

  2. Restore ROM

  3. Muscle activation

  1. Normal/symmetrical gait pattern (no assistive device)

  2. Pain free passive ROM (ankle dorsiflexion, hip and knee flexion)
2 2-6 weeks Pain < 3/10 with all activities

  1. No running, jumping, cutting, pivoting

  1. Neuromuscular control

  2. Proprioception

  3. Gentle muscular strength-ening

  1. Foot/Ankle: at least 1 unilateral SL heel raise through full ROM

  2. Knee/Hip: Single leg squat through partial ROM
3 6+ weeks N/A

  1. Monitor load progression‡

  1. Progressive strengthening

  2. Sport/region specific RTP preparation

  1. Lunge walk x 10 steps

  2. 5 push- ups (standard or knee supported)

  3. 10 single leg hops
4 12+ weeks Not applicable for all patients N/A

  1. Full unrestricted return to sport/work

  2. Transition to maintenance program (S&C, personal trainer, self-directed HEP)

  1. Specific to demands of sport/position

  2. Guided by AT and S&C staff

NWB, Non-weight-bearing; ROM, Range of motion; PWB, Partial weight-bearing; WBAT, Weight-bearing as tolerated; RTP Return to play; AT, Athletic trainer; S&C, Strength and conditioning; HEP, Home exercise program

† To be used as a general guide based on biologic tissue healing. This timeline does not consider the location and extent of diseased tissue as well as other intrinsic patient factors that may impact time to clinical healing.

‡ Basic load progression principles: Pain level <3/10 with activity. Any pain associated with the activity should not persist into the following day. If pain persists then load needs to be decreased.