2150 Stadium Dr. 2nd Floor 175 Inverness Drive West
Boulder, CO 80309 Englewood, CO 80112
303-315-9900 fax: 303-315-9902 303-694-3333 fax: 303-694-9666
Eric McCarty, M.D.
Updated February 2023
ACL and Meniscus Repair Rehabilitation Guidelines
Goals:
• Control pain and swelling
• Normal ROM with return to ADL’s
• Normal strength and proprioception
• Return to sports 5-6 months
Post op Time:
Exercise Progression
Initially
ROM
• Keep knee extended with leg on pillow under calf and ankle (not under
knee) for 10-15 min/ 4-6x/day
• Normal extension, day 1
Strength
• Quad sets (5-10/hr) / SLR (5/hr)
Control pain and swelling
Weight bearing
• PWB 0-3 weeks. If root repair, see below
Brace
• Brace can be unlocked up to 90°, needs to wear it at night
**If root repair, no weight bearing for 4 weeks. PWB from weeks 4-6 weeks.
Phase 1
Do all exercises 2x/day. Only advance in rehabilitation upon instruction from
the Sport medicine staff (MD, PT, or ATC)
Goals
ROM 0-90 (Increase ROM per MD orders)/ Full extension in 1 day
Establish and maintain good quad control (10 unassisted SLR, flexion)
Establish good hip strength (10 unassisted SLR all 4 ways)
Week 1
Weight bearing –
PWB with brace locked in extension
ROM - Flexion seated and prone to 90 deg.
Strength - Continue SLR x 4 and quad sets, T-band hip flex, add, abd
Treatment - Ice with elevation 15-20 min. with ankle pumps
Phase 2
Goals
Progress from partial to full weight bearing per MD (weeks 2-4)
ROM 0-100 deg. (Increase ROM per MD orders) (maintain 90 post. horn until wk 5)
Establish and maintain good quad control and hip strength
2150 Stadium Dr. 2nd Floor 175 Inverness Drive West
Boulder, CO 80309 Englewood, CO 80112
303-315-9900 fax: 303-315-9902 303-694-3333 fax: 303-694-9666
Eric McCarty, M.D.
Updated February 2023
Week 2-3
Weight bearing – 3
0% of your weight on crutches, progress with partial WB
ROM – flexion seated and prone to 90°, progress to 90° flexion seated
Strength – Continue SLR and quad sets (add) T-band plantarflexion 2x/20, TKE with T-band,
Treatment – Ice with elevation 15-20 minutes with ankle pumps
Brace – Open brace 0-90 while partial WB
Week 3
Weight bearing-
FWB only without a limp (sutures)
ROM- 100 deg. flexion seated and prone (per MD approval)
Strength - hamstring curls prone with cuff wt. or T-band 2 x 12, add seated calf raises 2 x 10
Proprioception- Balance on floor, one leg 2 x 30 sec.
Treatment- Ice with elevation 15-20 min. with ankle pumps
End of Phase
2 Goals
Progress from partial to full weight bearing per MD (weeks 2-4)
ROM 0-100 deg. (Increase ROM per MD orders)
Establish and maintain good quad control and hip strength
Phase 3
Goals
Progress to full weight bearing
Progress with more aggressive quad exercises
Advance in proprioceptive (balance) exercises
Restore full ROM
Discontinue brace as quad control allows and after they d/c crutches, around 5-6 weeks post
op
Week 4
Weight bearing
– Full WB
ROM - 100 deg. seated and prone (90 post. horn)
Strength - wall sits limited to 30 deg. of flex. 3 x 30 sec., standing calf raises 2 x 10
Treatment - Ice with elevation 15-20 min. with ankle pumps
Proprioception - Balance on floor 2 x 60 sec.
Brace – okay to unlock brace to 100 deg while WB
Week 5
ROM -
120 deg. seated and prone (90/ 110 post horn)
Strength - Add double leg mini squats 2 x 10
Proprioception - Balance on floor with ball- hand/ hand or around waist 3 x 60 sec
(Advanced) - Balance on uneven surface (per ATC or PT)
Treatment - Ice with elevation 15-20 min.
Brace- okay to unlock brace to 120 deg while WB
Week 6
ROM - 120 deg. to full, seated and prone (110/ 120 post. horn)
Strength - Step downs (short step) 2 x 10/ extension @ 90-45 if patient compliant
Proprioception - Balance on floor with ball toss 3 x 60 sec.
(Advanced) - Balance on uneven surface (per ATC or PT)
Treatment - Ice with elevation 15-20 min.
2150 Stadium Dr. 2nd Floor 175 Inverness Drive West
Boulder, CO 80309 Englewood, CO 80112
303-315-9900 fax: 303-315-9902 303-694-3333 fax: 303-694-9666
Eric McCarty, M.D.
Updated February 2023
End of Phase
3 Goals
Progress to FWB per MD (arrows)
Progress with more aggressive quad exercises
Advance in proprioceptive exercises
Restore full ROM
Phase 4
Goals
Full ROM and full quad/ hamstring strength
Pain free daily activities
Gradual return to activities/ linear running at week 12
Fully functional (able to perform all activities that did prior to surgery)
Week 7-8
ROM -
maintain full with heel slides/ quad stretching
Strength - Front and lateral step downs (higher step)
Proprioception - Balance on floor with ball toss 3 x 60 sec.
(Advanced) - Balance on uneven surface and move ball hand to hand/ jump and balance on
one foot (per ATC and PT only)
Activity specific - May begin walking program/ 10 min. 3 x (week 7)/ 15 min. 4 x (week 8)
Treatment - As needed with ice 15- 20 min.
Week 9-10
ROM -
maintain
Strength - Various double leg mini squats (stagger, ballet)/ Theraband walking, shuffle, week
10 may begin full extension with weight.
(Advanced) - Single leg mini squats/ double leg mini squats on uneven surface (per ATC or
PT)
Proprioception - Balance on floor and move ball hand to hand 3 x 60 sec.
(Advanced) - Balance on uneven surface and move ball hand to hand/ jump and balance on
one foot (per ATC and PT only)
Activity Specific - Continue walking program/ 20 min. 3 x (week 9)/ 25 min. 4 x (week 10),
can assess ligh jogging on treadmill, Alter-G, or pool
Treatment - As needed with ice 15 –20 min.
Week 11-12
Strength and proprioception -
continue
Activity specific - Continue walking program/ 30 min. 3 x (week 11)/ 35 min. 4 x (week 12)
and continue to progress per program.
(Advanced) - Begin running program- at 12 weeks. jog 5 min. 3 x week/ progress to 10 min.
as tolerate
Week 13
Per Dr. McCarty- Begin plyometric activities and side to side movements
Week 14
(Advanced) -
Continue running program- may begin light agility work week 12 (per
instruction from MD)
Week 15
Sport specific- non-contact per Dr. McCarty
Week 16-20
Full per Dr. McCarty
Review of
Goals
Full ROM (equal to opposite leg) and full quad/ hamstring strength (5/5 MMT)
Pain free daily activities
Gradual return to activities/ running by week 10-12 (per MD)
2150 Stadium Dr. 2nd Floor 175 Inverness Drive West
Boulder, CO 80309 Englewood, CO 80112
303-315-9900 fax: 303-315-9902 303-694-3333 fax: 303-694-9666
Eric McCarty, M.D.
Updated February 2023
Fully functional (able to perform all activities that did prior to surgery)
