Associate professor of orthopaedics chief division of sports medicine tel. This protocol is intended to provide the user with instruction, direction, rehabilitative guidelines and functional goals. Medial collateral ligament mcl rehabilitation protocol. Rehabilitation guidelines for knee multiligament repair. Lateral or outer view of the knee showing the lateral collateral ligament. Easy stationary bike for range of motion roms, quads, straight leg raises slrs, calf raises. It is by no means intended to be a substitute for ones clinical decision. It is to be used when up and moving around and not needed for controlled exercises or sleeping.
Rehabilitation after injury to the medial collateral ligament. Feb, 20 4010 west 65th street edina, mn 55435 phone. Active assisted knee flexion goal is try to increase 10. The following exercises are often included in my rehabilitation programs. Knee mcl repairreconstruction rehab protocol prescription patient name. Acl rehabilitation protocol updated june 2018 associate professor leo pinczewski m bbs, fracs associate professor justin roe mbbs, fracs dr matthew lyons mbbs, fracs dr benjamin. Acl rehabilitation protocol updated june 2018 associate professor leo pinczewski m bbs, fracs associate professor justin roe mbbs, fracs dr matthew lyons mbbs, fracs dr benjamin gooden mbbs, fracs dr lucy salmon b appscphty, phd emma heath m pthy, bappsc nor th sydney or thopaedic research group.
Patients will use a hinged brace locked in full extension for 4 weeks postop. This protocol was designed to provide the rehabilitation professional with a guideline of postoperative care. Mcl sprain rehabilitation protocol medial knee ligament. This blog aims to provide a succinct overview of the rehabilitation of mcl injuries, with the approach i use to return an individual to full function. Torn medial collateral ligaments rarely need surgery. Mcl nonoperative treatment grade i, ii, iii isolated mcl. Knee rehabilitation exercises to ensure that this program is safe and effective for you, it should be performed under your doctors supervision. Use of this image without authorization from primal pictures, ltd.
Rehabilitation protocol anterior cruciate ligament hamstring rehabilitation protocol based on the fowler kennedy sports medicine clinic acl rehab guidelines preoperative rehabilitation prior. All mcl sprains should include a continuous improvement protocol following the completion of any program. Exercises in rom guidelines to allow healing of mcl. The first six weeks after injury grade 2 and 3 three weeks after injury grade 1 the knee should be protected with a short. Rehabilitation protocol for acl reconstruction this protocol is intended to guide clinicians and patients through the postoperative course of an acl reconstruction. With a proper mcl injury rehabilitation protocol, even a complete mcl tear should completely heal. The anatomy of the medial knee has been divided into 3 layers, consisting of the deep fascia of the thigh. Do not ever do slr for hip adduction as this puts tremendous stress on the repaired mcl do not do any closed chain knee rehab exercises until at least 6 weeks postop which is when patient is allowed wbat stationary bicycle when md protocol allows at least 105 degrees and patient has no pinching with end range flexion.
Medial collateral ligament injury of the knee physiopedia. While you are recovering from your injury, you will need to change your. Posterior cruciate ligament rehabilitation protocol it is important to understand that all time frames are approximate and that progressions should be based on individual monitoring. Acl reconstruction rehab protocol general guidelines brace will remain locked until patient demonstrates good quadriceps control two to four weeks with weight bearing activities. The exercises may be suggested for a condition or for rehabilitation.
Mcl injury rehabilitation considerations the prehab guys. It is designed for rehabilitation following a pcl injurytear, typically grade i and ii. The first six weeks after injury grade 2 and 3 three weeks after injury grade 1 the knee should be to be protected with a hinged brace for 3 to 6 weeks, depending upon the severity of the injury. Full extension is obtained by doing the following exercises. A medial collateral ligament mcl injury is a stretch, partial tear, or complete tear of the ligament on the inside of the knee. To ensure that this program is safe and effective for you, it should be performed under your doctors supervision. Normally patients will be wearing postop knee brace locked in 30 degrees for ambulation and sleeping but droplocked for sitting and knee. This protocol is intended to provide a general guideline to treating an mcl sprain. Normally patients will be wearing postop knee brace locked in 30 degrees for ambulation and sleeping but droplocked for sitting and knee rom. No resisted knee flexion exercises for 4 weeks postop. Hold for one second, then lower slowly to the starting position. Mcl grade iii sprain rehabilitation program the gundersen. The rehabilitation protocol for a mild medial ligament sprain can be split into 4 phases.
Rehabilitation protocol anterior cruciate ligament hamstring rehabilitation protocol based on the fowler kennedy sports medicine clinic acl rehab guidelines preoperative rehabilitation prior rehabilitation is essential for improved outcomes following anterior cruciate ligament acl reconstruction surgery. Patient will wear immobilizer for 2 weeks following injury, except in p. Injuries to the medial collateral ligament mcl are very common. Phase 1 begins immediately following injury and usually lasts 1 week. Range of motion and strengthening exercises brace off. Acl reconstruction rehabilitation protocol 4 control pain and swelling crushed ice or an aircast knee cryocuff along with nonsteroidal antiinflammatory medications such as advil, nuprin, motrin. Patients are weight bearing as tolerated with crutch use as needed postoperatively. Return to certain activities and sports will depend on how stressful the activity is on your knee as well.
Pcl reconstruction protocol brigham and womens hospital. Anterior cruciate ligament hamstring rehabilitation protocol. Mcl nonoperative treatment grade i, ii, iii isolated mcl sprain rehabilitation guidelines note. The above program may be accelerated for first degree mcl sprains or may be extended depending on. Rehabilitation guidelines for knee multiligament repair uw health.
Posterior cruciate ligament pcl reconstruction rehabilitation protocol the following is a protocol for postoperative patients following pcl reconstruction. Acl reconstruction postoperative protocol rosenberg cooley. Sep 27, 2014 medial collateral ligament injuries occur following a traumatic valgus force, often while the knee is slightly flexed. Posterior cruciate ligament rehabilitation protocol.
It is important to appreciate the femoral insertion of the super. Early emphasis should be placed on achieving full passive terminal extension equal to the opposite side. Acl reconstruction postoperative protocol rosenberg. Rehabilitation after injury to the medial collateral ligament of the. Mcl knee sprain grade iii adopted 298, revised 204, revised 109 1 general principles.
Patients will wear the brace for 6 weeks and then they will be fitted with a functional hinged knee brace. Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. It is by no means in tended to be a substitute for ones clinical decision making regarding the progression of a. Early activity following pcl repair can lead to increased laxity. Quadriceps isometrics exercises, straight leg raises, and range of motion exercises should be started immediately. No open chain hamstring strengthening or isolated hamstring exercises. The mcl, unlike other ligaments like the anterior cruciate ligament acl, has a great blood supply. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. The anatomy of the medial knee has been divided into 3 layers, consisting of the deep fascia of the thigh, the superficial medial collateral ligament mcl and the deep mcl and posteriomedial joint capsule1. Nonoperative mcl tear rehabilitation protocol the intent of this protocol is to provide the clinician with a guideline for a nonoperative rehabilitation course of a patient with an isolated medial cruciate ligament injury. Progress should be modified on an individual basis. Talk to your doctor or physical therapist about which. Medial collateral ligament mcl reconstruction repair postop rehabilitation protocol the following is a protocol for postoperative patients following acl reconstruction.
The following schedule serves as guidelines to help in the expediency of returning a patient to his or her preinjury state. Stand facing a table, hands on the table for support and balance. Rehabilitation after injury to the medial collateral ligament of the knee phase 1. This is a state of common practices following a rehab protocol aimed.
Medial collateral ligament mcl rehabilitation protocol weeks postinjury 12 weeks initiate physical therapy. The primary goal of this protocol is to protect the reconstruction while steadily progressing towards and ultimately achieving preinjury level of activity. Early passive rom exercises are very important, as is preventing excessive anterior andor posterior tibia translation. If there is any increase in pain or swelling or loss of rom, these can serve as. Return to certain activities and sports will depend on how stressful the activity is on your knee as well as strength, balance, and movement control. The first six weeks after injury grade 2 and 3 three weeks after injury grade 1 the knee should be to be protected with a. Return to high demand sports such as basketball and soccer is approximately six months. Pcl non operative rehabilitation guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Acl reconstruction rehabilitation protocol 4 control pain and swelling crushed ice or an aircast knee cryocuff along with nonsteroidal antiinflammatory medications such as advil, nuprin, motrin, ibuprofen, aleve 2 tablets twice a day are used to help control pain and swelling. Do not do any closed chain knee rehab exercises until at least 6 weeks postop. Acl reconstruction rehabilitation protocol 4 restore normal range of motion you should attempt to achieve full range of motion as quickly as possible. If you have a grade 1 mcl sprain, you may have mild tenderness on the inside of the knee over the ligament.
Multiple ligament knee injuries acl r and mcl repair clinical practice guideline progression is time and criterionbased, dependent on soft tissue healing, patient demographics and. Open anatomic reconstruction of the medial collateral. Tighten the quadriceps to hold the knee fully straight. Medial or inner view of the knee showing the medial collateral ligament, b. The intent of this protocol is to provide the clinician with a guideline for a nonoperative rehabilitation course of a patient with an isolated medial cruciate ligament injury. Physiotherapy following acl reconstruction protocol rehabilitation following anterior cruciate ligament reconstruction aclr is an essential part of a full recovery. The above program may be accelerated for first degree mcl sprains or may be extended depending on the severity of the injury. Mcl sprain rehabilitation protocol medial knee ligament sprain. The first six weeks after injury grade 2 and 3 three weeks after injury grade 1 the knee should be protected with a shorthinged brace for 3 to 6 weeks, depending upon the severity of the injury.