Therapy West Physical Therapy

ACL Hamstring Autograft Reconstruction

ACL Hamstring Autograft Reconstruction

The information below is meant as a guideline only. The professional skills of a therapist must come into play for each individual patient.

Protocols of…

Dr. Chris Evensen

ACL Hamstring Autograft Reconstruction
  • PHASE ONE

    0-4 WEEKS

    WEIGHT BEARING

    As tolerated with crutches*

    BRACE

    0-1 week: Locked in full extension for ambulation and sleeping

    1-4 weeks: Unlocked for ambulation, remove for sleeping**

    RANGE OF MOTION

    As tolerated

    EXERCISES

    Heel slides, quad/hamstring sets, patellar mobs, gastroc/soleus stretch

    SLR w/ brace in full extension until quad strength prevents extension lag

  • PHASE TWO

    4-12 WEEKS

    WEIGHT BEARING

    Full, progressing to normal gait pattern

    BRACE

    Discontinue at day 28 if patient has no extension lag

    RANGE OF MOTION

    Maintain full extension and progressive flexion

    EXERCISES

    Progress Phase I

    Begin toe raises, closed chain quads, balance exercises, hamstring curls, stationary bike, step-ups, front and side planks, hip/glute/core, pool

  • PHASE THREE

    12-16 WEEKS

    WEIGHT BEARING

    Full, without use of crutches and with a normalized gait pattern

    BRACE

    None

    RANGE OF MOTION

    Gain full and pain-free

    EXERCISES

    Advance closed chain strengthening, progress proprioception activities

    Begin stairmaster, elliptical

  • PHASE FOUR

    16-24 WEEKS

    WEIGHT BEARING

    Full

    BRACE

    None

    RANGE OF MOTION

    Full and pain-free

    EXERCISES

    16 wks: Begin jumping and running in straight line

    24 wks: Advance running to sprinting, backward running, cutting/pivoting/changing direction, initiate plyometric program and sport-specific drills

  • PHASE FIVE

    > 6 MONTHS

    WEIGHT BEARING

    Full

    BRACE

    None

    RANGE OF MOTION

    Full and pain-free.

    EXERCISES

    Gradual return to sports participation after completion of FSA***

    Maintenance program based on FSA