ACL HAMSTRING AUTOGRAFT RECONSTRUCTION GUIDELINES
The information below is meant as a guideline only. The professional skills of a therapist must come into play for each individual patient.
Dr. Ben Robinson
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 **
ROM
As tolerated
EXERCISES
Heel slides, quad and hamstring sets, patellar mobs, gastroc and soleus stretch
SLR with brace in full extension until quad strength prevents extension lag
PHASE TWO
4-12 WEEKS
WEIGHT BEARING
Full
Progressing to a normal gait pattern
BRACE
Discontinue at day 28 if patient has no extension lag
ROM
Maintain full extension and progressive flexion
EXERCISES
Progress Phase One: Begin toe raises, closed chain quads, balance exercises, hamstring curls, stationary bike, step-ups, front and side planks, hip, glute, core, and pool.
PHASE THREE
12-16 WEEKS
WEIGHT BEARING
Full
Without the use of crutches and with a normalized gait pattern
BRACE
None
ROM
Gain Full + pain-free
EXERCISES
Advance closed chain strengthening, progress proprioception activities
Begin stair-master, elliptical and running straight ahead
PHASE FOUR
16-24 WEEKS
WEIGHT BEARING
Full
BRACE
None
ROM
Full + pain-free
EXERCISES
16 weeks: Begin jumping
20 weeks: Advance running to sprinting, backward running, cutting, pivoting, and changing direction.
Initiate plyometric program and sport-specific drills
22 weeks: Advance as tolerated FSA completed at 22 weeks ***
PHASE FIVE
> 6 MONTHS
WEIGHT BEARING
Full
Begin toe raises, closed chain quads, balance exercises, hamstring curls, stationary bike, step-ups, front and side planks, hip, glute, core and pool
BRACE
None
ROM
Full + pain-free
EXERCISES
Gradual return to sports participation after completion of FSA
Maintenance program based on FSA
