Straight leg raises: Lying supine, lifting leg off bed, hold for 2 sec and lower leg
Inner range quads (IRQ): Have a rolled up towel/pillow under knee, straighten knee and lift foot off bed, hold for 3 sec and repeat 4×15
Heel slides: slide heel up the bed, gently bending knee, hold and slide back down
Towel squeezes: have a rolled up towel under knee, push knee down into the towel, hold for 3 sec and release. Repeat 5×10 times. Place hand on thigh and ensure your muscles tighten adequately each time
Phase 2: (3 – 6 weeks)
Goals:
Maintain functional gait status
Reduce swelling and effusion
Decreasing pain levels
Guidelines:
Sitting: Increasing heel slides ROM, with a 2 sec hold at flexion and over pressure from uninvolved leg. Place a plastic bag under foot, so you can slide heel with ease.
Standing: Gentle calf and hamstring stretching
Mini squat holds: E.g. lean against wall with a small bend in knees, hold position, feeling tension in quadriceps muscle. 4x30sec holds
Proprioception: Balance on involved leg on firm surface. Aim for 4×30 sec holds
Hip abduction and extension: Standing with involved leg lifted out sideways, hold and return to midline (4×20). Standing with involved leg lifted backwards, hold and return (4×20)
Manual Therapy: Patellar mobilisations and soft tissue therapy (quadriceps, calf and hamstrings)
Lying: Bridging. Double leg, slow and controlled then progress to single leg as tolerated
Hamstring curls in prone. E.g. lying on stomach, lift heel off bed, bend knee to 90 degrees and slowly straighten. Progress to small ankle weight E.g. 5×10
Phase 3: (7 – 12 weeks)
Goals:
Scar management
Reduction in swelling
Normalised gait
Guidelines:
Progress mini squats. Increasing time and small pulses.
Bridging: Single leg bridges, small dips, hover and return. 4×8-12
Lateral stepping (using varied surfaces)
Backwards strides: focusing on deceleration
Stationary bike: low resistance
Proprioception: unstable/soft surface
Manual therapy: Soft tissue work
Phase 4: (13+ weeks)
Goals:
Gradual return to functional status
Scar management
Minimal to no pain in activity
No swelling
Guidelines:
Increase walking, varying surfaces and hills etc
Stationary bike: progress resistance
Gentle gym workouts: E.g. rowing machine, gentle leg press 0-60 degrees, etc.
Gradual return to sport
Regular stretching (gastrocs, soleus, hamstrings and quadriceps)