MPFL Rehab
Weeks 0-6
- Follow brace recommendations as per MD
- Progress from WBAT using brace/crutches to FWB
- Control swelling
- Protect fixation
- Regain quad control
- Minimize stiffness at knee joint and quickly notify physician if patient is not progressing appropriately
Phase I Weeks 1-3
- Flexibility/ROM
I. Gastroc/soleus stretches
2. Gentle hamstring stretches
3. Ankle pumps
4. Heel slides
5. Manual therapy
6. Teach patient patellar mobilization avoiding lateral glide
- Strength
I. Isometrics @ O deg, 45 deg, and 90 deg
2. 4 point: SLR w/ ERF Hip Abd w/ ER, Hip add, Hip ext(Use brace if patient has poor quad control)
3. Resisted ankle 4 way
4. Weight shifts
5. UBE
6. Upper body training
- Modalities
- Biofeedback to help with quad achieve quad control
- Ice.
Phase II weeks 4-6
- Flexibility/ROM
1. ITB stretching
2. Hip flexor stretching
3. Scar tissue mobilization
- Strength
I. Standing hip 4 way w/ light resistance
2. Leg press(NO flex>45 deg)
3. Total gym/Mini squats/Wall squats(NO flex >45 deg)
4. TKE in standing
5. Prone hamstring cur’s/carpet drags/roliing stool
6. Step ups
7. Heel raises
8. SAQ as tolerated
9. Core strengthening (i.e. planks, side planks, bridging, SL bridging, clamshells, etc.
- Cardiovascular
1. Stationary bike (begin w/ partial revolutions)
2. Treadmill walking (Fwd, retro)
3. Pool jogging (once incisions have fully healed)
- Proprioception
1. Wt. shifts progressing to single limb stance
2. Double leg BAPS progressing to single leg
3. SIS w/ foam, Star drill, ball toss on trampoline
- Modalities
- Russian/NMES
Phase III Weeks 7-12
- Flexibility/ROM
- Continue previous exercises to reach full knee AROM
- Strength
I. Fwd, lateral, retro, quad eccentric step downs
2. Fwd lunge/side lunge
3. Weight machine for leg extension/leg curl/hip 4 way
4. BOSU/balance board squats
5. Single leg calf raises
- Cardiovascular
I. Stairmaster
2. Pool running
- Proprioception
- SIS on BOSU/balance board
Phase IV Weeks 3 – 6 months / Progress to sport
- Running progression(no running back to back days) – 3 months
1. Treadmill: Walk/jog intervals
2. Treadmill: Running
3. Track: Run straight/walk turns
4. Track: Running laps
5. Road running
- Agility drills – 4 months
I. Ladders
2. Fwd, backward, side to side shuttle sprints
3. Stop and go
4. Lateral shuffles
5. Cutting/pivoting
6. Carioca
- Jumping – 5 months
1. Box jumps
2. Fwd, backward, side-side jumping
3. Drop vertical jump
4. Single limb hop for distance
5. Single leg triple hop
6. Single leg cross over hop