PCL & PLC Rehab
Goals
Prevention of posterior tibia translation through the entire rehabilitation program is paramount.
Full knee ROM – all ROM exercise must be performed in the prone or side lying position for the first month
(4-5 weeks)
50% WB in Brace and crutches for 4-6 weeks
Pain/Edema reduction
Begin and Enhance normalization of quad recruitment
Prevent posterior translation and tibia rotation
0-4 Weeks post op
Modalities as needed
Brace locked at 0° for the first two weeks at all times except for passive ROM exercise by ATC or PT for the first month
Advance brace from 0 -90° after week 2 if tolerated
Teach patient to perform ROM Stretching Exercise 2-3x’s daily
ROM Ex’s:
In prone position or side lying only, grip the heads of the gastroc/soleus group and maintain anterior pressure proximally to the tibia while flexing the knee
Advance ROM as tolerated
Begin patella mobilizations
Scar management
Quad sets/SLR in Brace at 0° (Assist patient with this exercise until solid quad contraction developed, prevent posterior sag)
No hamstring isometrics for 8 weeks
Seated calf ex’s
Teach Quad ex’s for home program
Stationary Bike to increase ROM, start with high seat and progress to normal height when able, resistance as tolerated
4 weeks post op
Cont. as above
Leg extensions
Leg press with both legs
6 weeks post op
Cont. as above
May begin aquatic therapy emphasizing normal gait, marching forwards/ backwards
Begin weaning off crutches, D/C brace and normalize gait mechanics
Full WB as tolerated
ROM – prone flexion 120° or more, and advance to full ASAP
Treadmill walking – forwards and retro
Closed and Open Chain Tubing ex’s
Single leg stands for balance/ proprioception
Unilateral step – ups start with 2’’ height and progress to normal step height as able
Chair/ Wall squats-keep tibia perpendicular to floor
12 weeks post op
Cont. as above
Advance hamstring strengthening into prone position
Slide Board – start with short distance and progress as tolerated
Stairmaster
Versa Climber
Nordic Track
Elliptical Trainers
Assessment of jogging on treadmill
Lateral Movement supervised by ATC or PT
Stepping, shuffling, hopping, carioca
20 weeks post op
Cont. as above
Plyometrics- low intensity vertical and lateral hopping to begin with, use both feet and move to one foot ASAP
Volume of plyometrics (this is not conditioning exercise but a strengthening one) for rehabilitation
40-60 foot contacts/sessions for beginners
60-80 foot contacts /sessions for intermediate
80-100+ foot contacts /sessions for advanced
If Plyometric exercise intensity is high the volume must be decreased, give ample recovery time between sets
Initiate sport-specific activities under supervision by ATC or PT
6-9 months post op
Cont. as above
Emphasize strength and power development
Running and sports specific drills under ATC or PT supervision
Cont. strength testing monthly until patient passes then perform functional testing
Functional testing is appropriate for people returning to advance recreational activities or sports