Posterior Cruciate Ligament Nonoperative
DAY 1 - WEEK 4:
Weight Bearing
- Day 1 to 5 Weightbearing as tolerated with crutches
- Day 5 to 7 Progress as tolerated
- Week 2 to 3 Without crutches week 3
Brace
- Day 1 to 5 0-60°
- Day 5 to 7 0-90°
- Week 2 to 3 0-115°
Therapeutic Exercise
Day 1 to 5
- Muscle stimulation to quads
- Quad sets
- Straight leg raises (all 4 planes)
- Knee extension (60-0°)
- Multi-angle isometrics at 60, 40, 20° (for quads)
- Mini squats (0-50°)
- Leg press (45-90°)
- Avoid active knee flexion
Day 5 to 7
Continue all strengthening exercises Initiate wall squats (0-50°) Initiate proprioceptive training
Week 2 to 3
- Progress exercises, using weight progression
- Bicycle for ROM stimulus (week 2-4)
- Pool program
- Leg press (30-90°)
- Vertical squats (0-60°)
- Lateral step ups
- Single leg squats
WEEK 3-6:
Weight Bearing
- Weightbearing as tolerated
Brace
Week 3
- Discontinue
- ROM 0-125° as tolerated
Week 4-6
- Fit for function brace
Therapeutic Exercise
Week 3
- Continue all above exercises (progress weight)
- Bicycle
- Stairmaster
- Rowing
- Knee extension (90-0°)
- Mini squats (0-60°)
- Leg press (0-100°)
- Wall squats (0-75°)
- Step-ups
- Hamstring curls (light resistance from 0-45°)
- Hip abduction/adduction
- Toe-calf raises
- Proprioceptive training
Week 4-6
- Continue all above exercises
- Pool running
- Agility drills
WEEK 7-12:
Weight Bearing
- Weightbearing as tolerated
Brace
- Functional brace
Therapeutic Exercise
- Continue all strengthening exercises
- Initiate running program
- Gradual return to sport activities
Criteria for Return to Sport Activities:
Therapeutic Exercise
- Isokinetic quad torque to body weight ratio
- Isokinetic test 85% > of contralateral side
- No change in laxity
- No pain/tenderness or swelling
