ACL/MCL Reconstruction/Repair Protocol

Weeks 0 – 4 (Acute)

Range of Motion

• Weeks 0 -1 
  • Flexion 0 to 30 degrees
• Weeks 1 – 2
  • Flexion 0 to 60 degrees
• Weeks 2 – 4
  • Flexion 0 to 90 degrees

Weightbearing

• Weeks 0 – 2
  • Toe-touch weightbearing
• 2+ Weeks
  • Weightbearing as tolerated

Brace

• Weeks 0 – 2
  • Braced locked at 0 degrees until 10 straight leg raises
• Weeks 2 – 4
  • Brace 0 to 60 degrees
• 4+ Weeks 
  • Open and discontinue once gait is normal

Weeks 6 – 12 Phase 2 (Strength)

Range of Motion

• Progress to full flexion

Strengthening

• Leg press, step ups, step downs, wall sits 
• Squat progression: bodyweight squats 
• Advance hip abduction & glut strength 
• Core exercises 
• Balance training

Conditioning

• Stationary bike: interval training
• 6+ Weeks — Elliptical & rowing machine 
• Initiate dynamic warm-up

Weeks 12 – 24 Phase 3 (Agility/Plyometrics)

Conditioning

• Dynamic warm-up & integrate sport specific warm up 
• Biking, elliptical, jogging, swimming, & rowing 
• Treadmill walk/jog progressions

Plyometrics

• Ladder drills, footwork agility drills, cone drills 
• Double leg plyos 
• High intensity predictable patterned movements, incoporate sport specific drills

Weeks 24 – 28 (Phase 4)

Strengthening

• Gym strengthening: squats, deadlifts, olympic lifting 
• Interval strength circuits 
• Dynamic eccentric loading: double & single leg 
• Dynamic core 
• Isokinetic training protocols

Conditioning

• Dynamic warm-up 
• Biking, elliptical, jogging, swimming & rowing 
• Advance to linear speed drills and sprinting drills

Plyometrics

• Tuck jumps, squat jumps, bounding, SL hop, SL triple hop, SL cross over hop 
• Change of direction drills 
• Non-contact sports specific drills

Weeks 28 – 36 (Return to Play)

Strengthening

• Gym strengthening: squats, deadlifts, and olympic lifting
• Interval strength circuits & work/rest timed intervals  
• Complex movement patterns 
• Isokinetic protocols: 300°, 180°, and 60°/sec

Conditioning

• Jogging, biking, swimming, rowing, & interval sprint workouts

Plyometrics

• Max effort DL and SL jumps 
• Lateral & rotational agility drills 
• Return to practice 🡪 return to contact practice 🡪 return to scrimmage 🡪 return to interval play 🡪 return to full play