Young woman having leg injury. Close up male hands massaging leg of an injured woman at the gym. Sport injury concept.

ACL/MCL Reconstruction/Repair Protocol

WOUND CARE

  • Maintain your operative dressing, loosen the bandage if swelling of the foot and ankle occurs.
  • It is normal for the kneed to bleed and swell following surgery.  If blood soaks onto the ACE bandage, do not become alarmed, reinforce with additional dressing.
  • To avoid infection, keep surgical incisions clean and dry for the first 7 days following surgery – you may shower by placing a large plastic bag over your brace beginning the day after surgery.  NO immersion of the operative leg 

(i.e.: bath or pool)

  • Wait until your first post-operative appointment to have Dr. Mead’s team remove the surgical dressing.
  • Please do not place any ointments, lotions, or creams directly on the incisions.
  • Once the sutures are removed at least 7-10 days post operatively you can begin to get the incision wet in the shower (let water and soap lightly run over the incision and pat dry).  NO immersion in a bath until given approval by our office.

ICE THERAPY

  • Icing is very important in the initial post operative period and should begin immediately after surgery.
  • Use an icing machine continuously or ice packs (if machine not prescribed) for 30-45 minutes every 2 hours daily until your first post-operative visit – remember to keep your leg elevated to the level of your chest while icing.  Care should be taken with icing to avoid frostbite to the skin.
  • You do not need to wake up in the middle of the night to change over the ice machine or ice packs unless you are uncomfortable.

PROBLEMS / QUESTIONS

If you have any problems or questions about your post op care, please do not hesitate to call our office at 

504-309-6500.  Let the operators know you just had surgery by your doctor and ask to speak with a medical assistant.  If you should need to call after hours, the answering service will get your information and have the on-call physician return your call.  If the matter is urgent, proceed to the emergency room.

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, incorporate 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

Add a Comment

Your email address will not be published. Required fields are marked *