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Lunges progress from single plane to tri-planar lunges, add medicine balls for resistance and rotation
Theraband walking patterns - forward, sidestepping, carioca, monster steps, backward, ½ circles forward/backward - 25 yds. Start band at knee height and progress to ankle height
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Microfracture
This protocol should be used as a guideline for progression and should be tailored to the needs of the individual patient.
- Strict protective weight bearing status for two months (8-9 weeks).
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- Allow to place weight of leg on ground (neutralizes joint reaction forces).
- Emphasis on range of motion.
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- Active assisted motion for home program.
- Pool program to initiate functional exercises in reduced weight environment.
- Emphasis on cycling for range of motion without resistance (as long as this is tolerated by the individual).
- At 2 months, transition to full weight bearing (transition variable).
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- Some transition immediately to full weight bearing status.
- Some require transition to 1 crutch or continued support for distances, which may be needed for 1-2 weeks.
- Minimum three months before progression of functional activities as tolerated.
Week 1Phase 1
Initial Exercises (Weeks 1-3)
Other Exercises Week 1
- Upper body ergometer, upper body strengthening
Week 2Phase 1
Initial Exercises (Weeks 1-3)
Other Exercises Week 2
- Standard stationary bike without resistance at 3 days post-op (10 min. if tolerated)
- Pool exercises (water walking, range of motion, march steps, lateral steps, backward walking, mini-squats, heel raises, hamstring and hip flexor stretches)
Week 3Phase 1
Initial Exercises (Weeks 1-3)
Other Exercises Week 3
- Active range of motion with gradual end range stretch within tolerance
- Active range of motion with gradual end range stretch within tolerance
- Leg raise - Adduction
Criteria for progression to Phase 2
Goals of Phase 1
Weeks 4-6Phase 2
Intermediate Exercises (Weeks 4-6)
Other Exercises Week 1
- Initiate elliptical machine
- Pool water exercises and flutterkick swimming, 4 way hip with water weights, step-ups
Goals of Phase 2
Week 7Phase 3
Advanced Exercises (Weeks 9-11)
Week 8Phase 3
Advanced Exercises (Weeks 7-10)
Week 9Phase 3
Advanced Exercises (Weeks 7-10)
Other Exercises Week 9
- Knee extensions, hamstring curls
- Single stability ball bridges
Week 10Phase 3
Advanced Exercises (Weeks 7-10)
Lunges progress from single plane to tri-planar lunges, add medicine balls for resistance and rotation
Theraband walking patterns - forward, sidestepping, carioca, monster steps, backward, ½ circles forward/backward - 25 yds. Start band at knee height and progress to ankle height
Criteria for Progression to Phase 4
Goals of Phase 3
Week 11-13Phase 4
Sports specific training rehab clinic based progression
Other Exercises Week 7
- All phase 3 exercises
- Pool running (progress from chest deep to waist deep), treadmill jogging
- Step drills, quick feet step-ups (4-6 inch box) forward, lateral, carioca
- Plyometrics, double leg and single leg shuttle jumps
- Theraband walking patterns 1 rep of six exercises x 50yds, progress to band at knee height and ankle height