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REHAB PROTOCOL · KNEE

ACL Reconstruction Rehab Protocol

By Dr. Shayne Kelly, DO — Fellowship-Trained Sports Medicine Surgeon · Tri-City Orthopedics, Kennewick, WA

The written protocol Dr. Kelly provides to his patients and their physical therapists in the Tri-Cities. Time frames are guidelines — progression is criteria-based, and your own post-op instructions always govern.

⬇  Printable protocol (PDF)Request an appointment →
Educational information, not medical advice. This is not a substitute for the specific instructions Dr. Kelly and your physical therapist give you. Your timeline depends on your surgery, your body, and your progress. Follow your own care team's directions. In an emergency, call 911.
0–2 Weeks
EARLY PROTECTION
2–6 Weeks
RESTORE MOTION
6–14 Weeks
BUILD STRENGTH
14–22 Weeks
RETURN TO RUNNING
22+ Weeks
RETURN TO SPORT

0–2 WeeksEARLY PROTECTION

  • •Weight bearing as tolerated, Brace locked at 0° for ambulation and sleeping; discontinue crutches when gait is non-antalgic
  • •ROM: 0–90° with emphasis on full extension; patella mobilization; SLR supine with brace locked at 0°, Quad Sets
  • •Ankle Pumps; short crank (90mm) ergometry
GOALS  Full extension  ·  Walk without crutches

2–6 WeeksRESTORE MOTION

  • •Brace: unlocked when quad control is adequate; discontinued brace when quad control is adequate (typically 4 weeks)
  • •ROM: 0–125° (Maintain full extension); active knee extension from 40°; standard (170mm) ergometry (if knee ROM > 115°)
  • •Leg Press (80–0-degree arc); mini squats / weight shifts; proprioception training; initiate step-up program
GOALS  0–125° motion  ·  Out of the brace

6–14 WeeksBUILD STRENGTH

  • •Progressive Squat program; initiate step-down program; leg press, lunges
  • •Isotonic Knee Extensions (90–40°, closed chain preferred); agility exercises (sport cord); versa climber/Nordic track
  • •Retrograde treadmill ambulation
GOALS  8″ step-down

14–22 WeeksRETURN TO RUNNING

  • •Begin forward running (treadmill) program when 8” step down satisfactory; continue strengthening & flexibility program
  • •Advance Sports-Specific Agility Drills; start plyometric program
GOALS  Pain-free running

22+ WeeksRETURN TO SPORT

  • •Advance Plyometric program, Return to Sport (MD Directed)
GOALS  Back on the field

Return to Sport & Discharge Criteria

  • •No effusion; full pain-free ROM; quad strength ≥90% of opposite side
  • •Hop battery ≥90% symmetry; agility & plyometrics without pain, swelling, or giving way
  • •Return to sport when cleared by Dr. Kelly

Time frames are guidelines — progress when phase goals are met, per Dr. Kelly and the treating therapist.

Procedure variants — printable protocols

When to call

Increasing pain, numbness, redness, drainage from the wound, or fever/chills — call (509) 460-5588. After hours, the answering service can reach Dr. Kelly. If your issue feels emergent, call 911 or go to the nearest emergency department.

Physical therapists

Treating one of Dr. Kelly's patients? Download the printable protocol for your clinic, and call (509) 460-5588 with questions about an individual patient's progression.

⬇  Protocol PDF

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Back on the field starts with a plan.

Fellowship-trained sports medicine care in Kennewick, Richland & Pasco.

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