PT Resources

LCL Repair

 

LATERAL COLLATERAL LIGAMENT RECONSTRUCTION/REPAIR REHABILITATION

 

 

(WITH OR WITHOUT ACL/PCL)

 

General considerations:

  • Patients are touchdown weightbearing with crutches for 6 weeks postoperatively.
  • Patients are to wear a knee immobilizer for 6-7 weeks postoperatively.
  • Early emphasis on achieving full passive terminal extension equal to the opposite side
  • No resisted knee flexion exercises for 8 weeks postop. Passive flexion okay.
  • Regular manual care of the patella, patellar tendon, and portals should be performed to prevent fibrosis.
  • All times are approximate with actual progression based upon clinical presentation.
  • No VARUS STRESS throughout rehab.

Week 1:

  • Gait training, pain and edema control, and muscle stimulation as needed for quadriceps recruitment
  • Ankle pumps, quad sets, and leg raises into flexion and adduction only.
  • Well-leg stationary bike and UBE for cardiovascular. Upper body weight machines and trunk exercises

Weeks 2-4:

  • Passive flexion and extension stretching.
  • Prone hip extension exercises performed in full knee extension only after 2 weeks.
  • Submaximal quad and gluteal isometrics.
  • Standing calf and hip exercises.
  • Balance and proprioception exercises.
  • Swimming and pool workouts as soon as incisions are well-healed.

Weeks 4-6:

  • Introduce mild isometric resisted knee extension within range of motion restrictions.
  • Short range squats/knee bends within range of motion restrictions.
  • Fit with Bledsoe medial aligner brace at 6-7 weeks to start at 8 weeks postop (when knee immobilizer d/c’d).

Weeks 6-8:

  • Gradually increase the depth of knee bends, step exercises, and proprioceptive exercises.
  • Introduce hamstring curls against gravity without resistance after 7 weeks. Focus on eccentrics.
  • Continue to increase the intensity and resistance of other exercises.
  • Passive range of motion should be near normal.

Weeks 8-12:

  • Wean off the use of the brace for activities of daily living (12 weeks).
  • Begin hamstring flexion exercises against light resistance – increase as tolerated.
  • Cautiously add lateral training exercises (i.e., lateral stepping, lateral step ups) (12 weeks).

Weeks 12-16:

  • Goals are to increase strength, power, and cardiovascular conditioning.
  • Sport-specific exercises and training program.
  • Maximal eccentric focused strengthening program.
  • Begin light running program as able to demonstrate good strength and mechanics.

4-6 months:

  • Goals are to develop maximal strength, power, and advance to sporting activities
  • Sport-specific exercises and training program.
  • Running program, balance drills, and agility program
  • Initiate plyometrics training as able to demonstrate adequate strength and proper mechanics.

Note: Wear Bledsoe-type brace for ≥ 1 year for heavier activities, especially sports.

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