Posterior Cruciate Ligament (PCL) Rehab Protocol

By Kevin M. Kaplan, MD

Posterior Cruciate Ligament Rehab Phase I (Weeks 0-4)

Please read this article on the Posterior Cruciate Ligament or PCL Rehab Protocol.

Weight bearing: Upon the Posterior Cruciate Ligament as tolerated with crutches (may be modified if concomitant posterolateral corner reconstruction, meniscal repair/meniscal transplant or articular cartilage procedure is performed)

Hinged Knee Brace: 

Locked in full extension for ambulation and sleeping (Weeks 0-1) 

Locked in full extension for ambulation – removed for therapy sessions (Weeks 1-4) 

Range of Motion – Weeks 0-1: None, Weeks 1-2: PROM 0-30°, Weeks 2-4: PROM 0-90° (MAINTAIN ANTERIOR PRESSURE ON PROXIMAL TIBIA AS KNEE IS FLEXED FROM WEEK 1-4—NEED TO PREVENT POSTERIOR SAGGING AT ALL TIMES)

Therapeutic Exercises 

Quad/Hamstring sets and ankle pumps

Straight-Leg Raise with brace in full extension until quad strength prevents extension lag

Hip abduction/adduction (RESISTANCE MUST BE PROXIMAL TO THE KNEE)

Hamstring/Calf stretch – Calf press with Thera Band progressing to standing toe raises with knee in full extension

Phase II (Weeks 4-12)

• Weight bearing: As tolerated with crutches– discontinue crutch use at 6-8 weeks post-op
• Hinged Knee Brace: Weeks 4-6: unlocked for gait training/exercise only, Weeks 6-8: unlocked for all activities, Discontinue brace at 8 weeks post-op 
• Range of Motion–Maintain full knee extension–work on progressive knee flexion (Goal of 110° by week 6)
• Therapeutic Exercises 
  • Weeks 4-8: Gait training, wall slides (0-30°), Mini-squats (0-30°), Leg press (0-60°)
  • Weeks 8-12: Stationary bicycle (with seat higher than normal), Stairmaster, Closed-chain terminal knee extension, Leg press (0-90°), Balance and proprioception activities

Phase III (Weeks 12-9 months)

• Weight bearing: Full weight bearing with normalized gait pattern
• Range of Motion – Full/Painless ROM
• Therapeutic Exercises 
  • Advance closed chain strengthening exercises, progress with proprioception/balance activities
  • Maintain flexibility
  • Begin treadmill walking – progress to jogging

Final Phase IV (9 months and beyond)

• Maintain strength, endurance and function – initiate plyometric program
• Begin cutting exercises and sport-specific drills
• Return to sports as tolerated
• To schedule a new patient or follow up patient appointment with your MD, please call (904)JOI-2000.
• To schedule an appointment for physical or occupational therapy, call 904-858-7045 or visit 12 area JOI Rehab Centers.

Related Articles: Concentric vs Eccentric Contractions and VMO Strengthening Exercises.

JOI and JOI Rehab

JOI Physicians continue to offer online new patient appointments. This is another option to make it more convenient to make new patient appointments with less phone hold times. Follow the link below to select your JOI MD and schedule online.

You can still call 904-JOI-2000 to make new patient JOI Physician Appointments if that is your preference.

To make appointments with JOI Rehab, please call 904-858-7045.