I. Early stage: edema inflammatory response period (0~2 weeks)
Purpose: To reduce pain and swelling; early muscle strength exercises; early weight bearing; early mobility exercises to avoid adhesions and muscle atrophy.
On the day of surgery: after anesthesia subsides, begin to move the toes and ankle; if pain is not obvious, try to contract the quadriceps. That is, tensing and relaxation of the anterior thigh muscles.
1 day after surgery: 24 hours after surgery, the affected limb can be walked without touching the ground by holding the double crutches.
1. Ankle pump: forcefully, slowly and with full range of flexion and extension of the ankle joint, as much as possible. (Important for promoting circulation, decreasing swelling and preventing deep vein thrombosis)
2.Quadriceps (anterior thigh muscle group) isometric exercises: i.e. thigh muscle tensing and relaxation. Do as much as possible without increasing pain, more than 500 times/day.
3, posterior thigh muscle group isometric exercise: the affected leg force down the padded pillow, so that the posterior thigh muscle tension and relaxation, more than 500 times / day.
4, correct body position: the affected leg is elevated on the pillow, the toe is directly above, not crooked to the side, the knee joint should be vacant below, do not use the pillow to cushion the leg into a slightly bent position. If the pain is unbearable, place in a comfortable position under the guidance of a doctor.
5.Start to try straight leg lift: fully straighten the leg lift until the heel is 15M from the bed and hold until exhaustion. 10 times/group, 2~3 groups/day.
2 days after surgery: remove the drainage tube, remove the cotton leg, install the chuck brace (0° position fixation), note that padding must be added in front of the tibia of the brace to push the tibia backward to reduce the tension of the reconstructed ligament. However, the compression of the common peroneal nerve behind the superior tibia must be prevented.
1.Continue straight leg raising exercises, 20 times/set, 2~3 sets/day.
2. Change the ankle pump to anti-gravity exercise (can be assisted by others or hold the thigh by hand). Performed after each time you get out of bed can effectively prevent swelling.
3.Start side leg raise exercise: 20 times/group, 2~4 groups/day, 30 seconds rest between groups.
4.Start posterior leg lift exercise: prone position, lift the affected leg straight backward until the toe is 5 cm from the bed for 1 time, 20 times/group, 2~3 groups/day, rest 30 seconds between groups.
3 days after surgery.
1. Continue the above exercises, and increase the number of leg lifts in each direction by 5~10 times per day.
2. Weight-bearing exercises: separate both feet under protection, alternately move the center of gravity left and right within the range of slight pain, and strive to achieve full weight-bearing standing on one leg, 5 minutes/time, 2 times/day.
3. Balance exercise: separate both feet back and forth, move the center of gravity, and strive to achieve full weight-bearing standing on one leg.
4 days postoperative: start joint mobility exercises according to the doctor’s decision.
1. Continue the above exercises.
2. Strengthen the weight-bearing and balance exercises, gradually until the affected leg can stand on one foot.
3. Start flexion exercises: Sit on the edge of the bed with the brace removed, hang below the knee outside the bed, and flex to the maximum within the range of 0°~60° once. But not more than 60 °.
4. Stretching exercises.
Stretching exercise: remove the brace, put a pillow at the heel, make the affected leg N fossa completely leave the bed, relax the muscles so that the knee joint is naturally straightened. (Very important to prevent limping) 3 times/day
Second, the initial period: protective rehabilitation training period (3~8 weeks)
Purpose: strengthen mobility and muscle strength exercises: improve joint control and stability; gradually improve gait.
3 weeks after surgery.
1. Passive flexion to 90°~110°.
2. Enhance active flexion and extension exercises and strengthen muscle strength exercises. (Straight leg lift can be done with a weight on the thigh side as a load).
3. If you can stand on one foot for 1 minute, you can walk with one crutch, and you can take off the crutch indoors.
4~5 weeks after surgery.
1. Passive flexion exercises up to 110°~120°.
2. Adjust the brace until you can walk in the range of 0°~30°, and try to achieve normal gait walking.
3. Start anterior-posterior and lateral striding exercises, with the affected leg in front and weight-bearing on the striding side.
6~8 weeks after surgery.
This period is a weak period for reconstruction of ligaments, protective rehabilitation training is the main focus, the flexion range is maintained within 120°, and all motor stopping is stagnated at the level of 5 weeks ago.
Third, the middle period: intensive muscle training period (9 weeks ~ 12 weeks)
Purpose: Strengthen joint mobility to the same level as the healthy side. Strengthen muscle strength and improve joint stability. Restore the ability to perform all activities of daily life.
9~11 weeks after surgery.
1. Passive flexion up to 120°~130°.
2. Adjust the knee functional brace to move within 0~60°, and perform static squatting exercises under the protection of the brace.
12~14 weeks after surgery.
1. Passive flexion angle gradually to the same as the healthy side.
2. After the “sitting knee” is exactly the same as the healthy leg, begin to gradually protect the full squat.
3. Strengthen the muscles, but do not increase the load, only increase the angle, number and time of exercises.
15 weeks~3 months after surgery.
1. The active flexion and extension knee angle is basically the same as the healthy side, and there is no significant pain.
2. Daily prone position flexion so that the heel touches the hip, continuous stretching for 10 minutes/time.
3. After the angle of the knee in the sitting position is exactly the same as that of the healthy side, start kneeling exercises.
4. Start pedaling exercises.
Fourth, the late stage: (3 months ~ 6 months) (can remove the support)
Purpose: To fully restore all activities of daily life, strengthen muscle strength and joint stability.
In the later stage, improve the maximum strength, choose a large load (complete 12 movements that fatigue load), 8-12 times / group, 2-4 groups of continuous exercises, rest 90 seconds between groups, until fatigue.
V. Recovery period: (7 months~1 year)
Purpose: To strengthen the muscle strength exercises in sports, and the stability of joints in running and jumping. Gradually resume general sports activities.