Posterior cruciate ligament surgery rehabilitation program
Correct position placement: the affected leg should be elevated on a pillow with the toe directly above, not crooked to the side, and the knee should be vacated below the knee joint, and the leg should not be padded with a pillow into a slightly bent position. If the pain is unbearable, the leg should be placed in a comfortable position under the guidance of a physician.
Note: In the early stages of functional exercises, the muscle strength level is low, the tissue has a more obvious inflammatory response, and the reconstructed ligaments are still fragile. Therefore, static exercises (joint inactivity, maintaining a certain posture until muscle fatigue) are the main focus. Gradually increase the small load of endurance exercises, that is, choose a light load (complete 30 movements that is the amount of fatigue), 30 times / group, 30 seconds rest between groups, 2-4 groups of continuous exercises until fatigue. Do not walk too much! Walking should not be used as an exercise method! Otherwise, it is very easy to cause joint swelling and fluid accumulation, which will affect functional recovery and tissue healing.
1. On the day of surgery: after the anesthesia subsides, start to move your toes and ankles; if the pain is not obvious, try to contract the quadriceps. That is, tense and relax the muscles on the front side of the thigh.
2.1 day after surgery: you can walk without touching the ground by holding the affected foot with double crutches (only to the toilet)
(1) Ankle pump exercises: ask to do as much as possible when awake.
(2) Quadriceps (anterior thigh muscle group) isometric exercises: do as much as possible without increasing pain, gradually increase to 500-1000 times/day.
(3) N cord muscle (posterior thigh muscle group) isometric exercises: do as much as possible without increasing pain.
3.2 days-2 weeks after surgery.
(1) Continue and strengthen the above exercises.
(2) After walking on the ground, perform “anti-gravity ankle pump exercises” to promote blood return to the distal extremity.
(3) Lateral leg raise exercise: After the strength is increased, you can add sandbag at the ankle joint as a load to strengthen the exercise. 30 times/group, 30 seconds rest between groups, 2-4 groups of continuous exercises, 1-2 exercises/day.
(4) Try straight leg raising exercise: after the strength is increased, you can add sandbag at the ankle joint as a load to strengthen the exercise. 30 times/group, 30 seconds rest between groups, 2-4 groups of continuous exercises, 1-2 exercises/day.
4.3 weeks after surgery.
(1) Continue and strengthen the above exercises.
(2) Start passive flexion exercises according to the situation: within the range of minimal pain, with flexion angle less than 60°. Remove the brace during the exercise and put on the brace again after the exercise. Exercise can be done with the help of others or by CPM machine.
5.4 weeks after surgery.
(1) Flexion exercises: passive flexion angle close to or up to 60°.
(2) Adjust the brace to move within the range of 0°-30° according to the stability of the knee joint.
6. 5-6 weeks after surgery.
(1) Passive flexion exercises with an angle greater than 90°, start active knee flexion exercises.
(2) Posterior leg raising exercises: After the strength is increased, sandbags can be added at the ankle joint as a load to strengthen the exercises. 30 times/group, 30 seconds rest between groups, 2-4 groups of continuous exercises, 1-2 exercises/day.
(3) Weight-bearing and balancing exercises: control the movement and body balance by tensing the muscles of both legs under protection, gradually increase the degree of weight-bearing and force of the affected lower limb, gradually reach full weight-bearing standing on one leg on the affected side. 5 minutes/time, 2 times/group, 2-3 groups/day. Exercise until 8 weeks after surgery can be affected side of the single leg standing stable for 1 minute, you can take off the city fierce fold # 4) gradually adjust the splint to 0-50 ° range of flexion and extension, full 6 weeks after surgery to adjust to 0-90 ° range.
7.7-9 weeks postoperatively.
(1) Passive flexion exercises up to 120°.
(2) Start anterior-posterior and lateral striding exercises: slow, controlled movements and no swaying of the upper body are required. After the strength is increased, you can lift heavy objects with both hands as load or add sandbags at the ankle joint as load. 20 times/group, 30 seconds interval between groups, 2-4 groups continuously, 2-3 times/day.
(3) static squat exercises: squat to a pain-free angle, adjust the distance of the foot from the wall, so that the knee has been perpendicular to the toe squat angle less than 90 °. Maintain a pain-free and controllable maximum angle for two minutes once. 2 minutes/time, 5 seconds interval, 5-10 times/group, 2 groups/day.
(4) Strive to achieve normal gait walking.
8.Postoperative 10 weeks-12 weeks: At 12 weeks, decide whether the splint can be removed according to the review.
(1) The passive flexion angle will gradually be the same as that of the healthy side.
(2) Intensify all muscle strength exercises. Begin seated resisted knee extension: use sandbags, etc. as load exercises, 30 reps/set, 30 seconds rest between sets, 4-6 consecutive sets, 2-3 exercises/day. As the muscle strength level increases, the exercises are based on absolute strength. Choose medium load, 20 times/group, 2-4 groups of continuous exercises, 60 seconds rest between groups, until fatigue.
9. 3 months-6 months after surgery: This period of training is aimed at strengthening muscle strength and joint stability, fully restoring all activities of daily life and gradually resuming sports.
(1) The active knee flexion and extension angle is basically the same as the healthy side, and there is no obvious pain. At the same time, prone stretching was added to strengthen the knee mobility.
(2) Daily prone flexion so that the distance from the heel to the hip is the same as the healthy leg, and continuous stretching for 10 minutes/time.
(3) Step front down exercise: 20 times/group, 30 seconds interval between groups, 2-4 consecutive groups, 2-3 times/day.
(4) Full squat under protection: 3-5 minutes/repetition, 1-2 times/day.
(5) Gradually resume activities of daily living.
(6) If conditions permit and the joints are in good condition, swimming can be started (breaststroke is prohibited in the early stage). Jumping rope and jogging.
Note: The reconstructed ligaments are not strong enough during this period, so the exercises should be done gradually and not reluctantly or blindly. You should strengthen the muscles to ensure the stability and safety of the knee joint during sports.
10. 7 months-1 year after surgery: During this period, you can build on the previous training, strengthen the muscle strength and stability of the joint during running and jumping, and gradually and fully resume strenuous activities or special training.