Phase 01

Immediate post-op

The knee will be bandaged in Velband and crepe post op, which are reduced to a tubigrip bandage on discharge.
Crutches may be helpful for a week or two; you can walk full-weight bearing on the knee.
Calf exercises to prevent blood clots, with anti-inflammatories on discharge.
DVT prophylaxis at the surgeon's discretion based on patient profile.

Phase 02 · Weeks 0 – 2

Phase I – Early recovery

Goals

Pain and swelling: control with simple pain killers (Panadeine, Panadol), non-steroidal anti-inflammatories if required, and cold therapy (4 to 6 times daily for 10 minutes and after physiotherapy).
Weight bearing as tolerated, with or without crutches as needed.
Hamstring static contraction at 30°/60°/90°.
Hamstrings/quadriceps co-contraction at 30°/60°/90° and standing if possible.
Calf pumps and core strengthening isometrics.

Phase 03 · Weeks 2 – 6

Goals

Weight bearing: attain full weight bearing as good quadriceps control is achieved.
Hamstrings: begin active strengthening — concentric contraction initially side lying, progressing against gravity, and eventually to eccentric.
Co-contraction: begin quarter squat; continue static co-contraction and also in full extension.
Proprioception: begin double-leg stance proprioception work at week 4 to 6.
Gait re-education.
Swim: once wounds are healed and dry, you may walk in the pool and do laps with straight kicking (no breast stroke).
Bike: begin static bike machine at week 4. No resistance. Minimum 5 min and build up.

Phase 04 · Weeks 6 – 12

Co-contraction: may proceed to half squats against gravity. Continue static program. May begin closed-chain leg curls at the gym, using and progressing to 5 – 20 kg weights. Step up/down exercises.
Proprioception: begin single-leg stance proprioception. Shift weight bearing from one foot to the other.
Bike: increase resistance on stationary bike, then begin ordinary bike (flat ground riding, no hills).
Swimming: continue straight-kick laps and walking; begin jogging in the pool.
Gait: progress to gentle jogging on firm ground (i.e. on grassy oval surface), no hills, no sprints and no stepping.

Phase 05 · Weeks 12 – 24

Phase 06 · Months 6 – 12

Strengthening: continue to increase weight in the gym, from closed to open chain. Resisted leg extensions, squats and leg curls.
Gait: begin sport specific (running/training).
Begin figure-of-8 cycles with progressively smaller 8s.
Begin side and backward running exercises.
Return over a 4 week lead-in to non-contact training.
Football: no sprigs for 4 weeks; training for 4 – 6 weeks progressing to practice game then a normal game.
Skiing: bindings set on low release settings for 8 weeks.
Proprioception: mini trampoline — progress to single leg hop and gentle side-to-side step.

Phase 07 · From 12 months

After review with surgeon: return to sport as confidence, training and return of normal muscle strength tests allow.

Last reviewed: 2025-10-15.