Phase 01 · Weeks 0 – 6

Phase I – Maximum protection

0 – 2 weeks: brace locked in full extension for 6 weeks.
0 – 2 weeks: non-weight bearing for 4 – 6 weeks per physician's instructions.
0 – 2 weeks: ice and modalities to reduce pain and inflammation.
0 – 2 weeks: aggressive patellar mobility drills.
0 – 2 weeks: range of motion 0° to 45° knee flexion.
0 – 2 weeks: begin submaximal quadriceps setting.
Weeks 2 – 4: continue with inflammation control and aggressive patellar mobility.
Weeks 2 – 4: range of motion 0° to 60°.
Weeks 2 – 4: continue with submaximal quadriceps setting, isometric hamstring/groin and global lower-leg strengthening.
Weeks 4 – 6: progressive weight bearing per physician's instructions.
Weeks 4 – 6: continue with ice and aggressive patellar mobility.
Weeks 4 – 6: range of motion 0° to 90° (by week 6).
Weeks 4 – 6: increase intensity with quadriceps setting.

Phase 02 · Weeks 6 – 12

Phase II – Progressive ROM and early strengthening

Weeks 6 – 8: full weight bearing.
Weeks 6 – 8: open brace to 45° – 60° of flexion week 6, 90° at week 7.
Weeks 6 – 8: continue with swelling control and patellar mobility.
Weeks 6 – 8: gradually progress to full range of motion.
Weeks 6 – 8: begin multi-plane straight leg raising and closed-kinetic-chain strengthening program focusing on quality VMO function.
Weeks 6 – 8: initiate open kinetic chain progressing to closed kinetic chain multi-plane hip strengthening.
Weeks 6 – 8: normalize gait pattern, begin stationary bike, initiate pool program.
Weeks 8 – 10: wean out of brace; continue with patellar mobility drills and gait normalization; restore full ROM.
Weeks 8 – 10: progress open and closed kinetic chain program from bilateral to unilateral; increase intensity on stationary bike; begin treadmill walking program.
Weeks 10 – 12: full ROM; aggressive terminal quadriceps stretching.
Weeks 10 – 12: advance unilateral open and closed kinetic chain strengthening; initiate proprioception drills; may introduce elliptical trainer.

Phase 03 · Weeks 12 – 16

Advance open and closed kinetic chain strengthening.
Increase intensity on bike, treadmill, and elliptical trainer.
Increase difficulty and intensity on proprioception drills.
Begin gym strengthening: leg press, hamstring curls, ab/adduction; avoid lunges and knee extensions.
Begin multi-directional functional cord program.
Initiate pool running program.

Phase 04 · Weeks 16 – 20

Phase 05 · Weeks 20 – 24

Last reviewed: 2025-10-15.