REHABILITATION PROGRAMME FOLLOWING PATELLAR TENDON REPAIR - DR JUSTIN ROE
Protocol Prepared by Catherine Moore sports physiotherapist North Sydney Orthopaedic and Sports Medicine Centre
Moore Health, Shop 2c/780 Bourke St Redfern 2016 Suite 2 The Mater Clinic, 3 Gillies St Wollstonecraft NSW 2065
Gradual return to sport specific drills and training
Continue agility, functional/dynamic drills – sports specific if needed
Equal leg strength, balance and motor control side to side
Plyometric ( jumping) exercises
Improve walking distance, speed and agility
Direction change exercises (shuttle runs, figure of 8s, side to side steps)
Increasing cycling/walking/ jogging programme
Add down slopes and hills and stairs
Return to training for particular sport graduating from straight line then progress to directional
Progress surface changes and speed progressions
Contact sport in 12 months
Running on treadmill and stationary bike
Cycling increasing endurance, speed and strength
Open -v- Closed Chain Exercises
DR JUSTIN ROE, ORTHOPAEDIC SURGEON
www.justinroe.com.au
Deep Vein Thrombosis – these are clots in the deep veins of the leg due to immobilisation and surgery where wound healing and swelling is present. This may present as hot, tender, swollen, red calf pain. These symptoms need to be addressed
Unusual swelling and bruising
Damage to nerves or blood vessels – this may present as tingling, numbness or sensation changes around the wound area.
Please contact your treating Dr or your GP immediately if you are concerned about any of the above.
In relation to the knee these exercises ensure that both the hamstring muscle group and the quadriceps muscle group contract simultaneously to achieve a bracing effect on the knee joint. Not only will these two groups be contracting, however, but
stabilisers above and below will also contract such as gluteals, psoas, TFL, adductors and calf muscles. To initially teach a co-contraction, it is easiest to place a rolled pillow under the knee and ask the patient to push into the pillow. This will switch on the
hamstrings and gluteals. They should then tighten the quadriceps. A co-contraction should initially be held for approximately 15 seconds.
Closed kinetic chain exercises are performed with the foot placed on a surface (eg floor, step, pedal) and the entire limb is bearing an axial load. Joint compression occurs when the limb is loaded by body weight and this provides inherent joint stability and
allows more strenuous strengthening without the degree of shearing forces, or anterior tibial displacement that occurs with conventional open kinetic chain exercises. Closed chain exercises performed with co-contraction of hamstrings and quadriceps also
lessen the patello-femoral joint forces. The closed exercises place functional stresses on the joint and entire limb. These exercises can easily be designed to be specific to normal weight bearing activities used for ACL as well as sport.
Plyometrics exercises are characterised by very powerful muscle contractions in response to a dynamic loading or stretching of the muscles involved in the exercise. The muscles are pre-loaded with an eccentric contraction before a powerful concentric
contraction. Plyometrics help to improve muscle power in the later stage of rehabilitation. Examples are box drop jumps, bounding and hopping.
Post operative complications are not common but can occur and it is important for every patient to be aware of the potential warning signs.
Infection i.e. redness, swelling and or pain in the knee area