Quadriceps Tendon Repair Rehab Protocol

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Phase 1 (0-2wks):

  • Goals: Control swelling, restore neuromuscular communication loops, prevent kinesiophobia; gait training
  • Modalities: Compressive cyrotherapy, e-stimulation
  • Weightbearing: WBAT in brace locked in extension at all times. Use crutches for support.
  • Brace: Locked in full extension for ambulation and sleeping, remove for hygiene and exercises
  • ROM:
    • Locked in extension 24-hours per day for initial 48 hours.
    • 0-2wks: unlock brace 0-30 degrees for exercises.
  • Exercises: Heel slides, quad sets, patellar mobs, SLR, calf pumps

Phase 2 (2-8wks) *

  • Weightbearing: Full while in brace
  • Brace:
    • 2-4wks: locked in full extension day and night; 0-60 deg at rest
    • 4-6wks: off at night; locked in full extension daytime; 0-90 deg at rest
    • 6-8wks: wean from brace. Advocate to be used as-needed for uncontrolled settings or adverse weather. ROM open 0-120°. Discontinue brace at 8wks altogether.
  • ROM:
    • 2-4wks: 0-60degrees
    • 4-6wks: 0-90degrees
    • 6-8wks: progress slowly as tolerated to Full ROM – refer to PT Rx for restrictions
  • Exercises: Advance phase 1 exercises. Add side-lying hip/core/glutes. Begin WB calf raises. No weight bearing with flexion > 90 degrees. 

Phase 3 (8-12wks)

  • Weightbearing: Full
  • Brace: None
  • ROM: Full
  • Exercises: Progress closed chain activities. Begin hamstring work, lunges/leg press 0-90 degrees, proprioception exercises, balance/core/hip/glutes. Begin stationary bike when able.

Phase 4 (12-20wks)

  • Weightbearing: Full
  • Brace: None
  • ROM: Full
  • Exercises: Progress phase 3 exercises and functional activities: single leg balance, core, glutes, eccentrip hamstrings, elliptical and bike. Swimming ok at 12 wks. Advance to sport specific drills and running/jumping after 20wks once cleared by MD.

***WB status may vary depending on nature of exact procedure. Please refer to specific PT Rx provided.