Non-Operative — PCL Sprain — Non-Operative Rehabilitation

Sutter Health / Palo Alto Medical Foundation · Kevin Roth MD

Weight-Bearing

WBAT with crutches day 1; without crutches by wk 3; WBAT wks 7-12

Key Restrictions

Brace 0-60° days 1-5, progressing to 0-90° then 0-115°, d/c wk 3; functional brace wks 4-6; avoid active knee flexion; RTS criteria: isokinetic quad torque 85% of contralateral, no laxity change, no pain/swelling

Timeline & Phases

Days 1-5: WBAT with crutches, brace 0-60° — quad sets, SLR (4 planes), knee ext 60-0°, multi-angle isometrics, mini squats 0-50°, leg press 45-90°; Days 5-7: progress WBAT, brace 0-90°, wall squats 0-50°, proprioception; Wks 2-3: without crutches by wk 3, brace 0-115° → d/c wk 3, bicycle, pool, leg press 30-90°, vertical squats, lateral step-ups, SL squats; Wks 3-6: WBAT, functional brace wks 4-6, ROM 0-125° — bicycle, stairmaster, rowing, knee ext 90-0°, mini squats 0-60°, leg press 0-100°, wall squats 0-75°, step-ups, light hamstring curls 0-45°, proprioception, pool running, agility; Wks 7-12: WBAT, functional brace, running program, gradual RTS; RTS criteria: isokinetic quad torque ratio, 85% strength vs contralateral, no laxity change, no pain/swelling

Notes

Non-operative PCL management; 3-phase protocol; criteria-based RTS (85% isokinetic quad strength vs contralateral, no laxity change, no pain/swelling)

Surgeon / Author

Kevin Roth MD

Published

2024