Proximal Hamstring Repair

University of Virginia Orthopaedic Surgery

Weight-Bearing

TTWB weeks 0-2; 50% WB weeks 2-6; wean crutches over 2 weeks in Phase 3 (weeks 6-8); WBAT thereafter

Key Restrictions

Knee brace locked at 30° extension for ambulation x6 weeks (may unlock for therapy); no active knee flexion or hip extension Phase 1; protect against simultaneous knee flexion and hip extension throughout all phases; passive knee ROM performed in prone with hip in full extension; walk-to-jog progression at 16 weeks; running/agility at 20 weeks

Timeline & Phases

Phase 1 (0-2 wks): TTWB, brace locked 30°, no active knee flex or hip ext, passive hip flex to 60° (knee flexed), passive knee ROM (no hip flexion during knee extension), quad sets, ankle pumps, abdominal isometrics; Phase 2 (2-6 wks): 50% WB, brace locked 30° ambulation (unlock okay), prone passive knee ROM in full hip extension, AAROM knee flex/hip ext, hip flex to 90°, AAROM hip abduction, calf raises, side-lying hip abduction, upper body training; Phase 3 (6-12 wks): wean crutches, wean brace, gradual active knee flexion, AAROM to full active hip extension, hip abd/add, stationary bike high seat, antigravity HS curls, SLR, bridges, clam shells, half squats; Phase 4 (12+ wks): full ROM, closed chain bilateral to single leg, gait normalization, walk-to-jog at 16 wks, running/speed/agility at 20 wks

Notes

Critical: protect against simultaneous knee flexion and hip extension throughout all phases — this is the primary repair protection; knee brace locked 30° extension x6 weeks for ambulation; passive knee ROM in prone with hip in full extension (never combined with hip flexion); upper body strength training permitted Phase 2; walk-to-jog at 16 weeks; progressive running and agility at 20 weeks; 4 phases

Published

12/2024