Soft Tissue Lengthening — Intramuscular Rectus Femoris Lengthening (at AIIS)

Children's Colorado / Center for Gait and Movement Analysis (CGMA) · CGMA Physical Therapy Team, Children's Colorado

Weight-Bearing

WBAT immediately; majority of time prone x 3 weeks; healing ~3 weeks

Key Restrictions

Avoid active/forceful hip flexion x 3 weeks; no impact x 3 weeks; no prolonged sitting; prone positioning majority of day (at school); no pillows under torso/hips in prone; avoid hip flexor substitution during abdominal strengthening

Timeline & Phases

Phase 1 (days 1-7): prone lying majority of day, gentle PROM/AAROM all planes, isometrics (glutes/quads/hamstrings); Phase 2 (days 8-21): abdominal strengthening (avoid stabilizing legs), AAROM to 10 deg hip extension, gait training/slow treadmill; Phase 3 (day 22+): scar mobility, hip extensor strengthening (bridging/step ups/therapy ball), reduce anterior pelvic tilt in standing/walking, trailing limb posture; return ~3 months

Notes

Pediatric; indication is rectus femoris contracture with positive Thomas/Ely test and anterior pelvic tilt in gait; RF tendon lengthened/released at AIIS; distinct from PT03 (transfer); Children's Colorado CGMA

Surgeon / Author

CGMA Physical Therapy Team, Children's Colorado

Published

October 2007