| Phase | Goals | Treatment | Criteria for progression to next stage |
| 1 | - Restore motion
- Limit swelling
| - RICE
- OTC analgesics (eg, NSAIDs)
- Gentle passive or assisted knee flexion
- Limited weightbearing
| - First 48 hours after injury
- Swelling stabilized
- ROM stabilized
- Tolerating at least partial weightbearing
|
| 2 | - Achieve full ROM
- Restore strength and cardiovascular fitness
| - Soft tissue therapy by physical therapist or athletic trainer (if available)
- Quadriceps stretching with prone knee flexion
- Eccentric strengthening of quadriceps with progression of resistance and motion arc (eg, reverse leg extensions starting at 3 sets of 10 reps and low resistance)
- Isotonic strengthening (eg, knee extension exercises, knee )
| - Full passive ROM
- Full weightbearing
- Performs 3 sets of 10 single leg hops pain free
- Ideally, can perform 3 sets of 20 single leg squats with good form
|
| 3 | - Return to running and/or kicking
| - Jogging for 10 minutes x 2 sets
- Running at 60% maximum strides for 80 m intervals – 3 sets of 5 reps
- Sprinting at 90% maximum speed for 30 m intervals – 3 sets of 5 reps
- Initiation of kicking activities over short distance with lighter ball
- Advancing isotonic leg extension resistance and motion arc
| - Completion of all stages without recurrence of significant pain or exacerbation of symptoms immediately following routines
|
| 4 | - Sport specific activities
| - 100% sprint over 60 to 80 m
- Shuttle runs
- Figure-of-8 sprints
- Full kicking with game ball
- Plyometric activities (eg, box jumps)
| - Successful completion of sports related activities
- Observed full function without deficit or compensation and without setback in symptoms following completion of training
|
