Phase Iiiadvanced

Goals

• Restoration of muscular endurance/strength

• Restoration of cardiovascular endurance

• Optimize neuromuscular control/balance/proprioception

Fig. 11. Single knee bends.

Precautions

• Avoid hip flexor/joint inflammation

• No ballistic or forced stretching/strengthening

• No treadmill use

• No contact activities

Criteria for Progression to Phase IV

• Hip flexion strength >70% of the uninvolved side

• Hip add, abd, ext, IR, ER strength >80% of the uninvolved side

• Cardiovascular fitness equal to preinjury level

• Demonstration of initial agility drills with proper body mechanics

Rehabilitation

The advanced phase of rehabilitation is typically started between 6 and 8 weeks postoperatively. During this phase, patients focus on restoration of muscular strength and endurance, restoration of cardiovascular endurance, and neuro-muscular control. Advanced strength and neuromuscular control exercises include lunges, water bounding and plyometrics, side to side lateral agilities

(Fig. 12), forward and backward running with a cord, initiation of a running progression, and initial agility drills. Cardiovascular training should continue with progressive biking, elliptic trainer, stairclimber, and swimming. Once the goals of phase III have been met, patients are allowed to begin sport specific training.

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