Z

Stationary biking with resistance • •

Swimming with fins • •

Manual long axis distraction • •

Manual A/P mobilizations • •

Dyna-disc (single leg stance) •

• •

Advanced bridging (single leg, swiss ball) •

• •

Single leg cord rotation

• • •

Pilates skaters

• • •

Side stepping

• • •

Single knee bends (lateral step downs)

• • •

Ellipti cal/Stairclimber

• • •

Phase III: advanced exercises

Lunges

• •

Water bounding/plyometrics

• •

Side-to-side lateral agility

• •

Fwd/Bkwd running with cord

• •

Running progression

• •

Initial agility drills

• •

Phase IV: sports-specific training

Z-Cuts

• • • •

W-Cuts

• • • •

Cariocas

• • • •

Ghiardelli's

• • • •

Sports-specific drills

• • • •

Functional testing

• • • •

Patient checklist: weightbearing: FFWB x 4 wk (foot flat = 20 lbs.). CPM: 4 wk. Bledsoe brace: 0°-90° x 10 d.

ROM limits: flex, 90° x 10 d; ext, no limits; abd, no limits;

ER, no limits; IR, no limits. Modalities: massage, active release technique, E-stim as needed starting week 3. Time

lines; week 1 (1-7 POD), week 2 (8-14 POD), week 3 (15-

21 POD), week 4 (22-28 POD).

Courtesy of Howard Head Sports Medicine Centers, Vail, Colorado; with permission.

Q Ui

Table 3

Microfracture

Phase I: initial exercise Ankle pumps

Gluteal, quad, HS, T-ab isometrics

Stationary biking with minimal resistance

Passive ROM (emphasize IR)

Piriformis stretch

Passive supine hip roll (IR)

Water walking

Quadriped rocking

Standing hip IR (stool)

Heel sides

Hip abd/add isometrics Uninvolved knee to chest Prone IR/ER (resisted) Sidelying clams

3-way leg raises (abd, add, ext) Water jogging Dbl leg bridges w/tubing Kneeling hip flexer stretch Leg press (limited weight) Short lever hip flexion/straight leg raises Phase II: intermediate exercises Double 1 /3 knee bends Side supports

Week

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