Quadriceps Tendon Tear Rehabilitation Protocol
PHASE I
Week 0-2
- Brace locked in full extension for 6 weeks except for passive range of motion exercises
- Partial weight bearing for two weeks with crutches
- Ice and modalities to reduce pain and inflammation
- Aggressive patella mobility drills
- Range of motion – 0 to 30 degrees knee flexion
- Begin submaximal quadriceps strengthening
Weeks 2-4
- Weight bearing as tolerated progressing off crutches
- Continue previous exercises
- Progress range of motion – 0 to 60 degrees
Week 4-6
- Full weight bearing
- Range of motion
- Continue previous exercises
- Modalities for pain and swelling
- Begin with AROM/Progress to AAROM as tolerated
- Heel Slides
- Wall Slides
- Stationary Bike
- Include prone hangs to maintain full extension ROM
- Patellar mobilizations
- Stretching for hamstrings, iliotibial band, and gastroc-soleus complex
- Strengthening
- Quadriceps sets
- Straight leg raises in all planes
- Heel Raises
- Mini squats
- Russian stimulation to quadriceps/vmo musculature for muscle re-education.
PHASE II
Week 6-8
- Continue to progress to full ROM
- Progress with strengthening/CKC activities
- Standing TKEs with Thera-Band
- Stool scoots-forwards and backwards
- Seated hamstring curls with Thera-Band
- Wall sits/Swiss ball squats
- Bilateral leg press (45° – 0°)
- Single leg balance
Week 8-12
- Normalize gait pattern
- Progress with strengthening/Quadriceps eccentric strengthening
- Bilateral leg press (90° – 0°)
- Lateral step-ups (begin with 2” step)
- Unilateral leg press (90° – 0°)
- Multi Hip machine
- Hamstring Curls
- Progress balance and proprioception exercises
- Lunges
- Elliptical trainer
- Stairmaster
Week 12-16
- Focus on progressing with CKC concentric/eccentric quadriceps strengthening and conditioning.
- May begin light OKC quadriceps strengthening
- Knee Extensions (light weight/many reps)
Return to Activities:
Return to full activities on average 4-6 months per Dr. Collard and approved by physical therapist.