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.