You are here

PCL reconstruction rehab protocol

  • Patients are weight bearing as tolerated with crutch use as needed post-operatively.
  • Patients will use a hinged brace LOCKED IN FULL EXTENSION for 4 Weeks post-op. It is to be used when up and moving around and not needed for controlled exercises or sleeping.
  • Early emphasis should be placed on achieving full passive terminal extension equal to the opposite side.

*No resisted knee flexion exercises for 4 Weeks post-op.

  • Regular manual care of the patella, patella tendon, and portals should be performed to prevent fibrosis.
  • All times should be considered approximate with actual progression based upon clinical presentation.
  • Passive flexion (bending) once or twice per day to maintain motion.

Week 1

  • M.D./Nurse appointment for dressing change day 2, review of home program.


  • Effleurage for edema, soft tissue mobilization to surrounding tissues, gentle range of motion.

“No touch zone” 2 inches from incisions/portals x 4 Weeks.


  • Gait training, pain and edema control, and muscle stimulation to improve quadriceps recruitment.
  • Ankle pumps, quad and adduction sets, leg raises in multiple planes (except hip extension), mild isometric resisted knee extension (between 0-60 degrees).
  • Well-leg stationary cycling and UBE for cardiovascular. Upper body weight machines and trunk exercises.


  • Decrease pain and edema.
  • Gait weight bearing as tolerated with brace locked in full extension x4 Weeks.

Weeks 2 - 4


  • Continue with effleurage, soft tissue mobilization, patellar glides, range of motion.


  • Progress weight bearing and functional mobility as able.
  • Passive flexion and extension stretching. Push for full hyperextension within this time.
  • Prone hip extension exercises performed in full knee extension only.
  • Submaximal quad, knee extension and adduction isometrics in multiple ranges.
  • Short range (0-60 degrees) squats/knee bends, calf exercises, standing hip exercises.
  • Balance and proprioception exercises.
  • Weight machines consisting leg press, calf raises, hip machines and abduction/adduction.
  • Progress to two-legged cycling and short range stair machines as able.


  • Decrease pain and edema.
  • Progress weight bearing as able with focus on good gait mechanics, brace locked in full extension x 4 Weeks.

Weeks 4 - 6

  • MD appointment at 4 Weeks, wean off the use of the brace.


  • Continue with soft tissue, joint mobilizations, patellar glides.


  • Introduce hamstring curls against gravity without resistance. Focus on eccentrics.
  • Gradually increase the depth of knee bends, step exercises and proprioception exercises.
  • Add toe straps and gradual resistance with stationary bike.
  • Swimming and pool workouts as soon as incisions are well-healed.


  • Gait full weight bearing, good mechanics with no brace.
  • Range of motion 80% of non-surgical leg.

Weeks 6 - 8


  • Continue with soft tissue, joint mobilizations, patellar glides to increase range of motion.


  • Add lateral training exercises (i.e. lateral stepping, lateral step-ups).
  • Continue to increase the intensity and resistance of other exercises.
  • Passive range of motion should be near normal.


  • Full range of motion.

Weeks 8 - 12

  • Begin hamstring flexion exercises against light resistance (i.e. open-chain, hamstring curls).
  • Continue to increase functional exercises, endurance, strength, and proprioceptive type exercises.


  • Initiate sport specific training drills.

Weeks 12 - 16

  • Sports Test 1, initiate return to run program.
  • Goals are to increase strength, power and cardiovascular conditioning.
  • Sport-specific exercises and training program.
  • Maximal eccentric focused strengthening program.
  • Fit for functional PCL brace to be used for sporting activities and more ballistic rehabilitation training.


  • Pass Sports Test 1.
  • Return to low impact activities, slow progression to higher impact activities. 4-6 months: Goals are to develop maximal strength, power and advance to sporting activities.
  • Resisted closed-chain rehabilitation through multiple ranges.
  • Running program, balance drills and agility program.

NOTE: All progressions are approximations and should be used as a guideline only. Progression will be based on individual patient presentation, which is assessed throughout the treatment process

To cut, or not to cut? To repair, or to let heal? To rehab without fixing? To live with imperfect parts? Each of these questions is faced every day by surgeons and their patients. Here are a few decisions about incisions.
Pot. Almost 50% of the patients in my practice recently used marijuana to reduce their post-op pain. I didn’t prescribe it; the word just seems to be out.
Many elements contribute to top athletic performance. Some are obvious—like diet and training—but another factor is more subtle.
July 14th, 2015
In light of Wes Matthews and other NBA athletes suffering Achilles ruptures, Dr. Stone speaks to Mavs Moneyball, a...
July 11th, 2018
Dr. Stone gives the nation running tips on how to avoid pain while protecting your joints.
April 27th, 2016
Dr Stone talking about Steph Curry's injury and the Warrior's season.

Stone, K.R., A.W. Walgenbach, A. Freyer, T.J. Turek, and D.P. Speer. 2006.

Stone, K.R., A. Freyer, T. Turek, A.W. Walgenbach, S. Wadhwa, and J. Crues. 2007.

Stone, K.R., A.W. Walgenbach, T.J. Turek, A. Freyer, and M.D. Hill. 2006.