MPFL (Medial Patellofemoral Ligament) Protocol
0-6 Weeks Post Op
- WBAT with brace locked in extension and crutches for first 6 weeks
- Unrestricted range of motion- progress as tolerated
- Stationary biking- no resistance, ROM only
- Begin patella mobilizations
- Scar management once incisions are healed
- Quad sets/SLR in Brace at 0° (assist patient with this exercise until solid quad contraction developed)
- Seated calf ex’s
- BFB- Initiate after post op day 14
6-12 weeks Post Op
- Continue as above
- Discontinue brace and normalize gait mechanics
- May begin aquatic therapy emphasizing normal gait, marching forwards/backwards
- Stationary Bike to increase ROM, start with high seat and progress to normal height when able, resistance as tolerated
- May begin flat, hard ground single leg balance once quad control is well established- slow progressions to more difficult variations
- Isometric squat and lunge holds
- DL Leg Press
- Bodyweight to low weight (with BFR, if available) squats, RDLs, and step ups
12-18 Weeks Post Op
- Continue as above
- Obtain baseline strength testing
- May begin transition into light impact exercises if strength is >70% contralateral side
- Increase load with strength exercises
- Squat, deadlift, RDL, step ups, leg press, etc
- Transition into single leg strengthening as tolerated
18- 24 Weeks Post Op
- Begin lateral movement supervised by ATC or PT
- Stepping, shuffling, hopping, carioca
- Initiate plyometric program as appropriate to patient’s functional goals
- Initiate sport specific activities under supervision by ATC or PT- if strength scores are appropriate around week 20
- Clearance by physician prior to return to sport