Lower Extremity

Use the links below to obtain PDF’s of the Sports & Orthopaedic Specialists Lower Extremity Physical Therapy Protocols. Our protocols draw evidence from the current literature and account for preferences of the providers at Sports & Orthopaedic Specialists. The protocols may be modified by the referring provider for an individual patient. If questions arise regarding the utilization of the protocols or the progress of a specific patient, contact Sports & Orthopaedic Specialists.


Click here to go to the Operative Knee, Ankle & Foot Protocols below

For information about Return to Activity, click here.

For more information on knee/ankle/foot anatomy and injuries check out our Lower Extremity Center.



Principles for the Management of Non-operative Lower Extremity Conditions

- Focus on active engagement of the patient through patient education and therapeutic exercise.  Establish a home exercise program that can be progressed as symptoms decline. 

- Home exercise program should result in minimal to no symptom exacerbation.  Max pain of 3/10 during and after exercise.  Differentiate pain from fatigue.  Patient should call the PT for recommendations if pain increases during or after exercise. 

- The main goal of physical therapy is to develop functional strength via improved neural recruitment and motor control.  

- Consider local tissue irritability in decision making when determining intervention.  Use caution to avoid post-treatment tissue inflammation and associated pain. 

- Use body weight against gravity and light free weights for resistance.  See protocols for specifics regarding weight maximums.  


Power's Program | PDF

Patellofemoral Pain Syndrome | PDF

ACL-Deficient Knee | PDF

Proximal Hamstring Strain | PDF

Tibialis Posterior Tendon Dysfunction PDF

Eccentric Calf Strengthening PDF



Principles for Post-operative Lower Extremity Rehabilitation

- Adhere to postoperative precautions. 

- Respect tissue healing.  The surgeons at Sports & Orthopaedic Specialists uniformly prefer a slow progression of postop patients with minimal postoperative pain. 

- Postoperative pain may be experienced.  However physical therapy, including the home exercise program, should result in minimal to no symptom exacerbation.  The patient should call the PT for recommendations if pain increases during or after exercise. 

- The therapeutic exercises in the protocols convey the appropriate load for the shoulder given the time elapsed since surgery in regards to tissue healing.  It is acceptable for a patient to progress more slowly.  However, it is not acceptable for a patient to progress more quickly unless directly indicated by the surgeon. 

- Encourage patient use of ice until pain free or 8 weeks after surgery. 

- No manual therapy unless explicitly prescribed by the surgeon.  No passive range of motion.  No theraband.  No pulleys.  


Knee Post-Operative Protocols

ACL Reconstruction | PDF

PCL Reconstruction | PDF

Meniscus Repair PDF

MPFL Reconstruction PDF

High-Tibial Osteotomy  PDF


Ankle Post-Operative Protocols

Achilles Tendon Repair PDF

Ankle Fracture with Syndesmosis Repair PDF

Ankle Fracture without Syndesmosis Repair PDF

Lateral Ligament Repair with Internal Brace PDF


Click here to return to the Conservative Knee, Ankle & Foot Protocols above