General considerations:
- Patients are weight bearing as tolerated with crutch use as needed post-operatively.
- Patients will use a hinged neoprene brace 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.
- Regular manual and self-mobilization 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.

Week 1:
-Patients are seen day 1 out of surgery for dressing change, review of medications and instructed on a home exercise program.
-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 exs.

Weeks 2-4:
- Progress weight bearing and functional mobility as able.
- Passive flexion and extension stretching. Push for full hyperextension within this time.
- 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 of light weight and high repetitions. Leg press, calf raises, hip machines and abduction/adduction.
- Patella, patella tendon and scar mobilization regularly.
- Progress to two-legged cycling without toe straps and short range stair machines as able. Swimming and pool workouts as soon as incisions are well-healed.

Weeks 4-6:
- Wean off the use of the brace for activities of daily living.
- Prone hip extension exercises performed in full knee extension only.
- Gradually increase the depth of knee bends, step exercises and proprioception exercises.
- Add toe straps and gradual resistance with stationary bike.

Weeks 6-8:
- Introduce hamstring curls against gravity without resistance. Focus on eccentrics.
- Continue to increase the intensity and resistance of other exercises.
- Passive range of motion should be near normal

Weeks 8-12:
- Add lateral training exercises (i.e. lateral stepping, lateral step-ups).
- Begin hamstring flexion exercises against light resistance (i.e. open-chain, hamstring curls).
- Fit for functional PCL brace to be used for sporting activities and more ballistic rehab training.

Weeks 12-16:
- Goals are to increase strength, power and cardiovascular conditioning.
- Sport-specific exercises and training program.
- Maximal eccentric focused strengthening program.
- Begin light running program as able to demonstrate good strength and mechanics. 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.
- Initiate plyometric training as able to demonstrate adequate strength and proper mechanics.