The aim of phase 3 is to increase strength and endurance of the quadriceps whilst maintaining length.
Treatment
To be done daily.
Taping/Bracing
As required
Cold therapy
Apply cold therapy if you have any soreness or reaction from exercises.
Massage/foam roller
Apply massage to the quadriceps muscles if available.
Use a foam roller each day before stretching.
Stretching
To be done daily.
Calf stretch
Teaching Points:
- Calf stretches should be done with your leg straight to stretch the larger gastrocnemius muscle and bent to target the deeper soleus muscle
- 15 second hold
- Do 2 sets of 3 reps on each leg.
Quadriceps stretch
Teaching point:
- Hold the foot of the leg to be stretched and gently pull up behind
- Aim to keep the knees together and pull the leg up straight not twisted
- A stretch should be felt at the front of the leg – It should not be painful!
- 2 x (3 15sec holds)
Hamstring swings
Teaching point:
- The affected leg is the one swinging
- Swing forwards and backward, keeping the knee straight
- Take it as far as you feel comfortable, keeping it smooth and rhythmical
- 2 x (3 15 reps)
Adductor swings
Teaching point:
- Swing the leg out sideways, making sure you rotate your leg so your toes point upwards as your leg swings upwards
- 2 sets of 3 to 15 reps on each side
Note: Dynamic adductor swings must be done within a pain-free range of motion.
Gluteal stretch
Teaching point:
- On your back cross your right ankle over the left knee
- Grip the thigh of your left leg and pull the knee towards you, lifting your foot off the floor
- Pull the knee further towards you to increase the stretch
- 2 sets and hold for 15 seconds
2 x (3 15sec holds)
Strengthening
2 to 3 times a week.
Squat
Teaching point:
- Start at 3 x 8 reps, add weight if needed/comfortable
- Progress to 3 x 10 reps then 3 x 12 reps as your knee is able to cope with increased loads
Single leg press
Teaching point:
- Progress from 3 x 6 reps to 3 x 8 reps then 3 x 10 reps as your knee can cope with higher loads
Single leg knee extension
3 x (6 to 10) reps each side
Single leg RDL
Teaching Points:
- Standing leg stays fairly straight
- Reach out and backward with the free leg
- Challenges stability around your hips
- 3 sets of 6 reps, each side
Single leg calf raise
Teaching point:
- Lift your heel as high as you can, pause, and then lower yourself back
- 3 sets of 6 to 10 reps
Functional
To be done every other day.
A lock at wall
Teaching Points:
- Leaning tower exercise, also known as ‘A’ lock is performed against a wall
- Drive the knee upwards and hold the position
- 2 sets of 5 each leg
Drop jump
Teaching point:
- Simply jump/drop off a step
- Absorb the impact with your legs, briefly holding the position at the bottom
- 2 x 5 reps each side
Activation
To be done daily.
Clam in flexion with band
Teaching Points:
- Lie on your side with your knees bent and slightly forward so your hips are in flexion
- Raise your knee up in a slow, controlled movement and return to the start position
- If you begin to find this exercise easy then you can increase difficulty with a stronger band
- 2 sets of 30 seconds
Clam in extension with band
Teaching Points:
- Performing the clam exercise with your knees moved further back places your hips into extension
- This targets the muscles on the outside of the hip in a slightly different way
- It is important to do these exercises on both sides
- If you begin to find this exercise easy then you can increase difficulty with a stronger band
- 2 sets of 30 seconds
Running
3 times a week max.
Running
3 min run, 1 walk @50% pace
Move on to phase 4?
Check if you are ready to move on:
Exit criteria
In order to progress to phase 4 you must:
- Be pain-free through all the exercises
- Have no pain when running
- No pain after running, for the following 24 hours
- Leg strength is 80-90% of the uninjured side