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Kestrel Sports Rehabilitation
Orthopedic & Performance Therapy
Dr. Mara Alvén, DPT, SCS
218 Cascade Ave · Bend, OR 97701
(541) 555‑0184 · [email protected]
Treatment Plan · Ref #TP‑2431

ACL Reconstruction Recovery Protocol

A progressive 12‑week program structured in three phases — protection, strengthening, and return to sport — calibrated to graft healing timelines and objective milestones.
i.

Program Overview

Phase 01
Weeks 1 – 4

Protection & Mobility

Graft protection, effusion control, ROM restoration, and quadriceps reactivation.

Phase 02
Weeks 5 – 8

Strength & Control

Progressive loading, single‑limb stability, and neuromuscular control under fatigue.

Phase 03
Weeks 9 – 12

Power & Return

Plyometrics, cutting mechanics, and sport‑specific conditioning with testing gates.

01I
Phase One
Protection & Mobility
Weeks 1 – 4 · 3× / week
  • Knee flexion ≥ 120°
  • Full passive extension (0°)
  • Minimal effusion (Stroke Test ≤ 1+)
  • SLR without lag
ExerciseSets × RepsLoad / TempoFrequency
Heel Slides
Progress ROM gradually; hold end‑range 5s
 3 × 15 Bodyweight · 2‑0‑5 Daily
Quad Sets w/ Biofeedback
EMG threshold > 60% uninvolved side
 4 × 10 Isometric · 10s hold 3× daily
Straight Leg Raise (4‑way)
No extension lag permitted
 3 × 12 Ankle weight 2 → 5 lb 3× / week
Stationary Bike (ROM focus)
Full revolutions when flexion allows
 1 × 10 min Low resistance · RPE 3 Each session
Mini‑Squat (0–45°)
Bilateral, symmetrical weight shift
 3 × 15 Bodyweight 3× / week
Calf Raises (bilateral)
Full ROM, eccentric emphasis
 3 × 20 Bodyweight · 1‑0‑3 3× / week
02II
Phase Two
Strength & Control
Weeks 5 – 8 · 3× / week
  • Quad strength ≥ 70% LSI
  • Single‑leg squat to 60° (no valgus)
  • Pain‑free jog progression
  • Hop test readiness screen
Loading Phase
ExerciseSets × RepsLoad / TempoFrequency
Bulgarian Split Squat
Knee tracks over 2nd toe; controlled descent
 4 × 8 / side DB 15 → 30 lb · 3‑0‑1 2× / week
Romanian Deadlift
Hip‑dominant, posterior chain emphasis
 4 × 10 BB 65 → 95 lb 2× / week
Leg Press (single‑leg)
Range 0–90°; slow eccentric
 4 × 10 60% 1RM · 4‑0‑2 2× / week
Step‑Down (8" box)
Mirror feedback — no trunk lean
 3 × 12 / side Bodyweight → 10 lb vest 3× / week
Nordic Hamstring Curl
Assisted → unassisted eccentric
 3 × 6 Bodyweight · tempo max 2× / week
Treadmill Jog Progression
Wk 7+ only; 1:1 run/walk intervals
 6 × 2 min 5.5 mph · RPE 5 2× / week
03III
Phase Three
Power & Return to Sport
Weeks 9 – 12 · 3–4× / week
  • Quad strength ≥ 90% LSI
  • Hop battery ≥ 90% symmetry
  • Y‑Balance composite ≥ 94%
  • Clear cutting & deceleration test
Return to Sport
ExerciseSets × RepsLoad / TempoFrequency
Back Squat
Depth to parallel; progressive overload
 5 × 5 75–85% 1RM 2× / week
Box Jump & Stick
Soft landing, 3s hold, knee alignment check
 4 × 6 18" → 24" box 2× / week
Lateral Bound (single‑leg)
Progressive distance; stick landing
 4 × 8 / side Max distance 2× / week
Cutting & Deceleration Drills
45° → 90° cuts; video feedback
 6 × 20 yd 75 → 100% effort 2× / week
Agility Ladder Complexes
Reactive patterns w/ coach cue
 5 × 30s High velocity 3× / week
Sport‑Specific Conditioning
Small‑sided scrimmage by wk 12 pending clearance
 20–30 min RPE 6 → 8 2× / week
ii.

Progress Metrics & Milestones

Quad LSI
≥ 90%
Isokinetic at 60°/s by wk 12 gate
Knee Flexion ROM
135°
Achieved by end of phase 2
Single Hop
≥ 90%
Symmetry index vs. uninvolved
Y‑Balance
94%
Composite score, both limbs
Treating Clinician
Dr. Mara Alvén, DPT, SCS
License OR‑PT‑11428 · Sports Certified Specialist
Patient Acknowledgement
Jordan T. Reyes
Reviewed and consented to plan of care