Hey there. I keep getting conflicting information from physical therapists and the literature. Some say OKC knee extensions are safe after ACL repair. Others say it shouldn’t occur until at least 3-6 months after surgery. Can you please give me some guidance on this?
Thanks
These are mostly made up recommendations from both “the literature” (typically expert consensus statements, not experimental trials) and physical therapists (anecdotes). Nothing wrong with this for helping to guide management of course, but we should be careful not to over-interpret this info.
For what purpose will you use this information? Patient vs. personal management would change the scope of the answer.
Patient management. I’m a physical therapist practicing about 2 years now.
Yea, in that case I feel that the main takeaway for a provider is that much of the “controversy” regarding OKC safety, efficacy, and timing for inclusion post-ACL reconstruction is artificial. In other words, I don’t understand why people have confident opinions on specific exercise selection. Like most training and/or rehab related things, exercise selection going to vary by individual.
To be clear, the wait for 3 to 6 months message is made up. I would not routinely recommend it. I do not think knee extensions are unsafe. There’s ample data showing good outcomes with OKC early (days to weeks) in the post-op period to write it off completely.
Thank you so much! This is very helpful.