Proximal Hamstring Repair

Physical Therapy Protocol

Brace Instructions

• Brace Settings: Blocked at 30° extension for 6 weeks. OK to unlock to 30–90° while seated.
• Discontinue Brace: Approximately 6 weeks post-surgery, based on repair strength.

Phase I (Weeks 1–4): Protection & Early Mobility

Weight-Bearing:

• TTWB (~10–14 days).
• 25% WB at 14 days, increasing by 25% weekly until crutches are discontinued at Week 5.

Range of Motion (ROM):

• PROM as tolerated, starting in Week 2, for hip and knee.
• Initiate gentle AROM by Week 3 or 4.

Phase II (Weeks 4–8): Controlled Progression

Weight-Bearing:

• FWB if normal gait patterns are demonstrated.

Exercises:

• Aquatic walking and ROM exercises.
• Closed-chain exercises with limited ROM.
• Isotonic exercises in limited ROM, avoiding terminal extension.
• PROM: Knee extension and hip flexion.
• Core pelvic strength training.

Phase III (Weeks 8–12): Strength & Stability

Exercises:

• Progress isotonic strength training.
• Advanced dynamic exercises.
• Core pelvic strength progression.

Strength Evaluation:

• At Week 10, perform isometric testing at 60° knee flexion.

Phase IV (Weeks 10–24): Advanced Training

• Dry land jogging/running.
• Functional hip testing.
• Sport-specific activities and training.

Phase V (Weeks 24+): Strength Testing

• Full isokinetic evaluation at 60°, 120°, and 180°/second.
• Bilateral comparison upon physician approval.

Phase VI: Return to Activity

• Gradual return to full activity per physician and physical therapist guidance.