Proximal Hamstring Repair
Physical Therapy Protocol
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.