Once all of the goals from the previous phase have been achieved, athletes can advance in their rehabilitation program per physician's protocol. Once 6 week mark has passed, most surgeons will allow the athlete to advance in strengthening program more aggressively. Closed and open kinetic chain exercises both should be used. Balance and proprioceptive/neuromuscular training also play an important role. However, all of these exercises should be done pain-free. Later in this phase, the athlete will be allowed to start jogging. Isokinetic knee extension/flexion exercise can be initiated around 12 weeks post-op if it is available. However, open kinetic chain knee extension should not be done past 30 degrees of extension since it is known that open kinetic knee extension will put stress on ACL past 30 degrees (between full extension to 30 degrees).
Main goals of this phases will be 1) maintaining full ROM, 2) continue with strengthening program and to achieve optimal strength to begin plyometrics, 3) continue with balance and proprioceptive training, 4) begin slow jogging. Again, rehabilitation program should be based on physician's protocol. Some surgeons may allow to advance earlier than others. It should also based on tissue healing and athlete's tolerance and reaction to the program.
