PT Protocol for Proximal Hamstring Repair

Physical therapy Postop Proximal Hamstring Protocol:

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PHASE I – 0-6 weeks

1. Goal – protect repair, pain control
2. Weight bearing
   A. non-weight bearing 0-2 weeks
   B. Toe touch weight bearing 2-4 weeks
   C. Partial weight bearing 4-6 week
   D. Weight-bearing as tolerated after 6 weeks
3. Brace – wear hip-knee-ankle orthosis
4. AVOID – hip flexion with knee extension
5. Exercises – ankle pumps, quadriceps sets, abdominal isometrics, PROM of knee
   With NO hip flexion during knee extension, scar mobilization, upper body ok

PHASE II – 6 -12 weeks postop

1. Goal – progress to weight-bearing as tolerated and gait training
2. Weight bearing
   A. Partial weight bearing week 4-6
   B. Weight-bearing as tolerated week 6 and on
3. AVOID – dynamic stretching, avoid loading the hip at deep knee flexion angles, and No running or impact
4. Physical therapy – gait training, stationary bike, non-impact balance and proprioceptive
   Drills (start double legged and progress to single), begin hamstring strengthening –
   Avoid hip flexion combined with knee extension – work hip extension and knee flexion
   separately, begin isometric and concentric strengthening with hamstring sets, heel slides, double leg bridge, standing leg extensions and physio ball curls, hip and core strengthening

PHASE III – 12 weeks to 20 weeks

1. No impact sports
2. Continue hamstring/hip/core strengthening
3. Bike, elliptical, deep water running

PHASE IV – 5-6 months

1. Sport specific movements and impact
2. Running okay if strong enough

No sports for 9 -12 months depending on rehab process