Post-Surgical Rehabilitation

Why criteria-based rehab matters

The biggest shift in post-surgical rehabilitation over the past decade is the move away from calendar-only timelines toward criteria-based progression. The most-quoted example is ACL reconstruction — Grindem et al. (BJSM 2016) showed that returning to sport before meeting strength and hop-test benchmarks increases re-injury risk significantly. The same principle applies across procedures: strength, control, and capacity dictate when you progress, not just how many weeks have passed.

Procedures I work with

• ACL Reconstruction — phase-based progression to criteria-based return to sport
• MPFL Reconstruction — for recurrent patellar instability
• Partial Meniscectomy — effusion control, quad strength, graded loading
• Meniscus Repair — extended protected phase, surgeon-protocol-driven
• Rotator Cuff Repair — MOON Shoulder Group-aligned, surgeon-specific timelines
• Total Knee / Hip Replacement — OARSI-aligned progressive exercise

How rehab is structured

Most post-surgical rehab unfolds across phases:

1. Protection and activation. Restore range gradually within surgeon-defined limits. Begin reactivating the muscles around the joint, particularly the quadriceps after knee surgery and the deltoid and scapular stabilizers after shoulder surgery.
2. Strength building. Progressive loading once the tissue can tolerate it. This is the longest phase and where most of the long-term outcome is built.
3. Power and reactive control. Plyometrics, change of direction, and sport-specific demands.
4. Return to sport / activity. Criteria-based: strength symmetry, hop or functional test symmetry, sport-specific tolerance, and (where appropriate) psychological readiness.

What to expect from the process

• Coordination with your surgeon. Every surgeon has their preferred protocol, and we work within it.
• Written progressions. You leave each visit knowing exactly what to do until the next one.
• Objective benchmarks. Strength testing, range measurements, and functional test scores are tracked, so progression decisions are based on data, not guesswork.
• Honest timelines. ACL is typically 9–12 months. Rotator cuff is 4–6+ months. Joint replacement is 3–6 months to full function. Calendar milestones matter, but only as outer bounds.