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We Work Wonders with Muscles, Bones, and Joints

Bellevue physical therapist


Come experience physical therapy in the Issaquah area and learn about treatments for knee, ankle, and other lower extremity injuries.

Achilles Repair

0-2 Weeks

  • No Achilles stretching
  • AROM: DF to 0 degrees only, PF as tolerated
  • Seated heel raises
  • WBAT with crutches, CAM Walker

2-6 Weeks

  • Wean from crutches, FWB in boot
  • Progress to shoe with heel lift
  • Bilateral standing heel raises
  • Stationary bike (in boot initially)
  • PF with resistance tubing/band
  • AROM all planes

6-12 Weeks

  • Initiate single- leg heel raise as able
  • Functional agility training: steps, SLS/balance activities
  • Ankle theraband exercises

12+ Weeks

  • Heel raises with weights
  • Light jogging if full ROM, strength and no pain
  • Sport specific activities
Ankle Fracture
  • 0-6 Weeks

    • GT with appropriate assistive device- weight-bearing status as determined by MD
    • ROM and strengthening for proximal joints

    6-8 Weeks

    • CAM Walker/boot as prescribed by MD
    • Ankle AROM/gentle theraband exercises
    • Progress weight-bearing status as allowed
    • Initiate stretching
    • Stationary bike
    • Modalities PRN

    8-12 Weeks

    • Normalize gait mechanics
    • Progress ankle TB exercises
    • Initiate/progress CKC exercises
    • Balance/propriception activities
    • Joint mobilization as needed
ITB Syndrome


  • Modalities for pain modulation and decreased inflammation
  • LE stretches for ITB, gluteals, hamstrings, quads, and hip flexors


  • Continue LE stretches
  • Initiate hip abduction strengthening
  • Return to activity as symptoms allow

Care should be taken to accurately assess causative factors to determine need for further intervention such as footwear recommendations and/or orthotics.

Patella Tendon Repair

0-2 Weeks

  • Brace at 0 degrees
  • Crutches for ambulation, WBAT
  • PROM: full extension, Flexion to ______
  • Patella mobs
  • Exs.: SLR in brace, quad sets, ankle TB
  • Edema control

2-6 Weeks

  • Wean from crutches
  • Flexion to 90 degrees
  • Increase brace ROM

6-12 Weeks

  • D/C brace when good quad control and functional stability
  • LE PREs with light weight, high reps
  • Stationary bike
  • Full ROM
  • CKC exs.: SLS, balance/propriocetion, mini-squats, step ups

3-6 Months

  • Progress CKC and strengthening
  • Agility/Sport specific training
  • Initiate plyometrics

6 Months

  • Return to play
Patellafemoral Pain Syndrome

There are a number of etiologies of anterior knee pain; therefore, effort should be made to accurately determine the etiology of pain to direct treatment.

Acute Phase

  • Avoid aggravating activities
  • Modalities may be used for pain control
  • Patella taping/bracing
  • Orthotic/shoe evaluation and recommendations
  • LE stretching
  • Patella mobilizations
  • Initiate strengthening as able (pain-free)


  • Continue stretching
  • Progress strengthening within tolerance
  • Continue patella mobilizations/manual therapy as indicated
  • Return to activity as tolerated
  • Modalities PRN
ACL Reconstruction

0-2 Weeks

  • Full TKE
  • Edema control
  • Patella mobs
  • WBAT-minimize gait deviations, crutch use PRN
  • Quad facilitation (NMES PRN)

2-6 Weeks

  • 0-120 degrees ROM
  • Normalize gait- weight shifting, SLS proprioception activities
  • CKC exercises- mini squats, wall squats, lunges
  • Stationary bike when ROM allows

6-12 Weeks

  • Full ROM
  • Normal Strength
  • Progress proprioception and strengthening activities
  • Agility training

12 Weeks

  • Initiate jogging/running progression, if full ROM, strength and no pain
  • Progress agility
  • Elliptical

6 Months

  • Return to full sport participation
Hamstring Strain
  • 0-2 Weeks

    • RICE
    • Crutches if needed
    • Modalities for pain modulation, decreased edema and inflammation
    • Gentle stretching
    • Prone AROM short-arc knee flexion (pain-free)

    2-6 Weeks

    • Normalize gait- discontinue crutches
    • Progress stretching as tolerated
    • Full range AROM- progress to light weights as tolerated
    • Initiate stationary bike
    • Progress walking to light jogging as able
Knee Microfracture Chondroplasty

Femoral Condyle

  • Full ROM as quickly as possible
  • Edema/pain control
  • TTWB with crutches x 6-8 weeks, then WBAT
  • Low resistance bike beginning 1-2 weeks post-op
  • Full weight training at 16 weeks


  • Edema/pain control
  • WBAT immediately
  • Brace 0-20 degrees x 8 weeks
  • Strength training- avoid defect contact angles x 4 months
Total Hip Arthroplasty
  • No adduction beyond neutral
  • No internal rotation
  • No flexion >90 degrees with LE in neutral or adducted
  • No SLR x 6 weeks

0-2 Weeks

  • WBAT with appropriate assistive device
  • PROM
  • AROM- abduction
  • Prone lying
  • Bridging

2-6 Weeks

  • Wean from assistive device when no Trendelenburg
  • Balance/Propriception training
  • PREs- abduction and extension
  • Stationary bicycle/TM

6-12 Weeks

  • Functional activity training
  • Progress toward HEP
Total Knee Arthroplasty

0-2 Weeks

  • WBAT with appropriate assistive device
  • A/AA/PROM- knee hangs for full TKE
  • Patella mobilizations
  • Pre-gait and gait training activities as needed
  • LE PREs

2-6 Weeks

  • Wean from assistive device as gait pattern normalizes
  • Stationary bicycle when ROM allows
  • Balance training- single limb stance
  • Progress PREs
  • Progress flexion ROM

6-12 Weeks

  • Balance/Proprioception activities
  • Flexibility
  • Functional activity training