Lateral Lengthening Rehabilitation Protocol

Home » UncategorizedJanuary 5, 2017

Lateral Lengthening Rehabilitation Protocol

Dr. Jared Lee

Big Horn Medical Center

Lateral Lengthening: Lateral Lengthening is used to relieve pressure on the lateral facet of the patella due to tight retinacular structures. It is performed by separating the lateral retinaculum and patellar slip of the IT band from the underlying capsule and sewing them back together side to side to lengthen the lateral restraints. It has recently been shown to provide superior results to traditional lateral release.

Phase One: Emphasis is placed on protecting the lengthened structures, establishing full knee ROM and maintaining lateral patellar excursion. Rehabilitation should start on postoperative day one. This phase is maintained for 4-6 weeks depending on patient progression with rehab.

  • The patient may be weight bearing as tolerated
  • Patella mobilization is initiated POD 1
  • Manual lifting of the lateral patellar edge is emphasized
  • Straight leg raise
  • Quad sets

Phase Two: This is the beginning of strengthening of the operative extremity. A patient may begin phase 2 once full ROM is obtained with quad function but no sooner than 4 weeks postoperatively. Phase 2 is usually 4-6 weeks in duration

  • Functional Quad strengthening, short leg squats
  • Increase resistance on stationary bike
  • Continue lateral retinacular stretching
  • Progress toward full activity

Phase Three: This phase is the return to functional rehabilitation. Full strengthening is initiated with retraining of athlete. Position specific drills should be initiated. This phase typically begins 10 to 12 weeks postoperatively.

  • Return to running, cutting, and pivoting
  • Continue lateral retinacular stretching
  • May initiate plyometric training
  • Return to sport