Intended for licensed physical therapists coordinating care with Dr. Vasileff. Defer to the operative note and the surgeon’s office for patient-specific direction.
Knee · Patellofemoral
Patellofemoral Pain Syndrome
Non-operative protocol · Dr. Chris Vasileff, MD
For the treating physical therapist. This protocol is a guideline; progression is criteria-based and individualized. Defer to the operative note and the surgeon’s office for patient-specific direction.
Phase I Inflammatory Phase
- Modalities to control inflammation
- Prescription anti-inflammatories
- Ice
- Clinical modalities as needed
- Evaluate and treat lumbar, sacral, and pelvic dysfunction
- Evaluate for corrective orthotics
- Implement appropriate, selective stretching
- Iliotibial band
- Hamstrings
- Quadriceps
- Gastrocnemius/soleus
- Piriformis
- Apply appropriate patella mobilizations
- Evaluate lateral retinaculum and apply patellar tilt mobilization when indicated
- Begin early VMO/quadriceps strengthening • Quad setting
- Multi-plane straight leg raises
- Open kinetic chain multi-plane hip strengthening
- Cardiovascular exercise
- Stationary bike
- Treadmill walking
Phase II – Subacute and Early Strengthening Phase:
- Continue with appropriate Phase I activities
- Advance strengthening
- Proprioception
- Closed kinetic chain squat program
- Closed kinetic chain unilateral squats, dip, and step-up progression
- Closed kinetic chain multi-plane hip strengthening
- Advance intensity and duration of biking and treadmill walking program
Phase III – Advanced Strengthening
- Advance closed kinetic chain strengthening as appropriate
- Begin gym strengthening, using caution with leg extensions
- Begin light jogging progressing as tolerated
Phase IV – Return
- Continue with Phase III Program
- Re-evaluate with physician and therapist
- Advance to return to sport program as motion, strength, and endurance allow
Questions about a protocol? Contact Dr. Vasileff’s office at (704) 865-0077.