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This prevention protocol is designed to reduce strength and coordination deficits in the stabilizing muscles around the knee. It is very important to utilize proper technique throughout the protocol with special emphasis on limiting lateral motion in the knee during jumping and emphasizing soft landings. Patient should not be progressed to single leg plyometrics until they can demonstrate substantial control. Full program should be performed 3 times per week.

Warm Up
Straight Line Jogging
1 minute: Keeping hips, knees, and feet in line

Side shuffle
1 minute: No dropping in of knee

Backward Jogging
1 minute: Maintain soft landing on toes with knees slightly bent at all times

Stretching: 30 Second Hold x 2 Reps Each Leg
Calf Stretch
Stand leading with right leg. Keep left heel on the ground and lean forward until a stretch is felt in the left calf.  Repeat on opposite side.

Quad Stretch
Standing tall, reach back, grab right ankle with right hand, and pull ankle to your buttocks. Right knee should point straight down and stay close to left leg. Repeat on opposite side.

Hamstring Stretch
Sit with right leg straight out in front. Bend left knee and place bottom of left foot on right inner thigh. Keeping back straight, push chest forward towards right knee. Repeat on opposite side.

Adductor Stretch
Sit with legs evenly spread. Keeping back straight, first stretch to center.
Then repeat to the right reaching towards toes with both arms. Repeat on opposite side.

Hip Flexor Stretch
Lunge forward with right leg and drop left knee to ground. Keeping back straight, lean forwards with hips and keep hips square with shoulders.
If possible, pull left ankle to buttocks. Repeat on opposite side.

Strengthening: 1-2 minutes of each
Walking Lunge
Lunge forward leading with right leg.  Push off right leg and lunge forward with left leg. Keep bent knee directly over ankle. Do not allow knee to move laterally or over toes.

Russian Hamstring
Kneel on the ground with back straight and ankles firmly held by a partner.
Keeping back and hips in line slowly lean forward.

Single Leg Calf Raise
Stand on one leg and while maintaining balance slowly rise up on toes.
Repeat on opposite side.

Single Leg Squat
Stand on one leg. Keep chest up and squat down.
Keep knee in line with foot and do let knee come over toes.

Half Kneeling Chop and Lift
Lunge forward with right knee letting left knee rest on ground.
Holding a medicine ball or weight lift up over right shoulder then down to left hip.
Repeat on opposite side with left leg forward.

Lie on floor. Lift hips up off floor so only toes and elbows are touching the ground.
Keep core tight and body in a straight line.

Plyometrics – 30 Seconds of Each
Focus on landing softly on balls of feet with knees bent.

Lateral Hops over Cone
Stand with a cone on one side. Hop to the side over the cone and back.

Forward/Backwards Hops over Cone
Stand with a cone in front. Hop forward over the cone, then backwards over the cone.

Single Leg Hops over Cone
Repeat above exercises standing on one leg.
Perform on both legs.

Vertical Jumps with Squat
Stand with hands at side. Squat down and jump straight up.
Land softly on balls of feet and do not leg knees cave inward.

Scissors Jump
Lunge forward with right leg keeping knee over ankle.
Push off right foot and bring left leg forward into lunge position.
Do not let forward knee cave in our out.

Agility – 2 times each
Lay out 3-6 cones a minimum of 20 feet apart

Forward/Backward Running – Cones in Straight Line
Start at first cone and sprint forward. Use a quick 3 step stop before you reach the second cone. Continue through the rest of the cones in the same manner.
Repeat facing backwards. Do not let knees go past toes or cave inwards.

Diagonal Runs – Cones at an angle from each other
Sprint forward to first cone on right. Pivot off right foot and push off to sprint to cone on left.
Alternate cones on each side.

Bounding Run
2 Cones, 40-50 yards apart.
Run between cones bringing knees as high as you can.
Land on balls of feet keeping knee in line with ankle.