Hamstring origin repair

Post-op recovery	First 2 weeks	Date
Goals	Protect the hip and surgical incision Recover from swelling and inflammation Control of post-surgical pain
Precautions	Touch-weight bearing on crutches No hamstring stretches Best position is hip extended (pushed backwards) and knee flexed (bent) Worst position is hip flexed up and knee extended (out straight)
Recommendations	Rest as desired Mobilise on a kneeling scooter where able Do not swing leg forward with knee straight Ice the hip as desired – particularly in the first week Range of motion exercises of ankle Range of motion exercises of knee
Suggested exercises	Stretching: Supine abduction and adduction Gentle pendulum movement of the leg when standing Strengthen: Static gluteal and Quads contractions Isometric abduction, adduction Flex and extend the knee when standing (hip extended – knees side by side) Range of motion of the ankles – ankle pumps

Phase 1	Week 2 to week 6
Goals	Protect the hip and surgical incision Recover from swelling and inflammation Control of post-surgical pain Begin to gain control of the leg
Precautions	Touch weight bearing with crutches
Recommendation	Mobilise on a kneeling scooter where able Do not swing leg forward with knee straight Range of motion exercises of ankle Range of motion of the knee
Suggested exercises	Hip abduction standing – side only (not backwards) Side leg raise – leg straight and leg bent Supine and standing leg extensions Core strengthening abdominals Flex and extend the knee when standing (hip extended – knees side by side) Range of motion of the ankles – ankle pumps

Phase 2	Week 7 to week 12
Goals	Begin to walk normally (11-12 weeks) Increase range of motion
Precautions	Partial weight bear (20 kg) for 2 weeks (week 7,8) Partial weight bear (50 kg) for 2 weeks (week 9,10) One crutch (opposite to operated side) for one week Discard crutches if comfortable week 12 No hamstring stretches
Recommendations	Begin to gently engage hamstring and include in movements No resistive strength training of hamstring – weight of the leg only No running Gradually increase walking distance
Suggested exercises	Hip abduction standing – side and back at 45 degrees Side leg raise – leg straight and leg bent Supine straight leg raise Supine and standing leg extensions Core strengthening abdominals Single leg stance exercises for balance and neuromuscular control (after week 11) Double calf raise – progress to single (after week 11)

Phase 3	3 Months – 6 months
Goals	Comfortably walk normally Strengthen Normal functional daily activities
Precautions	Avoid collision sports or high risk recreational activity Return to running or physical activity slowly in a graduated fashion
Recommendations	Concentrated full rehab program that includes strengthening of core, hip flexors, gluteal muscles, external rotators of the hip, quadriceps, hamstrings and calves. Gain in confidence during athletic activity. Neuromuscular control and co-ordination of leg Long walks
Suggested exercises	Thermaband exercises for gluteals and abductors Lunges Step up, step downs Squats (limit to 60 degrees if using weights) Leg press Double calf raise – progress to single Single leg stance exercises Bridging with gluteal contraction Core strength training Exercycle, elliptical trainer, swimming