Intermediate Knee Overuse Rehabilitation

Quadriceps activation with isolated VM/VL recruitment without anterior tibial translation stress,Pain level ≤3/10 during weight-bearing activities on tibiofemoral joint,Full knee extension ROM achieved with patellar mobility preserved,MCL/LCL medial-lateral stability graded as 1+ or less on valgus/varus stress test,No joint line tenderness on medial/lateral meniscus palpation,Swelling volume reduction ≥50% as measured by knee circumference

→ Advance to: Week 2 - Early Mobility Phase

Knee flexion ROM ≥90 degrees without posterior tibial sag indicating PCL integrity,Hamstring curl strength ≥3/5 bilaterally without posterior knee pain,Patellar tendon tenderness ≤2/10 with resisted quad set,Weight-bearing symmetry ≥75% during stance phase gait analysis,Single-leg stance time ≥10 seconds without knee valgus collapse,Proprioception score within 20% of contralateral side on joint position sense testing

→ Advance to: Week 3 - Progressive Strengthening

Quadriceps strength ≥4/5 on isokinetic testing at 60°/sec,Hip abduction strength ≥80% of contralateral side to control frontal plane knee mechanics,Patellofemoral joint compression forces tolerated during squat progression 0-45°,Cartilage loading tolerance demonstrated during low-impact activities,MCL flexibility normalized with valgus stress test showing endpoint feel,Functional movement pattern without compensation patterns

→ Advance to: Week 4 - Advanced Strengthening

Squat depth to 70° knee flexion without patellofemoral symptoms,Plyometric hops tolerated without increased knee swelling,ACL/PCL laxity tests stable compared to baseline examination,Single-leg hop test distance ≥80% of contralateral side,Meniscal symptoms absent during pivot shift and McMurray testing,Core endurance sufficient for dynamic knee stability

→ Advance to: Week 5 - Return to Activity Preparation

Knee ROM within 5° of contralateral side for flexion and extension,Quadriceps strength ≥90% of contralateral side on isokinetic testing,Running program completed without patellofemoral or tibiofemoral symptoms,Agility movements tolerated without knee instability reports,Patient-reported outcome scores improved ≥minimal clinically important difference,Functional movement screening cleared for return to activity level