General Instruction:

1. Check with your Doctor / Physical Theropist on the type of program you should be on.
2. Perform each exercise slowly and carefully. Stop if the exercise increases your pain.

	Hip and Knee Strengthening. Straight Leg Raise. Rest on forearms, tighten muscle on front of thigh, then lift leg 8 - 10 inches from surface, keeping knee locked. Hold for ____ seconds, then slowly bend knee to starting position. Repeat _____ time on each side. Do ___ session per day
Self-Mobilization Prone Knee flexion Stretch Bring heel toward buttocks as far as possible. Hold for ____ seconds, then slowly bend knee to starting position. Repeat _____ time on each side. Do ___ session per day
	Side-Lying Hip Adduction Lying on side, tighten muscle on front of thigh, then lift let 8-10 inches away from floor. Hold for ____ seconds, then slowly bend knee to starting position. Repeat _____ time on each side. Do ___ session per day
Prone Hip Extension Lying on stomach, tighten muscle on front of thigh, then lift leg 8 - 10 inches from floor, keeping knee locked Hold for ____ seconds, then slowly bend knee to starting position. Repeat _____ time on each side. Do ___ session per day
	Self- Mobilization - Downward knee cap push With both thumbs on upper border of knee cap, gently push knee cap toward foot Hold for ____ seconds, then slowly bend knee to starting position. Repeat _____ time on each side. Do ___ session per day.
Standing Unilateral Heel Rise Balance on Right Left foot, then rise on ball of foot. Hold for ____ seconds, then slowly bend knee to starting position. Repeat _____ time on each side. Do ___ session per day.
	Side-Lying Hip Adduction Lying on side, tighten muscle on front of thigh, then lift let 8-10 inches away from floor. Hold for ____ seconds, then slowly bend knee to starting position. Repeat _____ time on each side. Do ___ session per day.
Terminal Knee Extension With knee bent over bolster, straighten knee by tightening muscle on top of thigh. Be sure to keep bottom of knee on bolster. Hold for ____ seconds, then slowly bend knee to starting position. Repeat _____ time on each side. Do ___ session per day.
	Wall Slides Leaning on wall, slowly lower buttocks toward floor until your thighs are parallel to floor. Hold for ____ seconds, then slowly bend knee to starting position. Repeat _____ time on each side. Do ___ session per day.
Standing Knee Flexion Standing, bend knee up as far as possible. Hold for ____ seconds, then slowly bend knee to starting position. Repeat _____ time on each side. Do ___ session per day.
	Standing Bilateral Heel Rise Rise on ball of feet Repeat _____ Repetition/set. Do ____ Sets/session. Do ______ Sessions/day.
Passive Range of Motion Knee Flexion With towel around heel, gently pull knee upwards with towel until stretch is felt. Repeat _____ Repetition/set. Do ____ Sets/session. Do ______ Sessions/day.
	Bridging with Straight Leg Raise Begin by lifting buttocks 6 to 8 inches from floor, then slowly extend one knee keeping stomach tight. Hold for ____ seconds, then slowly bend knee to starting position. Repeat _____ time on each side. Do ___ session per day.
Bridging Slowly rise button from floor, keeping stomach tight. Hold for ____ seconds, then slowly bend knee to starting position. Repeat _____ time on each side. Do ___ session per day.
	Terminal Knee Extension in Standing Start with knee slightly bent and tubing just above knee, gently pull knee back straight. do not overextend knee. Repeat _____ Repetition/set. Do ____ Sets/session. Do ______ Sessions/day.
Double Leg Wall Sit: With the back against the wall and the feet 12-24 inches away from the wall, squat down until the knees are bent ______ degrees. Hold for ____ seconds, then slowly bend knee to starting position. Repeat _____ time on each side. Do ___ session per day.
	Single Leg Wall Sit: With the back against the wall and the feet 12-24 inches away from the wall, squat down until the knees are bent ______ degrees. Hold for ____ seconds, then slowly bend knee to starting position. Repeat _____ time on each side. Do ___ session per day.
Lateral Step Ups: Place the involved extremity on a ______ inch stool or step. Lift the opposite extremity's toes off the ground and then straighten the involved knee so as to lift the body straight upwards. Begin with ____ repetitions and progress to _______ repetitions.
	Front Steps: Stand in front of a _____ inch stool or step with the involved extremity on top of the step. Straighten the knee and lift the body straight upwards onto the step. Step back down leading with the uninjured leg. Begin with ____ repetitions and progress to _______ repetitions.
Double Leg Squat: Stand with feet spread shoulder width apart. Squat down by bending at the knees. The shoulders should move forward by bending at the waist as you descend. Depth of squat is to _____ degrees. _____ sets of ______ repetitions.
	Single Leg Squat: Stand on the involved foot. The uninvolved foot should be off the ground or lightly touching for balance. Squat down by bending at the knee. The shoulders should move forward by bending at the west as you descend Depth of squat is to _____ degrees. _____ sets of ______ repetitions.
Retro Double Leg Squat: Stand with feet spread shoulder width apart. Squat down by bending at the knees. The body weight should move backwards while keeping the legs perpendicular to the ground. The shoulders should flex forward to counterbalance your body weight as you descend. Depth of squat is to _____ degrees. _____ sets of ______ repetitions.
	Retro Single Leg Squat: Stand on the involved foot. The uninvolved foot should be off the ground or lightly touching for balance. Squat down by bending at the knee. The body weight should move backwards while keeping the leg perpendicular to the ground. The shoulders should flex forward to counterbalance your body weight as you descend. Depth of squat is to _____ degrees. _____ sets of ______ repetitions.

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