Post 1 year ACL recon

[alophysio]

What about his back?? You say the hip and ankle are cleared but what about his SIJ and L/S joints?

What is the status of his ITB?

How is his glut med strength?

[karen.hankey]

Agree with Alophysio, I would check ITB, but also TFL for tightness and alos his Glut Med stability.

What I meant by checking the hip and ankle was not so much looking for injuries, but assessing tightness and lack of strength which may affect the pull on the patella. e.g. He may have weak hip abductors which would cause internal rotation of the femur leading to a tight ITB causing altered pressure of the patella in its groove and therefore contributing to his problem. (hope I explained that ok)

[uranfeman]

Agree with the above. Patellofemoral dysfunction is common after patella tendon graft ACL recon's. This would need a total approach to his biomechanics. I would get the stability and mobility of the ankle and hip/pelvis right first, otherwise anything you achieve for the knee will be short term.

If you aren't confident with assessing functional biomechanics I would suggest checking out Gary Gray's functional movement screen - www.functionalmovement.com

Kevin