Guidelines: Post-Operative Elbow Lateral Collateral Ligament Reconstruction (with autograft or synthetic graft)
Dr Tanya Mackenzie PhD
Specialist Upper Limb Physiotherapist, Manchester Shoulder Clinic
Maximum Protection (0 to 14 Days)
Control swelling in wrist & hand
Immobilization in sling for 6 weeks
Wound care
AROM wrist & fingers
AAROM & AROM elbow flex & ext with patient lying supine, shoulder flexed to 90 degrees
AROM Pro/supination with elbow in 90 flexion
Do not force supination
Progressive ROM & introduction to light isometrics (2 to 6 Weeks)
Finger & Wrist isometrics
Increase AAROM & AROM elbow flexion & extension as tolerated
Short lever scapular & kinetic chain rehab
Light proprioceptive exercises
(Week 4) isometric elbow flexion & extension (Isometric anconeus)
Maintain shoulder AROM with flexed elbow
Do not force supination – Active supination done in 90° elbow flexion
CKC work to be feather weight bearing in full pronation
No forced movements – active motions done as tolerated
Avoid full elbow extension combined with supinated forearm
Progressive ROM & introduction to strength program (6 weeks)
Full kinetic chain rehab with UL short lever initially progressing to long lever
Assess shoulder biomechanics & address
Isotonic strengthening program elbow & shoulder & forearm
CKC gradually increasing weight bearing
Avoid varus elbow load (long lever in abduction)
Progressive strengthening & return to function (Week 8)
Maintain full elbow ROM
Introduce light activity/sport specific activities
Initiate eccentric elbow activity
Introduce diagonal PNF patterns
Introduce plyometrics
Continue to strengthening elbow & shoulder
Time scales
Full AROM – 6 weeks
Begin a general strengthening program in the gym with slow, light loads– 16 weeks
Return to work guidelines:
❏ Light sedentary: 6 weeks.
❏ Heavy Manual: 12 weeks.
Sport: depends on the sport your consultant & physio will advise
May return to unrestricted activity at one year
Download here – guidelines-lat-lig-recon-elbow