commit 050bbfb7237f3b233b24a85ec56d2560eb2d9f37 Author: Jan Novak Date: Sun Jan 18 23:32:16 2026 +0100 add knee-rehab-program diff --git a/training/knee-rehab-program.md b/training/knee-rehab-program.md new file mode 100644 index 0000000..16c18a6 --- /dev/null +++ b/training/knee-rehab-program.md @@ -0,0 +1,810 @@ +# Knee Rehabilitation Program +## Post-Meniscectomy + ACL-Deficient Knee + +> **Status:** Active program +> **Started:** _______________ +> **Last updated:** _______________ + +--- + +## Table of Contents + +1. [Understanding Your Knee](#understanding-your-knee) +2. [Core Training Principles](#core-training-principles) +3. [Block 1: Foundation (Weeks 1-4)](#block-1-foundation-weeks-1-4) +4. [Block 2: Strength Development (Weeks 5-10)](#block-2-strength-development-weeks-5-10) +5. [Block 3: Performance/Movement (Weeks 11+)](#block-3-performancemovement-weeks-11) +6. [Movement Culture / Ido Portal Style Work](#movement-culture--ido-portal-style-work) +7. [Progression Guidelines](#progression-guidelines) +8. [Weekly Schedule Templates](#weekly-schedule-templates) +9. [Equipment List](#equipment-list) +10. [Tracking & Notes](#tracking--notes) + +--- + +## Understanding Your Knee + +### What's Causing the Sounds + +| Source | Mechanism | +|--------|-----------| +| **Altered joint mechanics** | Missing meniscal tissue = less cushioning, changed load distribution. Cartilage surfaces contact differently. | +| **ACL deficiency** | Increased anterior tibial translation and rotational instability. Abnormal femur tracking on tibia. | +| **Early degenerative changes** | Meniscectomy + ACL tear accelerates cartilage wear. Sounds reflect cartilage fibrillation. | +| **Synovial fluid changes** | Gas bubbles (cavitation), potentially reduced viscosity. | +| **Scar tissue/adhesions** | Post-surgical tissue snapping over bony prominences. | + +### Intermittent Swelling + +Lateral or medial swelling that comes and goes = **reactive synovitis**. Joint is intermittently inflamed from mechanical irritation. This is feedback that the knee is being stressed beyond current capacity. + +### Why This Program Works + +- **Quad strengthening (VMO focus)** — compensates for ACL instability +- **Hamstring strengthening** — acts as dynamic ACL substitute, limits anterior tibial translation +- **Hip abductor/external rotator work** — reduces valgus stress +- **Proprioception training** — retrains neuromuscular control +- **Movement variability** — builds resilient, adaptable tissue + +--- + +## Core Training Principles + +### Loading Philosophy + +| Principle | Details | +|-----------|---------| +| **Tissue adaptation rates** | Tendons/cartilage: 12-24 weeks. Muscle: 4-8 weeks. Respect the slower tissues. | +| **Progressive overload** | Small, consistent increases. Never rush. | +| **Pain tolerance** | ≤3/10 during exercise is acceptable IF it resolves within 24h | +| **Primary feedback signal** | Swelling. If it increases, reduce volume/intensity. | + +### ACL-Deficient Specific Rules + +``` +⚠️ AVOID: Open-chain knee extension in 0-45° range (max ACL strain zone) +✓ PREFER: Closed-chain exercises (squats, lunges, step-ups) +✓ CRITICAL: Train hamstring co-contraction deliberately +``` + +### Tempo Notation + +Format: **eccentric-pause-concentric** (in seconds) + +- `3-1-2` = 3 sec lowering, 1 sec pause, 2 sec lifting +- `5s down` = 5 second eccentric (negative) phase + +--- + +## Block 1: Foundation (Weeks 1-4) + +**Focus:** Neuromuscular control, proprioception, basic strength + +### Session A — Quad/Stability Focus + +| Exercise | Sets × Reps | Tempo | Notes | +|----------|-------------|-------|-------| +| Terminal Knee Extension (band) | 3×15 | 2-1-2 | Safe open-chain for VMO, stay in 0-30° range | +| Wall sit isometric | 3×30-45s | hold | Start at 60° knee flexion | +| Split squat (assisted) | 3×8/leg | 3-1-2 | Hold wall/rack, control descent | +| Single leg stance (eyes closed) | 3×30s/leg | — | Progress to unstable surface | +| Calf raises (bilateral) | 3×15 | 2-1-2 | Full ROM | + +**Exercise Descriptions:** + +
+Terminal Knee Extension (TKE) + +1. Loop resistance band around fixed point at knee height +2. Step into band so it's behind your knee +3. Stand facing anchor point, knee slightly bent +4. Straighten knee against band resistance +5. Focus on VMO (inner quad) contraction +6. Stay in 0-30° flexion range only + +
+ +
+Wall Sit Isometric + +1. Back flat against wall +2. Slide down until knees at ~60° angle +3. Feet shoulder-width apart, weight through heels +4. Hold position, breathe normally +5. Progress by increasing time or decreasing knee angle (toward 90°) + +
+ +--- + +### Session B — Posterior Chain/Hamstring Focus + +| Exercise | Sets × Reps | Tempo | Notes | +|----------|-------------|-------|-------| +| Glute bridge | 3×12 | 2-2-2 | Squeeze glutes hard at top | +| Nordic curl negative (assisted) | 3×5 | 5s down | Use band/partner, eccentric only | +| Romanian deadlift (light) | 3×10 | 3-1-2 | Dumbbells, feel hamstrings | +| Side-lying hip abduction | 3×15/side | 2-1-2 | Slight external rotation | +| Prone hip extension | 3×12/leg | 2-1-2 | Keep knee bent 90° | + +**Exercise Descriptions:** + +
+Nordic Curl Negative (Assisted) + +1. Kneel on pad, ankles secured (partner, strap, or loaded barbell) +2. Hold band attached to high anchor for assistance +3. Keep hips extended (straight line from knees to shoulders) +4. Lower slowly (5+ seconds) toward ground +5. Use arms to push back up (don't use hamstrings concentrically yet) +6. Focus on controlling the descent + +
+ +
+Romanian Deadlift (RDL) + +1. Stand with dumbbells at thighs, slight knee bend +2. Hinge at hips, pushing butt back +3. Lower weights along legs until hamstring stretch +4. Keep back flat, chest up +5. Drive hips forward to return +6. Squeeze glutes at top + +
+ +--- + +### Session C — Movement Quality/Proprioception + +| Exercise | Sets × Reps | Notes | +|----------|-------------|-------| +| Quadruped rocking | 2×10 | Feel joint movement without load | +| Half-kneeling hip flexor stretch | 2×45s/side | Address common tightness | +| Lateral band walks | 3×12/direction | Mini-band above knees | +| Step-ups (low box, 10-15cm) | 3×8/leg | Control the negative | +| Balance beam walking | 2×10m | Use line on floor or 2×4 | + +**Exercise Descriptions:** + +
+Quadruped Rocking + +1. On hands and knees +2. Rock hips back toward heels +3. Feel knees moving through flexion range +4. Keep spine neutral +5. No load, just movement exploration + +
+ +
+Lateral Band Walks + +1. Mini-band just above knees +2. Quarter squat position +3. Step laterally, maintaining tension +4. Don't let knees cave inward +5. Keep feet parallel, toes forward + +
+ +--- + +### Block 1 Frequency + +``` +Week structure: A - B - C - A - B (5 sessions) +Rest days as needed between sessions +``` + +--- + +## Block 2: Strength Development (Weeks 5-10) + +**Focus:** Progressive loading, single-leg strength, hamstring emphasis + +### Session A — Squat Pattern + +| Exercise | Sets × Reps | Tempo | Notes | +|----------|-------------|-------|-------| +| Goblet squat | 4×8-10 | 3-1-2 | Depth to where form holds | +| Bulgarian split squat | 3×8/leg | 3-1-2 | Rear foot elevated, torso upright | +| Leg press (single leg) | 3×10/leg | 3-1-2 | Foot high on platform = more hamstring | +| Spanish squat (band) | 3×12 | 2-2-2 | Band behind knees, vertical shin | +| Single leg calf raise | 3×12/leg | 2-1-2 | Progress with weight | + +**Exercise Descriptions:** + +
+Bulgarian Split Squat + +1. Rear foot on bench/box behind you +2. Front foot far enough forward for vertical shin at bottom +3. Lower until rear knee nearly touches ground +4. Keep torso upright, core braced +5. Drive through front heel to rise +6. Control descent (3 seconds) + +
+ +
+Spanish Squat + +1. Loop heavy band around squat rack at knee height +2. Step into band, positioned behind knees +3. Walk back to create tension +4. Squat down, band pulls knees forward +5. This allows vertical shins — very patella-friendly +6. Excellent for quad loading with reduced joint stress + +
+ +--- + +### Session B — Hinge Pattern + +| Exercise | Sets × Reps | Tempo | Notes | +|----------|-------------|-------|-------| +| Trap bar deadlift | 4×6-8 | 2-1-2 | Or conventional if unavailable | +| Single leg RDL | 3×8/leg | 3-1-2 | Contralateral load | +| Nordic curl (partial) | 4×4-6 | 3-5s down | Increase ROM progressively | +| Seated hamstring curl | 3×10 | 2-1-3 | Slow eccentric | +| Hip thrust (barbell) | 3×10 | 2-2-2 | Full hip extension | + +**Exercise Descriptions:** + +
+Single Leg RDL + +1. Hold dumbbell/KB in hand opposite to standing leg +2. Slight bend in standing knee +3. Hinge forward, raising rear leg behind +4. Body forms straight line from head to rear foot +5. Feel hamstring stretch on standing leg +6. Return by driving hips forward + +
+ +
+Hip Thrust + +1. Upper back on bench, feet flat on floor +2. Barbell across hip crease (use pad) +3. Lower hips toward ground +4. Drive through heels, squeeze glutes at top +5. Full hip extension at top (no hyperextension) +6. Controlled lowering + +
+ +--- + +### Session C — Unilateral/Athletic + +| Exercise | Sets × Reps | Notes | +|----------|-------------|-------| +| Step-up (higher box, 30-40cm) | 3×8/leg | No push-off from rear leg | +| Lateral step-down | 3×8/leg | Slow, control valgus | +| Single leg glute bridge | 3×10/leg | Progress with foot elevated | +| Pallof press | 3×10/side | Anti-rotation core | +| Reverse lunge | 3×8/leg | Control deceleration | + +**Exercise Descriptions:** + +
+Lateral Step-Down + +1. Stand on box/step (20-30cm) +2. Slowly lower opposite foot toward floor +3. Tap heel lightly, return to start +4. Keep knee tracking over toes (no valgus collapse) +5. This is SLOW and controlled — 3-4 seconds down +6. Excellent for VMO and knee stability + +
+ +
+Pallof Press + +1. Cable or band at chest height +2. Stand perpendicular to anchor +3. Hold handle at chest +4. Press straight out, resisting rotation +5. Hold 2-3 seconds, return to chest +6. Core stays braced throughout + +
+ +--- + +### Block 2 Frequency + +``` +4 sessions/week +Example: Mon (A) - Wed (B) - Fri (C) - Sat (A or B) +Add load when hitting rep targets with good form +``` + +--- + +## Block 3: Performance/Movement (Weeks 11+) + +**Focus:** Power, agility prep, movement complexity + +### Session A — Strength Maintenance + Power Introduction + +| Exercise | Sets × Reps | Notes | +|----------|-------------|-------| +| Front squat or Zercher squat | 4×5 | Heavier loading | +| Box jump (step down) | 3×5 | Concentric only initially, soft landing | +| Nordic curl (full) | 3×5-6 | Full ROM target | +| Kettlebell swing | 4×12 | Hip power, hamstring ballistic | +| Single leg squat to box | 3×6/leg | Pistol regression | + +**Exercise Descriptions:** + +
+Box Jump (Step Down) + +1. Choose box height you can land softly on +2. Jump up with both feet +3. Land softly in quarter squat position +4. STEP down (don't jump down) — reduces eccentric stress +5. Reset and repeat +6. Progress height gradually + +
+ +
+Kettlebell Swing + +1. Hinge to grip KB between legs +2. Hike KB back like hiking a football +3. Explosively drive hips forward +4. KB floats to chest height from hip power (not arms) +5. Let it fall, hinge to absorb +6. Continuous rhythmic motion + +
+ +--- + +### Session B — Deceleration/Agility Prep + +| Exercise | Sets × Reps | Notes | +|----------|-------------|-------| +| Broad jump (stick landing) | 4×4 | Hold landing 3s, no valgus | +| Lateral bound (stick) | 3×5/side | Progress distance gradually | +| Skater squat | 3×6/leg | Counterweight in hands OK | +| Drop landing (low box) | 3×6 | Athletic position, quiet landing | +| Deceleration runs | 4×20m | Jog → stop in 3 steps | + +**Exercise Descriptions:** + +
+Lateral Bound (Stick) + +1. Stand on one leg +2. Jump laterally to opposite leg +3. Stick the landing — hold 3 full seconds +4. Check: knee over toes, no valgus, quiet landing +5. Progress by increasing distance +6. Critical for ACL-deficient knees — trains lateral stability + +
+ +
+Skater Squat + +1. Stand on one leg, other leg behind you +2. Hold counterweight (plate, DB) in front for balance +3. Lower by bending standing knee +4. Rear knee approaches ground (don't touch) +5. Drive through standing leg to rise +6. Pistol squat regression — excellent single leg strength + +
+ +--- + +## Movement Culture / Ido Portal Style Work + +### Philosophy + +> Movement practice develops attributes often neglected in standard rehab: adaptability, body awareness, ground-based mobility, and movement variability. These qualities build resilient tissue and reduce injury risk. + +### Ground Movement Locomotion + +**Practice 2-3×/week, 10-15 minute sessions** + +| Movement | Description | Focus | +|----------|-------------|-------| +| **Loaded Beast** | Quadruped, knees hover 1-2" off ground. Move forward, backward, lateral. | Core, shoulder stability, hip mobility | +| **Crab Walk** | Supine position, hips up. Walk forward, backward, diagonal. | Hip extension, shoulder mobility | +| **Frogger** | Deep squat → hands forward → jump/step feet to hands → repeat | Hip mobility, squat depth | +| **Shinbox Rotations** | Seated, knees bent 90°. Rotate both legs side to side. | Hip internal/external rotation | +| **Lizard Crawl** | Low crawl, contralateral movement pattern | Full body coordination | +| **QDR (Quadrupedal Movement)** | Ido's system — start with basic positions | Movement complexity | + +**Locomotion Descriptions:** + +
+Loaded Beast + +1. Start on hands and knees +2. Lift knees 1-2 inches off ground +3. Maintain this hover while moving: + - Forward: opposite hand/foot advance together + - Backward: reverse the pattern + - Lateral: side-step pattern +4. Keep hips low, core braced +5. Breathe normally (don't hold breath) +6. Start with 30 seconds, build to 2+ minutes continuous + +
+ +
+Shinbox Rotations (90/90) + +1. Sit on ground, both knees bent at 90° +2. One leg in front (external rotation), one behind (internal rotation) +3. Lift knees and rotate to opposite side +4. Both legs now in mirrored position +5. Smooth, controlled transitions +6. Works hip mobility in all planes + +
+ +--- + +### Squat Mobility / Deep Squat Practice + +**Daily practice:** + +| Practice | Target | Notes | +|----------|--------|-------| +| **Squat sit accumulation** | 30 min/day total | Break into chunks throughout day | +| **Squat transitions** | 5-10 min session | Deep squat → half-kneeling → tall kneeling → deep squat | +| **Cossack squat progression** | 2-3×10/side | Shift weight side to side, increase ROM gradually | + +**Deep Squat Sit Tips:** + +``` +- Start with assisted (hold doorframe, squat rack) +- Heels down if possible (elevate heels with wedge if needed) +- Work on spreading time throughout day (5 min chunks) +- Read, work on laptop, watch TV in squat position +- Goal: comfortable, unassisted squat for 5+ minutes continuous +``` + +--- + +### Balance / Single Leg Flow + +| Level | Exercise | Progression | +|-------|----------|-------------| +| 1 | Single leg stand | 30-60s, eyes open | +| 2 | Single leg stand | Eyes closed | +| 3 | Single leg stand | Unstable surface (pillow, balance pad) | +| 4 | Single leg stand | Eyes closed + head turns | +| 5 | Single leg hinge reaches | Touch points around clock face | +| 6 | Single leg squat + rotation | Partial depth with torso rotation | +| 7 | Slackline work | If available — excellent proprioception | + +--- + +### Hanging / Upper Body Integration + +> Hanging work decompresses spine, allows lower body recovery while maintaining training stimulus, and builds grip strength. + +| Exercise | Time/Reps | Progression | +|----------|-----------|-------------| +| Passive hang | 3×30-60s daily | Just hang, relax shoulders | +| Active hang | 3×15-30s | Engage scapula (pull shoulders down) | +| Scapular pulls | 3×8-10 | Active hang → pull scapula down/together | +| Single arm hang | 3×15-30s/arm | Shift weight to one arm | +| Brachiation | If available | Swing hand to hand on bars | + +--- + +### Movement Flow Sequences + +**Beginner Flow (5-10 minutes)** + +``` +Start in deep squat (30 seconds) + ↓ +Shinbox rotations (5 each side) + ↓ +Loaded beast forward (2 meters) + ↓ +Frogger (3 reps) + ↓ +Crab walk backward (2 meters) + ↓ +Cossack squat transitions (5 each side) + ↓ +Return to deep squat + +Repeat 2-3 cycles +Rest 1 minute between cycles +``` + +**Intermediate Flow (10-15 minutes)** + +``` +Deep squat (30s) + ↓ +Shinbox rotations (10 total) + ↓ +Shinbox → loaded beast transition + ↓ +Loaded beast travel (3m forward, lateral, backward) + ↓ +Loaded beast → frogger transition + ↓ +Frogger (5 reps) + ↓ +Frogger → crab transition + ↓ +Crab walk (all directions, 2m each) + ↓ +Crab → supine roll → prone + ↓ +Lizard crawl (3m) + ↓ +Lizard → squat transition + ↓ +Cossack squats (10 total) + +Continuous flow, 2-3 rounds +``` + +--- + +## Progression Guidelines + +### Strength Work Load Progression + +**Week-to-week model:** + +``` +Week 1: 3×8 @ 20kg (establish baseline) +Week 2: 3×10 @ 20kg (add reps) +Week 3: 3×12 @ 20kg (add reps) +Week 4: 3×8 @ 22.5kg (add load, drop reps) +Week 5: Deload — 2×8 @ 20kg (reduce volume 40-50%) +``` + +**Guidelines:** + +- Add reps first within set (8→10→12) +- Then add load (2.5-5kg) and reset to lower reps +- Target: ~10% volume increase per week maximum +- **Deload:** Every 4th week, reduce volume 40-50%, maintain intensity + +### Movement Work Progression + +| Dimension | How to Progress | +|-----------|-----------------| +| **Complexity** | Add transitions between movements | +| **Duration** | Extend continuous flow time (5 min → 10 min → 15 min) | +| **Constraint removal** | Less hand support, smaller base of support | +| **Speed** | Slow → controlled → fluid (never rushed) | + +### Swelling/Pain Decision Tree + +``` +┌─ Post-session swelling increased? +│ +├── Yes, resolves in 24h +│ └── ✓ Acceptable, monitor closely +│ +├── Yes, persists 48h+ +│ └── ⚠️ Reduce volume 30%, reassess +│ +└── No + └── ✓ Progress as planned + +┌─ Pain during exercise? +│ +├── 0-3/10, resolves immediately +│ └── ✓ Continue +│ +├── 4-6/10 OR lingers hours +│ └── ⚠️ Modify exercise or reduce load +│ +└── 7+/10 + └── ✗ STOP, reassess in 48h +``` + +### When to Progress to Next Block + +**Block 1 → Block 2:** (after ~4 weeks) +- [ ] Can perform all exercises with good form +- [ ] No increased swelling from sessions +- [ ] Single leg stance 30s+ eyes closed +- [ ] Wall sit 60s at 60° knee flexion + +**Block 2 → Block 3:** (after ~6 weeks) +- [ ] Bulgarian split squat bodyweight+20kg, 8 reps +- [ ] Full Nordic curl negative (5 second descent) +- [ ] Single leg RDL with good balance +- [ ] No swelling increase from Block 2 sessions + +--- + +## Weekly Schedule Templates + +### Block 1 Template (Weeks 1-4) + +| Day | Focus | Duration | +|-----|-------|----------| +| Monday | Session A (Quad/Stability) | 45 min | +| Tuesday | Movement flow + squat sits | 20 min | +| Wednesday | Session B (Posterior Chain) | 45 min | +| Thursday | Rest or light walking | — | +| Friday | Session C (Movement Quality) | 40 min | +| Saturday | Movement flow + hanging | 25 min | +| Sunday | Active recovery (walk, swim) | 30 min | + +### Block 2 Template (Weeks 5-10) + +| Day | Focus | Duration | +|-----|-------|----------| +| Monday | Session A (Squat Pattern) | 50 min | +| Tuesday | Movement flow (15 min) + hanging | 25 min | +| Wednesday | Session B (Hinge Pattern) | 50 min | +| Thursday | Rest or light activity | — | +| Friday | Session C (Unilateral) | 50 min | +| Saturday | Movement flow (20 min) + squat sits | 35 min | +| Sunday | Active recovery | 30 min | + +### Block 3 Template (Weeks 11+) + +| Day | Focus | Duration | +|-----|-------|----------| +| Monday | Session A (Strength + Power) | 55 min | +| Tuesday | Movement flow | 20 min | +| Wednesday | Session B (Deceleration/Agility) | 50 min | +| Thursday | Hanging + mobility | 20 min | +| Friday | Session A or B (alternate) | 50 min | +| Saturday | Extended movement flow | 30-40 min | +| Sunday | Active recovery | 30 min | + +--- + +## Equipment List + +### Essential (Minimum Setup) + +- [ ] Resistance bands (light, medium, heavy loop bands) +- [ ] Mini-band (for lateral walks) +- [ ] Kettlebell (16-24kg depending on current strength) +- [ ] Adjustable dumbbells OR single heavy dumbbell +- [ ] Foam roller +- [ ] Exercise mat + +### Recommended Additions + +- [ ] Slant board (for Spanish squats, calf work) +- [ ] Nordic curl strap OR setup (doorway anchor, loaded barbell) +- [ ] Pull-up bar (for hanging) +- [ ] Parallettes (for ground flow progressions) +- [ ] Balance pad or Bosu ball + +### Nice to Have + +- [ ] Slackline +- [ ] Trap bar +- [ ] Cable machine access +- [ ] Plyo box set (various heights) + +--- + +## Tracking & Notes + +### Weekly Check-in Template + +``` +Week #: ___ +Dates: ___ to ___ + +Swelling status (0-10): ___ +Pain levels (0-10): ___ +Confidence in knee (0-10): ___ + +Sessions completed: ___/___ + +Top exercise this week: _______________ +Struggled with: _______________ + +Load progressions made: +- Exercise: ___ → ___ +- Exercise: ___ → ___ + +Notes: +_________________________________ +_________________________________ +_________________________________ + +Next week focus: +_________________________________ +``` + +### Exercise Log Template + +``` +Date: ___________ +Session: A / B / C / Movement Flow + +| Exercise | Weight | Sets×Reps | RPE | Notes | +|----------|--------|-----------|-----|-------| +| | | | | | +| | | | | | +| | | | | | +| | | | | | +| | | | | | + +Post-session: +- Swelling: none / mild / moderate / significant +- Pain: none / during / after / lingering +- Energy: low / moderate / good / great +``` + +### Long-term Progress Markers + +| Milestone | Target Date | Achieved | +|-----------|-------------|----------| +| 30s single leg balance (eyes closed) | Week 4 | [ ] | +| Full Nordic negative (5s) | Week 8 | [ ] | +| Bulgarian split squat BW+20kg | Week 10 | [ ] | +| Box jump (step down) 40cm | Week 12 | [ ] | +| 5 min continuous deep squat | Week 12 | [ ] | +| 10 min continuous movement flow | Week 16 | [ ] | +| Lateral bound + stick landing | Week 14 | [ ] | +| Full pistol squat (or to low box) | Week 20 | [ ] | + +--- + +## Additional Resources + +### Recommended Reading/Watching + +- Ido Portal's movement culture content +- Knees Over Toes Guy (Ben Patrick) — ATG training +- Dr. Aaron Horschig (Squat University) — squat mechanics +- FRC/Kinstretch — controlled articular rotations + +### Professional Support + +Consider working with: +- Sports physiotherapist (for technique checks) +- Orthopedic specialist (if instability episodes occur) +- Movement coach (for flow progressions) + +--- + +## Important Notes + +``` +⚠️ The sounds may reduce somewhat as muscle control improves + and joint loading normalizes, but some crepitus is likely + permanent post-meniscectomy. + + Focus on FUNCTION, not noise. + +⚠️ If you experience: + - Giving way / instability episodes + - Locking or catching + - Significant swelling increase + - Sharp pain + + → Consult orthopedic specialist before continuing +``` + +--- + +*Document version: 1.0* +*Created for post-meniscectomy + ACL-deficient knee rehabilitation* \ No newline at end of file