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Physical therapy phase II – external fixator

Physical therapy phase II – external fixator

These exercises are for current patient reference only. You will receive a personalized rehab plan after surgery.

General guidelines

Patient on crutches wearing fixator


  1. Standing and walking on surgical leg is encouraged! Crutches/walker are for comfort and balance only and may be weaned as able.
  2. Home exercise program twice daily.
  3. May use ankle weights and resistance bands under PT guidance.
  4. May pedal stationary bike, walk on treadmill, use elliptical as tolerated.

Positioning bracewear


  1. Wear ankle brace or dorsiflexion strap as instructed.
  2. Lie flat on stomach at least once daily for 30 minutes.
  3. No compression garments or devices. May elevate and ice as needed for swelling.


Ankle pumps

Ankle pumps: With leg resting on bed and knee straight, slowly pump ankle up and down as far as possible.

Quad sets

Quad sets: Tighten thigh muscle and straighten knee as much as possible. Hold 5 seconds.
Glute sets:Tighten buttocks, hold 5 seconds.

Short arc quads

Short arc quads: Place a firmly rolled blanket under knee, with foot resting on bed. Straighten knee and hold 5 seconds.

Heel slides

Heel slides: Slowly bend your knee by sliding your foot as close to your buttocks as able.

Long arc quads

Long arc quads: Sit with knees bent. Slowly straighten knee. Hold 5 seconds.

straight leg raise

Straight leg raise: Lie on your back with opposite knee bent. Slowly raise leg, keeping knee straight. Hold 2 seconds.

Straight leg raise, sidelying

Straight leg raise, sidelying: Bend bottom leg. Keep top leg in line with shoulder. Raise leg slowly, keeping knee straight. Hold 2 seconds.

Straight leg raise, prone

Straight leg raise, prone: Tighten buttocks and raise leg, keeping knee straight. Hold 2 seconds. Optional: place pillow under hips.

Hamstring curls

Hamstring curls: Slowly bend knee, bringing foot towards buttocks until you feel a stretch on front of thigh. Hold 5 seconds.

Standing hip flexion with knee bent

Standing hip flexion with knee bent: Stand with hand on a support. Lift leg with knee bent, as if marching.

Standing hip abduction

Standing hip abduction: Stand with hand on a support. Tighten outer thigh and lift leg to the side, keeping knee straight and trunk upright.

Standing hip extension

Standing hip extension: Stand with hand on a support. Tighten buttocks and lift leg behind you, keeping knee straight and trunk upright.

Standing hip flexion with knee straight

Standing hip flexion with knee straight: Stand with hand on a support. Lift leg forward, keeping knee straight.

Weight bearing on scale

Weight bearing on scale: Practice placing as much weight as tolerated through leg. Use a bathroom scale to measure progress.


Heelcord stretch

Heelcord stretch: Pull heelbone AWAY from patient while pushing ball of foot TOWARDS patient. Hold 20 seconds.

Knee extension stretch

Knee extension stretch: Gently push down on top of thigh (just above the knee) while lifting calf upward, to straighten knee. Hold 20 seconds.

Hip extension stretch

Hip extension stretch: Lying on side. Stabilize pelvis with one hand firmly on buttocks while slowly moving thigh backwards, to straighten hip. Hold 20 seconds.

Knee flexion stretch

Knee flexion stretch: Lying on stomach. Stabilize hip while gently bending knee. Do not allow bottom to rise from bed. Hold 20 seconds.

Hip abduction stretch

Hip abduction stretch: Take leg out to side until a stretch is felt on inner thigh. Stabilize hip on opposite side. Keep knee straight and avoid leg rolling outward. Hold 20 seconds.

Hamstring stretch

Hamstring stretch: Begin with hip and knee bent in a chair position. Keeping thigh in place, gently straighten knee until stretch is felt on back of thigh. Hold 20 seconds.

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  External Fixator Exercise Program, Phase 2
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Where to call with questions or concerns

Tracy Przybylski, PT
Physical Therapist
Limb Reconstruction and Lengthening
314-432-3600, ext. 1138

Jill Hahn, Clinical Coordinator
Limb Reconstruction and Lengthening