What is meant by criterion-based progression in rehab?

• A. Progression is based on time or calendar stages
• B. Progression is determined by meeting specific functional and physiological criteria (pain, swelling, strength, ROM)
• C. Progression based on surgeon's mood
• D. Progression based on athlete request

Answer: (B)

Criterion-based progression means you move through rehab stages only after meeting specific, objective criteria that show the injured tissue is ready for the next load. In practice, this means progression is guided by how the body actually responds, not by simply following a calendar.

Typical criteria include having low or no pain during activities, minimal swelling, and full or near-full range of motion. Strength should be back to a target level relative to the uninjured side, and the person should be able to perform controlled, functional tasks or sport-specific movements without pain or instability. Proprioception, balance, and endurance tests may also be used to confirm readiness before increasing difficulty.

If these criteria aren’t met, the program is stepped back or slowed to protect healing tissue and reduce the risk of re-injury. This approach contrasts with time-based progression, which follows a fixed schedule regardless of how the injury is healing. Decisions aren’t based on surgeon mood or athlete request; they rely on objective measures and clinical judgment to ensure safe, effective recovery.