The following exercises are examples of those that could be used in the rehabilitation of a lateral cartilage meniscus injury and are for information purposes only.
The following meniscus tear exercises are strengthening exercises which are split into early stage exercises which can be done as soon as pain allows, mid stage which are progressed onto once the early stage exercises are easy and finally late stage which should take the athlete back to full fitness. We have also included some proprioception or co-ordination exercises.
Early stage lateral meniscus tear exercises
Static Quadriceps Contractions
This exercise is used to prevent quadriceps muscles wasting away in the early stages of injury. In this stage weight bearing and more difficult exercises may be either not advised or too difficult. This exercise may be started as soon as pain will allow and done on a daily basis. Simply contract the quad muscles, hold for count of 10 and relax. Repeat 10 to 20 times. This can be performed either flat on the floor, or with a foam roller or rolled up towel under the knee.
Static Hamstring Hold
This exercise is used to maintain the strength of the hamstring muscles when other exercises may be too difficult. Again it may be started as soon as pain will allow and can be done on a daily basis. Lie on your stomach with the knee bent at 45 degrees. Hold for count of 10 and lower slowly. Repeat 10 to 20 times. This can be progressed by increasing the length of hold, as well as using some external force such as a partner to increase the resistance or ankle weights.
Static Hamstring Contractions
This exercise is more difficult than the one above and also helps in increasing the range of movement in the knee joint. This involves contracting the hamstring muscles without movement - by pushing against a static object or partner.. You can do this by attempting to either bend the knee or extend the hip, or both!
Mid-stage lateral meniscus tear exercises
Straight Leg Raises (SLR)
This exercise is more difficult than the static quadriceps exercise as it involves lifting the entire weight of the leg against gravity. Position yourself sitting on the floor with both legs straight out in front of you. Raise the straight leg off the floor and hold for 10 seconds, relax, rest for 3 seconds and repeat 10 to 20 times.
This exercise specifically targets the quadriceps muscle group. It may be used relatively early in the rehab process but care should be taken not to overload the injured leg. It can be done with a weights machine in a gym or with rehab band as shown.
You can perform this with either ankle weights, a resistance band or a weight machine. Aim for 3 sets of 10 repetitions initially with light weights/low resistance and gradually increasing.
Hip Raises (Bridging)
This works the hamstrings and buttock muscles. Lie on your back with your knees bent and feet flat on the floor. Lift your hips up off the floor as far as they will go, hold for 3 seconds and lower. Repeat 10 to 20 times. To progress this exercise, increase the length of time that the hips are held up, initially to 5 and then to 10 secs.
Raise up and down on the toes on the edge of a step in a smooth movement. Aim for 3 sets of 20 repetitions. This exercise can be progressed to single leg calf raises as fitness and tolerance increases.
Late Stage Exercises
This is arguably the best exercise to increase quadriceps muscle strength. Nevertheless, extreme care should be taken with this exercise as it involves large loading of the quadriceps muscles and the knee joint itself
- Squat down half way to horizontal and return to standing.
- Try to sink down through the knees, keeping the back straight and not allowing your knees to move forwards past your toes
- Return to the start position and repeat
- Aim for 3 sets of 10 repetitions during rehabilitation.
- Progress this exercise by adding weight or moving to single leg squats.
Later in the rehabilitation process, squats can be progressed to horizontal (90 degrees flexion at knee and hip)
Hip Flexor Exercises
- Start with the band tied around your ankle and also something close to the floor.
- Make sure you have something to hold on to.
- Raise the knee up towards the chest, against resistance Play video
- Slowly return to the start position and repeat.
- Aim for 3 sets of 10 repetitions.
If you do not have rehabilitation band or suitable weights then this exercise can be done without resistance. However in this situation more reps should be added to the rehab program.
Hip Adduction Exercises
The hip adductors are better known as the groin muscles.
- Attach a resistance band around your ankle and then fasten it to a secure object, to the side of you.
- Start with the leg out to the side, away from the body, with the knee straight.
- Pull the leg across your body as far as comfortable, before slowly returning back to the start position
Hip Abduction Exercises
The hip abductors are vital components in gait as they allow the hips to support the weight of the body. Thus strengthening exercises for this muscle group is vital to any lower limb rehabilitation program. These can be performed in lying in the acute stage and progressed into standing with a resistance band.
- Tie the band around your ankle and around a sturdy object to the side of you.
- Start with the leg to be worked on the opposite side to the attachment point
- While keeping the leg straight, take leg out to the side as far as comfortable
- Slowly return to the start position.
This exercise can be progressed using elastic bands to increase resistance.
Proprioception can be considered as the body's ability to sense where it is in space. In the event of an injury this mechanism becomes disrupted and proper training is needed to re-educate the muscles to fire at the right time to allow further injury prevention. The most common way to achieve this is to first stand and then walk on an uneven surface. As balance continues to improve proprioceptive exercises can progressed as follows:
- Two footed stand on wobble board -aim to maintain balance for as long as possible
- Progress to one legged (injured side) wobble board exercises
- Practice hopping on the injured leg on an uneven surface
- Gradually increase difficulty by throwing a ball against a wall and catching it while standing on the wobble-board. Aim to challenge yourself by throwing the ball outside your comfortable center of gravity.
Proprioceptive exercises should be continued even after a return to full fitness to prevent future injury.