Medial Meniscus Rehabilitation

The following is for information purposes only. We recommened seeking professional advice before beginning rehabilitation.

Rehabilitation after surgery is usually rapid. Advice will vary on how long an athlete should stay off their feet, from not at all to 3 to 4 weeks. Athletes should follow their surgeons advice on this.

1. For Partial or Complete Menisectomy

(for athletes who've had part of or all of the medial meniscus taken out)

Phase 1. (0-10 days)

• Wear a compressive support or brace to help reduce the swelling and protect the joint.
• Use crutches to allow partial weight bearing but move as quickly as you can to walking without them.
• Perform range of motion exercises as pain allows (bending and straightening the knee).
• Strengthening the Quadriceps - starting with static quad contractions and then straight leg raises.
• Cycling if this is pain free.

Phase 2 (10-21 days)

• Use a compressive brace or support if required.
• Range of motion exercises - full motion should be achieved within 14 -21days.
• Continue with the straight leg raises - leg weights can be introduced to make it more difficult.
• Start more advanced strengthening exercises such as squats when pain allows.
• Swimmin can be done when the wound has healed.
• Cycling or swimming everyday - can help maintain the kee strength and range of motion, as well as cardio fitness.

Phase 3 (week 3 onwards)

• Increase the reps and difficulty on the exercises above. Increase weights, swimming and cycling.
• Don't over-do the rehab and if struggling or in pain then stop and seek medical advice.
• Don't get depressed. Remain focused and remember that you won't be injured for ever.

People who had a complete removal of the meniscus can (after many years) suffer degeneration or wear and tear at the ends of the bones.

2. For a Meniscal Repair

(athletes who have had a repair of the cartilage)

Phase 1 ( 0-21 days)

• Wear a knee brace which allows a range of movement bewteen 30 and 80 degrees.
• Use crutches (Non weight-bearing)
• Range of motion exercises should be done passively (someone else or a machine moves the limb) whilst in the brace.
• Very light exercises can be done whilst wearing the brace. Do not put in maximum effort. Straight leg raises (knee bent at 30 degrees) - lift, hold for 10 seconds, down, rest for 3 seconds, repeat 10 times, do 3 to 5 sets.
• Use electrical stimulation to help the muscles contract.

Phase 2 (3-6 weeks)

• Increase the range of movement allowed by 10 degrees each week.
• Mobility exercises stick within the movement allowed by the brace until 6 weeks when motion should be full - 0 degrees (straight) to 120 degrees (bent).
• Straight leg raises should be built on from what you did before using a weight if possible and increasing reps.
• After 6 weeks leg extensions and leg curls can be performed from 90 to 30 degrees.
• Progress to full weight bearing throughout this phase.

Phase 3 (7 weeks onwards)

• Continue to build reps and weight on all exercises.
• By now it should be possible to do full range of motion exercises and only use the brace occasionally.
• It should be possible to swim and cycle.

Final points

• Continue to train the quad and hamstring muscles even after returning to sporting activities. These muscles need to be very strong to support the knee.

3. Conservative Treatment - No Surgery

If surgery is not performed, a rehab programme should be used to improve the movement and strength of the knee. A rehab programme can be very effective in many cases (depending on the location and extent of the tear).

• Use R.I.C.E (rest, ice, compression, elevation) to reduce bleeding and swelling.
• Rest for a few of days, or until weight bearing is no longer painful.
• Start gentle mobility exercises and stretches to regain full knee range of motion.
• Once there is no pain, start strengthening exercises for the thigh and calf muscles.
• Proprioception exercises are also recommended to increase balance and the sense of joint positioning. A wobble board is a fantastic product for this.