An example of a lateral meniscus tear rehabilitation programs for patients who have had a complete or partial meniscus removed, patients who have had a cartilage meniscus repair and those who have not had surgery but are attempting conservative treatment.
We recommend seeking professional advice before attempting any self-rehab.
1. For Partial or Complete Meniscectomy
(athletes who have had part or all of the cartilage meniscus taken out)
Phase 1 (0-10 days)
- Wear a compressive brace or support to protect and help reduce the swelling.
- Range of motion exercises as pain will allow (bending and straightening your knee as much as pain will allow).
- Quadriceps strengthening – start with static contractions and then straight leg raises.
- Cycling if pain will allow.
- Use crutches, partial weight bearing but move as quickly as you can to full weight bearing.
Phase 2 (10-21 days)
- Use a compressive brace or support if needed.
- Range of motion exercises – you should be up to full range of motion by now.
- Continue to build on the straight leg raises perhaps introducing leg weights to make it more difficult.
- Start to perform more advanced strengthening exercises such as squats.
- When the wound has healed you can swim.
- Cycling – try do 20 minutes a day of aerobic exercise whether it is cycling or swimming – it will make you feel better.
Phase 3 (week 3 onwards)
- Build on what has been achieved so far. Increase weights, swimming, and cycling.
- Do not overdo the rehabilitation and if the athlete is struggling or in a lot of pain then they should stop and seek medical advice.
- Do not get downhearted. Stay focused and remember you cannot stay injured forever. Try to do regular aerobic exercise even if it is swimming.
2. For a Meniscal Repair
(athletes who have had a repair of the cartilage)
Phase 1 ( 0-21 days)
- Wear a knee brace allowing range of movement from 30 to 80 degrees.
- Range of motion exercises should be done passively (someone else moves the limb for you) while in the brace.
- Exercises can be done in the brace very lightly. You should not go to the maximum effort. Straight leg raises(bent at 30 degrees) – lift, hold for 10 seconds, down, rest for three seconds, repeat 10 times, do 3 to 5 sets.
- Use electrical stimulation to contract muscles.
- Crutches (Non-weight bearing)
Phase 2 (3-6 weeks)
- Increase the range of movement allowed by the brace in flexion and extension (bending and straightening) by 10 degrees each week.
- Range of motion exercises follows the movement allowed by the brace until at 6 weeks you have 0 degrees (straight) to 120 degrees (bent).
- Exercises – straight leg raises build on what you did before using a weight if possible.
- After 6 weeks you can do leg extensions and leg curls from 90 to 30 degrees.
- Crutches – start this phase partial weight bearing and progress to full weight bearing by the 10th week you are full weight bearing.
- Phase 3 (7 weeks onwards)
- Continue to build on all exercises. By now you should be able to do a full range of motion exercises and only use a brace if it is needed.
- The athlete should be able to swim and cycle.
A few final points
- Continue to train the quadriceps and hamstring muscles long after a return to sports activity. It is important these muscles are very strong to support the knee.
- Sometimes after complete removal of the meniscus, a new weaker tissue may grow in its’ place. This new tissue can tear giving the same symptoms as before.
- People who had complete removal of the meniscus can (after many years) suffer degeneration or wear and tear at the ends of the bones.
3. Conservative Treatment – No Surgery
If surgery is not undertaken, a rehabilitation programme should be used to increase the movement and strength in the knee. In many cases (depending on the location and extent of the tear), a rehab programme can be very effective.
- Use R.I.C.E to reduce bleeding and swelling.
- Rest for a couple of days, or until walking is not painful.
- Start gentle mobility exercises and stretches to regain full knee range of motion.
- Once pain-free, 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.