Meniscus Repair

Physical Therapy Protocol

Phase I – Maximum Protection (Weeks 0–6)

Precautions:

• Non-weight bearing (NWB) with crutches for the first 6 weeks.
• No deep squats or cross-legged sitting for 4 months.
• Brace locked at 0° extension.
• Passive range of motion (PROM) limited to 0–90° for the first 4 weeks.

Goals:

• Protect surgical repair.
• Control inflammation and pain.
• Initiate quad activation and gentle ROM.

Exercises:

• Wall slides (flexion/extension).
• Seated flexion/extension.
• Patella and tendon mobilization.
• Extension mobilization.
• Quad sets.
• Sit and reach for hamstrings (with towel).
• Ankle pumps.

Cardiovascular:

• Bike or rowing machine with well leg only.

Phase II – Protected Motion (Weeks 6–10)

Precautions:

• Avoid loaded knee flexion or deep squats.
• Gradual reintroduction of active hamstring use.

Goals:

• Improve range of motion.
• Begin muscle activation (hamstrings and calves).
• Initiate cardiovascular and proprioception training.

Exercises:

• Hamstring sets.
• Toe and heel raises.
• Balance series.
• Continue quad sets, patella mobilization, wall slides.
• Continue hamstring stretch with towel.

Cardiovascular:

• Bike with both legs (start with no resistance, then progress).
• Aquajogging.
• Treadmill walking (up to 7% incline).
• Swimming with fins (once incisions are healed).

Phase III – Early Strengthening (Weeks 10–16)

Goals:

• Normalize gait mechanics.
• Begin functional strength progression.
• Improve neuromuscular control.

Exercises:

• Double knee bends.
• Double leg bridges.
• Static reverse lunges.
• Beginning cord resistance exercises.
• Single-leg deadlifts (as tolerated).

Cardiovascular:

• Elliptical trainer.
• Rowing machine.
• Stair stepper.
• Continue treadmill walking and swimming.

Phase IV – Strength & Control (Weeks 16–20)

Goals:

• Improve strength and coordination.
• Advance to unilateral strength and balance.

Exercises:

• Balance squats.
• Leg press.
• Advance proprioceptive balance series.
• Continue previous strength training progression.

Cardiovascular:

• Increase endurance on elliptical, stair stepper, and treadmill.

Phase V – Agility & Return to Activity (Weeks 20–24+)

Goals:

• Prepare for return to sport and high-level activities.
• Restore full confidence in limb function.

Agility Drills:

• Running progression: single-plane then multi-directional.
• Functional sports testing.

High-Level Activities (As tolerated):

• Golf.
• Outdoor biking, hiking, snowshoeing.
• Skiing, basketball, tennis, football, soccer (clearance required).

Timeline Overview (Post-Op Day Reference)

• Week 1 (POD 1–7): NWB, brace locked at 0°, begin passive motion and quad sets.
• Week 2 (POD 8–14): Progress ROM and maintain precautions.
• Week 3–4: Add seated flexion/extension, introduce gentle functional tasks within limits.