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 setting: 0° locked in extension.
• Passive range of motion (PROM): 0–90° only for first 4 weeks.

Goals:

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

Exercises:

• Flexion/Extension – wall slides
• Flexion/Extension – seated
• Patella and tendon mobilization
• Extension mobilization
• Quad sets
• Sit and reach for hamstrings (towel)
• Ankle pumps

Cardiovascular:

• Bike or rowing with well leg only

Phase II – Protected Motion (Weeks 6–10)

Precautions:

• Continue to 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:

• Begin hamstring sets
• Toe and heel raises
• Balance series
• Continue quad sets, patella mobilization, wall slides
• Continue sit and reach stretch

Cardiovascular:

• Bike with both legs (start with no resistance, progress to light resistance)
• Aquajogging
• Treadmill walking (incline up to 7%)
• Swimming with fins (if wounds 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
• 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 progression of previous exercises

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
• Begin with single-plane running
• Advance to multidirectional agility
• 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