Meniscus Repair Rehab

General Guidelines

• Ensure you achieve full extension
• Full patellofemoral mobility all planes
• Limit ROM for flexion to 90° for the first 3 weeks
• Avoid deep squatting for 6 months
• Avoiding twisting on a planted foot for 6 months

Phase I – Week 0-6

• Weeks 0-3: TDWB, Brace locked full extension (Permit AROM 0-90)
• Weeks 4-6: PWB 50%, Brace locked full extension (Permit AROM – Full)
• Re-established ROM with heels slides, ham/calf stretching, gravity assisted stretching
• Start aqua jogging once incisions are closed
• Quad setting with four directional SLRs
• Ankle theraband exercise
• Core exercises at 4 weeks (planks/sideplanks 10 x each for time)
• At 6 weeks start swiss ball bridging 30 x 10-20 seconds holds

Phase II – Week 6-12

• Normalize gait pattern
• Initiate body weights squats
• Initiate balance program (start on ground and progress to unstable surfaces/eyes closed)
• At 8 weeks start single leg machine press from 10-80° 4 x 10
• At 10 weeks start eccentrics with single leg machine press 40 x 10 second duration with weight lowering (continue 10-80°)
• At 10 weeks start step-downs (reverse with eccentric control) 4 x10 (small step height 4-3 inches)
• At 10 weeks and hypers and reverse hypers
• Continue with cycling and aqua jogging program
• Continue with SLRS
• Continue stretching until completely symmetric ROM
• Can add prone quad stretching with strap at 12 weeks

Phase III – Week 12-16

• Continue with phase II activities
• Star single leg closed chain exercise 4 x 10 each (ie single leg squats with forward reaches, single leg RDLs, single leg squats with real-leg elevated, step- downs reverse, reverse split-squats). Add loads progressively (ie hold weight plate, med ball, or wear weighted vest).
• Start dynamic warm-up drills at 12 weeks
• Start dynamic lunges (forward, reverse, walking) at 16 weeks. Add loads progressively
• If pressing strength is at 80% or greater of unaffected leg (test with 10 rep max on the cybex ) then begin running program at 12-16 weeks
  • • Begin with interval jogging on treadmill with feedback to normalize pattern
    • Progress to treadmill jogging
    • Move outdoors to running on track 
• Continue with core training progressively (add WB core exercises)

Phase IV – Weeks 16-20 to return to sports

• Start agility training at 16 weeks
• Start double leg plyos at 18 weeks (begin with broad jumps- take- off and landing must be fully symmetric to progress jump training). Progress to single leg plyos when double leg plyos are symmetric (at 20 weeks)
• Initiate sprinting and return to sport drill at 20 weeks
• Pass functional/ strength testing and return to sport at 24 weeks or when released by MD

• Pressing strength at 90% or greater
• Symmetric with single leg unsupported squat
• No faulty movement patterns
• Triple hop teste at 85% or greater with symmet4ric movement quality