Meniscus Repair Rehabilitation Protocol

WEEK 1:

Weight Bearing

  • 50% partial weight bearing when ambulating
  • No weight bearing at all in flexion angles > 90°

Brace

  • Locked at 0° extension
  • OK to remove for hygiene and exercises
  • Wear at night

ROM

  • 0 – 90°

Therapeutic Exercise

  • Flexion: wall slides, heel slides to patient tolerance
  • Extension: Passive knee extension using towel roll, prone hangs
  • Strengthening: Quad setting with knee support, hamstring digs with knee support, plantarflexion/ dorsiflexion, eversion/inversion strengthening

WEEK 2:

Weight Bearing

  • 50% partial weight bearing when ambulating
  • No weight bearing at all in flexion angles >90°

Brace

  • Locked at 0° extension
  • OK to remove for hygiene, exercises AND SLEEP

ROM

  • 0 – 90° when weight bearing
  • PROM as tolerated when not bearing weight

Therapeutic Exercise

  • Flexion: wall slides, heel slides, sitting flexion
  • Extension: Passive knee extension using towel roll, prone hangs
  • Open kinetic chain: straight leg raise, Hip abd/adduction, hip extension, hamstring set or prone hamstring curl
  • Closed Kinetic Chain: Heel raises, leg press with minimal resistance
  • Trunk stabilization
  • Manual Interventions: patellar mobs, tibiofemoral mobs into extension, soft tissue as indicated

WEEKS 3-4:

Weight Bearing

  • Continue to ambulate with crutches, but may begin to advance weight bearing to 75%
  • No weight bearing at all in flexion angles >90°

Brace

  • Brace unlocked, with ROM set to 0-90° for ambulation
  • OK to remove for hygiene, exercises AND SLEEP

ROM

  • Increase flexion PROM approx. by 10° per week
  • Achieve and maintain full passive and active extension

Therapeutic Exercise

  • Open Kinetic Chain: Straight leg raises into flexion with emphasis on endurance of quadriceps and full knee extension
  • Open Kinetic Chain: Hip strengthening and leg extensions 90-40 degrees without weight
  • Closed Kinetic Chain: step ups, heel raises progressing to single leg
  • Single leg standing
  • Hamstring PREs
  • Manual interventions, modalities and trunk stabilization exercises

WEEKS 4-6:

Weight Bearing

  • Continue crutches
  • Advance to full weight bearing, but with crutches
  • No weight bearing at all in flexion angles >90°

Brace

  • Gradually discontinue brace use

ROM

  • Full active and passive extension
  • Flexion within approx. 10° of uninvolved leg

Therapeutic Exercise

  • Open Kinetic Chain: Straight leg raises into flexion with emphasis on endurance of quadriceps and full knee extension
  • Open Kinetic Chain: Hip strengthening and leg extensions 90-40 degrees without weight
  • Closed Kinetic Chain: step ups, heel raises progressing to single leg
  • Single leg standing
  • Hamstring PREs
  • Manual interventions, modalities and trunk stabilization exercises

WEEKS 6-8:

Weight Bearing

  • Full weight bearing
  • Gradually discontinue crutch use
  • No weight bearing at all in flexion angles >90°

Brace

  • None

ROM

  • Full active and passive extension and flexion ROM

Therapeutic Exercise

  • Begin Stationary Bike
  • Progress intensity of strengthening program, stair climber, walking incorporating single leg activities
  • Lunges 0-90°
  • Leg press 0-90°
  • Functional Goals: reciprocal stair ascending, walking with normal gait pattern
  • Progress intensity of strengthening program incorporating single leg activities

WEEKS 8-12:

Weight Bearing

  • Full weight bearing

Brace

  • None

ROM

  • Full and pain free range of motion

Therapeutic Exercise

  • Jumping activities on gravity eliminated shuttle (progress to single leg)
  • Jogging on trampoline
  • Dynamic single/double leg functional exercises as anticipated for sport activity

WEEKS 12+:

Weight Bearing

  • Full weight bearing

Brace

  • None

ROM

  • Full and pain free range of motion

Therapeutic Exercise

  • Progress to running when: 90% of quadriceps strength as measured, single leg squat depth, hop Testing, single leg balance duration
  • Return to running: treadmill walk/run intervals, treadmill running, track running (run straight, walk turns), track running full, road running
  • Agility and plyometric exercises
  • Lateral and cutting maneuvers

Related Links