This is our physiotherapy protocol after meniscus repair based on ISAKOS, AAOS, and ESSKA Guidelines
Phase 1: Initial Postoperative Phase (Weeks 0-2)
Goals:
Protect the healing meniscus repair.
Reduce pain and swelling.
Restore full knee extension.
Exercises and interventions:
Work on extension - no towel roll under the knee. Prone hangs for knee extension.
Cryotherapy and compression to manage pain and swelling.
Education on weight-bearing and use of crutches as necessary.
Gentle active and passive range of motion exercises within a pain-free range.
Isometric quadriceps and hamstring exercises. Muscle stimulation as needed.
Ankle pumps and calf muscle activation exercises.
Soft tissue mobilization to address scar tissue and facilitate healing.
Patella mobilisation.
Prone hamstring curls: 10 repetitions, 4 x / day
Phase 2: Intermediate Rehabilitation Phase (Weeks 2-6)
Goals:
Progressively increase range of motion.
Improve quadriceps and hamstring strength.
Enhance proprioception and joint stability.
Gradually transition to functional activities.
Interventions:
Continued cryotherapy and compression as needed.
Active and passive range of motion exercises to restore full knee range. Full extension!
Prone hamstring curls 0-90°, Active knee extension 90-45°
Strengthening exercises for the quadriceps, hamstrings, and calf muscles.
Proprioceptive and balance exercises (e.g., single-leg stance, wobble board exercises).
Closed kinetic chain exercises (e.g., squats, lunges) with proper form and control.
Aquatic therapy for low-impact strengthening and range of motion.
from week 4 unless advised against by me: single leg stance.
Continue exercises from phase 2.
Phase 3: Minimal Protection Phase (Weeks 6-12)
Goals:
Improve strength, endurance, and stability.
Restore normal gait pattern.
Gradually return to sports-specific activities.
Interventions:
Progressive strengthening exercises focusing on functional movements.
Plyometric exercises to improve power and agility.
Dynamic balance exercises challenging stability in various positions.
Treadmill running and gradual return to jogging.
Functional training to mimic sport-specific movements.
Phase 4: Return to Sport Phase (Weeks 12 and beyond)
Goals:
Achieve full functional recovery.
Ensure adequate strength, stability, and endurance.
Prepare for a safe return to sports.
Interventions:
Sport-specific training and drills.
Dynamic movements that replicate the demands of the chosen sport.
Plyometric exercises with increasing intensity.
Interval training to build cardiovascular fitness.
Gradual return to competitive play under medical and coaching supervision.
Note: This protocol is a general guideline, however, individual variations and specific surgical considerations should be taken into account. The progression through the phases should be based on the patient's response to treatment, pain level, and the surgeon's guidance. Regular communication with the surgical team is crucial for appropriate progression and successful rehabilitation.
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