Meniscal Repair Rehab Protocol

Protects the healing meniscus — therapist reference

Physical Therapy Protocols · From Dr. Allred · Transcribed from the printed sheet · 7 sections

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If you have questions about a protocol or a specific patient, call the clinic where the surgery was performed.

After hours & emergency numbers → Weekdays, business hours.

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Important / Precautions

  • Early weight bearing and range of motion are allowed, but protect the repair: avoid loaded deep flexion — no squatting or lunging past 90° under load, and no deep squats, until ~12 weeks.
  • For a meniscal root or complex/radial repair, follow that more restrictive protocol instead.
  • Progression is criterion-based; a reactive effusion means back off a step (if persistent, see the physician).

Phase 1 · Week 0–1 (Control & Activate)

  • Goals: control pain and swelling; ROM 0–90°.
  • Weight bearing as tolerated; wean crutches once quad control is good.
  • Quad sets (NMES if quad lag), short-arc quads, SLR ×4; mini-squats 0–45° with UE support; hamstring bridging; double-leg heel raises; bike for ROM.
  • Patellar mobilizations; cold therapy with the knee elevated in full extension.

Phase 2 · Weeks 1–6 (Motion & Gait)

  • Goals: full ROM (0–120°+) and a normal gait; wean assistive devices.
  • SLR ×4; hip and core strengthening; wall squats to 30°; forward/lateral/retro step (UE support); single-leg heel raises; stationary bike (no resistance from ~4 weeks).
  • Hold leg press and hamstring curls until 6 weeks.

Phase 3 · Weeks 6–12 (Strength in a Protected Range)

  • Progress strength within a limited range: wall squats, leg press, and hamstring curls to 0–90° only (no deep loaded flexion).
  • Hip machine (4-way); proprioception (single-leg balance, varied surfaces); slide board.
  • Treadmill walking progression; elliptical; pool therapy once the wound is closed.

Phase 4 · Weeks 12+ (Advance & Impact)

  • If there is no effusion, may advance to deep flexion and deep squats.
  • Agility drills and plyometrics; treadmill running progression; StairMaster; transition to a home/gym program.

Return to Sport (Criterion-Based)

  • No effusion and full, pain-free ROM.
  • Quadriceps and lower-extremity strength symmetric to the other leg (≥90%); passes hop/functional testing.
  • Tolerates sport-specific demands. Typical timing is ~4–6 months and testing-driven, not calendar-based.

References

  • The Formal EU-US Meniscus Rehabilitation 2024 Consensus (ESSKA–AOSSM–AASPT), Part I — Management after Meniscus Surgery. JOSPT Open, 2025.
  • Rehabilitation and return to sports after isolated meniscal repairs: a new evidence-based protocol. PubMed, 2022.
  • Rehabilitation Protocol for Arthroscopic Meniscal Repair. Massachusetts General Hospital.
Questions about this sheet? Call the clinic where the surgery was performed. I'm happy to talk through the plan. Numbers are at the top of this page, and every after-hours line is on the emergency numbers page.