Physical Therapy Protocols

Meniscal Repair Rehab Protocol

Protects the healing meniscus — therapist reference

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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 protocol? Call the clinic where the surgery was performed — Dr. Allred is happy to talk through the plan.