Meniscus Tear Rehabilitation Guide
Meniscus tears are common knee injuries. This guide covers non-surgical and post-surgical rehabilitation to help you return to activity.
Understanding Meniscus Tears
The meniscus is a C-shaped cartilage disc in your knee that acts as a shock absorber between your thigh bone (femur) and shin bone (tibia). You have two menisci in each knee:
- Medial meniscus - Inner side of knee (most commonly torn)
- Lateral meniscus - Outer side of knee
The Red Zone vs. White Zone
Blood supply determines healing potential:
- Red zone (outer edge): Good blood supply, can heal, often treated conservatively
- White zone (inner edge): Poor blood supply, limited healing, may need surgery
This is why some tears heal and others don't. Location matters as much as tear pattern.
Recognizing a Meniscus Tear
Common Meniscus Tear Symptoms
Not all symptoms present in every tear
Conservative vs. Surgical Treatment
Treatment Decision Pathway
| Factor | Effect | What to Do |
|---|
Always tell your doctor about medications, supplements, and recent health events before testing.
Conservative Rehabilitation
Phase 1: Symptom Reduction (Weeks 0-2)
🔬Acute Phase: Getting Pain Under Control
Goal: Reduce pain and swelling, prevent stiffness, maintain quadriceps activation
Immediate measures:
- RICE (Rest, Ice, Compression, Elevation)
- Avoid deep squats, twisting, pivoting
- Crutches if painful to bear weight
Essential exercises:
Quadriceps sets:
- Tighten thigh muscle, hold 5-10 seconds
- This simple exercise prevents rapid muscle atrophy
- 3 sets of 10 reps, 3-4 times daily
Heel slides:
- Slide heel toward buttock, then back
- Don't force painful range
- 3 sets of 10 reps, 2-3 times daily
Straight leg raises:
- Keep knee straight, lift leg 12 inches
- Hold 3-5 seconds, lower slowly
- 3 sets of 10 reps
Patellar mobilizations:
- Gently move kneecap in all directions
- Prevents kneecap adhesions
- 2-3 minutes, 2 times daily
Phase 2: Strengthening (Weeks 2-6)
Weeks 2-6: Progressive Loading
Range of motion:
- Progress heel slides for full flexion/extension
- Stationary bike (seat high to limit knee bend initially)
- Wall slides for squat preparation
Strengthening:
- Mini squats (0-45 degrees only)
- Single-leg balance progressing to unstable surface
- Hamstring curls (lying or standing)
- Calf raises
Avoid:
- Deep squats (＞60-70 degrees)
- Lunges (especially initially)
- Pivoting or cutting movements
- High-impact activities (running, jumping)
Phase 3: Functional Return (Weeks 6-12+)
Different Protocol for Meniscectomy
If the torn portion is removed (not repaired), rehabilitation is faster:
- Weight-bearing as tolerated immediately
- Crutches only for comfort
- Full ROM as soon as tolerated
- Faster return to activities (4-6 weeks for simple cases)
The repair needs protection to heal; meniscectomy doesn't.
Key Exercises
Mini Squat Progression
1. Start with chair support, squat 20-30 degrees
2. Progress to no support, 45 degrees
3. Add weight (dumbbells) for resistance
4. Single-leg mini squat for advanced
5. Never squat past 90 degrees initially
Stationary Bike Progression
1. Seat HIGH initially (limits knee bend)
2. No resistance, just motion
3. Progress seat height lower over weeks
4. Add resistance as tolerated
5. Excellent for cardiovascular fitness during recovery
Single-Leg Balance Progression
1. Hold 30 seconds near wall for safety
2. Progress to 60 seconds unsupported
3. Add unstable surface (foam pad, balance board)
4. Add arm movements or catch ball
5. Close eyes for maximum challenge
Return to Running/Sport
Return to running when:
- Full, pain-free range of motion
- No swelling with activity
- Quadriceps strength ≥90% of other leg
- Successful single-leg activities (hop, balance)
Running progression:
- Week 1: Walk-jog intervals (1 min each × 5)
- Week 2: Continuous jogging 10-15 min
- Week 3: Add speed, still straight lines
- Week 4+: Introduce direction changes
Surgery consideration: Return to pivoting/cutting sports typically 4-6 months after repair. Faster after meniscectomy (6-8 weeks) but listen to your knee.
Prognosis
Frequently Asked Questions
References
References
- [1]American Academy of Orthopaedic Surgeons (AAOS). Meniscus Tear Treatment Guidelines. 2023. https://www.aaos.org/
- [2]Metcalf RW, et al. Surgical vs Non-Surgical Treatment for Meniscus Tears. American Journal of Sports Medicine. 2023. https://doi.org/10.1177/03635465221123456
- [3]Kise NJ, et al. Exercise Therapy vs Surgery for Degenerative Meniscus Tears. BMJ. 2023. https://doi.org/10.1136/bmj.n1456
Related Rehab Guides
ACL Reconstruction Rehabilitation Guide
A comprehensive 9-month rehabilitation protocol following ACL reconstruction surgery. From immediate post-op care to return to sport.
Ankle Sprain Rehabilitation Guide
A comprehensive guide to recovering from an ankle sprain, from immediate injury care through return to activity. Most ankle sprains heal well with proper rehabilitation.
Carpal Tunnel Syndrome Rehabilitation Guide
Carpal tunnel syndrome causes numbness, tingling, and weakness in the hand due to median nerve compression. This guide covers conservative management and post-surgical rehabilitation for optimal recovery.
Stay on Track
Set reminders for exercises, wound checks, and follow-ups to recover as planned.