Physiotherapy after Meniscus Tear Surgery

One of the most common injuries to come through our door are tears to the meniscus in the knee. These don’t only result from sports related or traumatic events, but also degenerative changes in the knee over time. When conservative management fails to alleviate symptoms, surgical intervention may be necessary to address the issue and restore knee function. Physiotherapy plays a large role in the postoperative rehabilitation process, guiding patients through the stages of recovery while aiming to optimise outcomes and minimise complications or re-injury. This blog will address the key phases of physiotherapy rehabilitation after meniscus tear surgery, using evidence-based practices to outline what the journey will look like.

Realistic Timeline for Recovery

The very first misconception we see time and time again is that it is believed that after the surgery to clean up the meniscus, you will bounce back and return to your usual activities, and be pain free, within a few weeks. More realistically, your journey to recovery can be anywhere between 3 to 6 months plus.

Understanding the actual timeline for recovery is crucial for setting realistic expectations and achieving successful outcomes following meniscus surgery. While individual recovery timelines will always vary based on factors such as the specific surgical procedure, the extent of injury, age, preoperative fitness level, and adherence to the rehabilitation process, a general framework can provide guidance for patients. Let’s delve into this now.

Immediate Postoperative Period (Days 1-2 Weeks):

Pain Management and Swelling Reduction

During the immediate postoperative period, the focus is on pain management and swelling reduction. You just had surgery don’t forget! The knee will be sore and swollen. Patients may experience discomfort and swelling around the surgical site, which can be managed through prescribed medications by your surgeon, ice therapy, and elevation of the affected leg in those early days.

Range of Motion and Early Movement

With swelling and pain comes stiffness! Gentle soft tissue massage, partnered with gentle range of motion exercises, and early mobilisation with your physio, are used to prevent joint stiffness and promote circulation. Patients gradually progress from passive range of motion with your physio heling guide the movements entirely, to active-assisted and then active range of motion exercises as tolerated requiring you to work through the range on your own.

Weight-Bearing Progression

Weight-bearing status is progressively loaded based on the surgeon’s early recommendations and the specific surgical procedure you had. Patients may initially use crutches or a walker for support. You may even be in a knee brace for a time before gradually transitioning to partial or full weight-bearing as time permits.

Reconditioning Rehabilitation Phase (Weeks 2-12):

Muscle Strengthening and Functional Rehabilitation

The focus of rehabilitation shifts to progressive muscle strengthening, functional rehabilitation, and restoration of knee joint stability. This is the big phase that will take the better part of 3 months at least. Your Physio will guide you through targeted exercises to strengthen key muscle groups like your quadriceps, hamstrings, hip abductors, and calf muscles while also working on balance, proprioception, and functional movement patterns.

Cardiovascular Conditioning

Low impact cardiovascular exercises such as stationary cycling, swimming, or elliptical training are introduced to improve cardiovascular fitness and endurance without placing excessive stress on the knee joint. Impact exercises like running are still not introduced yet due to the meniscal tissue still healing, along with some minor swelling and pain levels still potentially being present.

Gradual Return to Activities of Daily Living

Patients gradually resume activities of daily living, such as walking, stair climbing, and light household chores, as pain and function permit. Your physio will do a lot of work with you during this period where emphasis is placed on proper biomechanics and adherence to postoperative precautions to minimise the risk of reinjury.

Advanced Rehabilitation and Return to Activity (Months 3-6+):

Sports-Specific Rehabilitation and Performance Enhancement

For athletes or individuals involved in competitive or recreational sports, the focus shifts to sports specific rehabilitation and performance enhancement. Patients engage in plyometric exercises, agility drills, and sport-specific training to prepare for a safe return to activity. Basically, your knee needs to learn how to hop, jump and skip again effectively without putting stress through the knee joint.

Functional Performance Testing and Return to Sport Criteria

Testing is key! Functional performance testing may be utilised to assess readiness for return to sport or high level activities. Objective measures such as strength, balance, agility, and movement quality will be assessed by your physio to ensure safe and successful return to pre-injury levels of function.

Injury Prevention Strategies and Long-Term Maintenance

As patients transition back to full activity participation, injury prevention strategies become the name of the game. Your physio will provide guidance on proper warm up and cool down routines, biomechanics in the gym or on the field, appropriate equipment/shoe selection, and training modifications to reduce the risk of recurrent meniscus injuries or other knee related issues.

Take Home Message:

It’s important to note that while significant progress can be made within the first few months following surgery, full recovery and return to pre-injury levels of function can take six months to a year or longer. Patience, consistency, and adherence to your rehabilitation plan are key factors in achieving optimal outcomes and more importantly, minimise the risk of complications or setbacks along the way. Close communication with your physio, diligent adherence to the rehabilitation guidelines they set, and a progressive and graded return to activity are essential components of a successful recovery journey.

Joel Adelman – BeFit Training Physio Coogee

Joel Adelman – BeFit Training Physio Coogee

Joel Adelman is a physiotherapist based in Coogee in the Eastern Suburbs of Sydney. Joel has successfully treated musculoskeletal problems on the basis of a thorough assessment and diagnosis coupled with evidence-based rehabilitation programs tailored to the needs and goals of each individual. To book a consultation, click the link below.

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