Return to Sports after Meniscus Surgery
Arthroscopic surgery, whether involving partial meniscectomy or meniscus repair, remains the gold standard for treating meniscal tears. The timeline for returning to sports depends on the type of procedure performed and whether there are additional injuries.
Patients undergoing partial meniscectomy generally progress through rehabilitation faster, as there is no need to wait for the meniscus to heal. The rehabilitation protocol is typically divided into three phases:
- 0-2 Weeks Post-Surgery: Initiate weight-bearing as tolerated, range of motion exercises, and light strengthening exercises focusing on the quadriceps, hamstrings, and core.
- 2-4 Weeks Post-Surgery: Begin sport-specific exercises and cardio training.
- 4-6 Weeks Post-Surgery: Advance sport-specific training and strength exercises. Clearance for competitive sports is given once strength, range of motion, and endurance match the non-injured leg.
Full quadriceps strength is often the most critical factor limiting the return to sports. Essential exercises include:
Quad Sets:
- How to Do It: Sit on the floor with the operated leg extended. Tighten the thigh muscles by pressing the back of the knee into the floor. Hold for 6 seconds and rest for 10 seconds.
Straight Leg Raises:
- How to Do It: Lie on your back with the operated leg extended and the non-injured leg bent. Contract the thigh muscles and lift the straight leg about 6 inches. Hold for 3 seconds and rest for 10 seconds.
Squats:
- How to Do It: Stand with feet hip-width apart. Lower your body slowly, shifting weight to the heels. Hold for 2-3 seconds, return to the center, and push up using the heels.
Studies indicate that athletes can return to their sport between 19 and 89 days after partial meniscectomy, depending on factors like age, competition level, and the type of meniscal tear. Early and consistent engagement in quadriceps-strengthening exercises significantly aids in the recovery process.
Meniscal repair offers the advantage of preserving the native meniscus but involves a longer recovery period compared to meniscectomy. The rehabilitation program limits early weight-bearing and knee flexion to protect the repair.
- 0-2 Weeks Post-Surgery: Patients wear a knee brace locked in full extension and may only touch down weight bear using crutches. Gentle range of motion exercises (0-90 degrees) and isometric quadriceps exercises (quad sets, straight leg raises, and heel slides) are encouraged.
- 2-4 Weeks Post-Surgery: Gradual progression to full weight-bearing as pain allows, without exceeding 90 degrees of flexion. Closed-chain exercises like terminal knee extensions with resistance bands are introduced.
- 4-8 Weeks Post-Surgery: Brace and crutches are phased out if quadriceps strength permits normal walking. Wall sits and other strengthening exercises are introduced.
- 8-12 Weeks Post-Surgery: Full weight-bearing and full range of motion without a brace are permitted. Hamstring and proprioception exercises, such as leg presses and lunges, are started, alongside stationary bike workouts for cardio.
Leg Press:
- How to Do It: Sit with a neutral spine and place feet shoulder-width apart on the pad, creating a 90-degree angle at the knees. Push through the heels to extend the legs without locking the knees.
Lunges:
- How to Do It: Step forward with the operated leg, keeping the other leg on a step. Lower the body, ensuring the front knee does not extend past the toes, and rise back up.
- 12-16 Weeks Post-Surgery: Strength and range of motion continue to improve, with single-leg strengthening exercises incorporated. Swimming may start as early as week 12, and sport-specific activities, including running and jumping, are typically resumed by week 16.
Research supports that most athletes can expect to return to sports approximately 5-6 months after meniscus repair, provided they adhere to the rehabilitation protocol and achieve the required strength and mobility levels.
In conclusion, with the right diagnosis, treatment, and dedication to rehabilitation, most patients, whether casual exercisers or professional athletes, can return to their pre-injury activities and sports.
Orthopedic surgeon Dr. Mark Cinque is a sports medicine surgeon in San Diego, California who specializes in the treatment of complex knee injuries. He has spent time training at The Steadman Clinic and Stanford Orthopaedic Surgery. He has published over 100 peer-reviewed manuscripts and has presented research internationally. He uses minimally invasive arthroscopic procedures to preserve the natural joint and reduce recovery time to accelerate his patients’ return to the activities they love.
At a Glance
Mark Cinque, MD
- Board-certified, fellowship-trained orthopedic surgeon
- Orthopedic Residency: Stanford University, Fellowship: The Steadman Clinic
- Authored over 100 peer-reviewed publications
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