Phase 1
Protect the Repair
Week 0 – Week 3🎯 Goals
- Protect the meniscal repair: this is the priority
- Control swelling and pain
- Restore full knee straightening (0°)
- Begin quad activation without stressing repair
- Walk safely on crutches
⚠️ Precautions
- Partial weight bearing: brace locked straight, both crutches
- No active knee bending past 90° in this phase
- No pivoting or twisting on operated leg
- Do not actively pull knee to chest: support the leg
- Stairs: good leg up first, crutches and operated leg down first
🧊
Ice, Elevation and Rest are critical this phase:
Ice (wrapped in cloth) for 20 min every 2–3 hours · Leg elevated above heart level when resting · Compression bandage as instructed · Reducing swelling early protects the repair.
Exercises: Week 0–3
- Ankle pumps: 20 reps every hour
- Quad sets: press knee flat into bed, hold 5 sec
- Straight leg raise: only once knee fully straightens
- Heel slides: slide heel gently towards buttocks (avoid active hamstring pull)
- Kneecap mobilisation: push kneecap up/down, side to side
- Prone hang: lie face down, let leg hang to restore extension
- Hip abduction: side lying or standing
- Calf raises: standing, holding chair
- Upper body exercise: to maintain fitness
✅ Ready for Phase 2 When:
- Knee fully straight (0°): equal to other leg
- Knee bending to 90°
- Quad contraction strong with good kneecap movement
- Straight leg raise without lag
- Swelling significantly reduced
Phase 2
Controlled Mobility
Week 3 – Week 6🎯 Goals
- Continue protecting the repair
- Progress knee bending to 120°
- Maintain full straightening
- Begin gentle strengthening
- Reduce swelling to minimal
Exercises
- Stationary cycling: gentle range only, no resistance
- Calf raises: standing, holding chair
- Bridges: lie on back, lift hips, hold 5 sec
- Clamshells: lie on side, open and close knees
- Double leg balance: wobble board
- Hip strengthening: side raises, standing extension
✅ Ready for Phase 3 When:
- Swelling minimal or absent after exercise
- Knee bending to 120°
- Knee fully straight equal to other leg
Phase 3
Progressive Strengthening
Week 6 – Week 9🎯 Goals
- Wean off brace and crutches after surgeon review
- Normalise gait on all surfaces
- Full ROM equal to other leg
- Build quad, hamstring and hip strength
- No swelling or pain after exercise
Exercises
- Partial squats: 0–60° only
- Wall slides and mini squats
- Hamstring curls: prone and standing
- Step-ups: low step initially
- Single leg balance: progress to uneven surface
- Cycling with light resistance
- Swimming flutter kick / pool jogging
- Hip and core strengthening: bridges, side plank
🏠 Daily Life
- Driving: from Week 6: off crutches, full quad control, off strong painkillers
- Two-wheeler: minimum 3 months
- Office/desk work: from Week 3–4 with movement breaks
- Light housework: from Week 6
✅ Ready for Phase 4 When:
- No swelling or pain after exercise
- Full ROM equal to other leg
- Normal gait on all surfaces
- Good balance and joint position sense
Phase 4
Return to Function
Week 9 – Week 12🎯 Goals
- Full range of motion
- Progress strengthening safely
- 10 single-leg squats with good form
- Prepare for return to running
Exercises
- Squats to chair and lateral lunges
- Single leg press (gym)
- Step-ups/step-downs: higher step
- Single leg squats: aim 10 reps, 60° depth, good form
- Romanian deadlift: single and double leg
- Lateral band walks
- Elliptical / stair climber
✅ Ready for Phase 5 When:
- No giving-way episodes
- 10 single-leg squats with good form to 60° depth
- Thigh strength ≥80% of other leg
Phase 5
Return to Sport
Month 3 – Month 6🎯 Return to Running Program
- Week 1: Walk 5 min / Jog 1 min × 5 sets
- Week 2: Walk 3 min / Jog 3 min × 5 sets
- Week 3: Walk 2 min / Jog 4 min × 5 sets
- Week 4+: Continuous jogging: build to 20–30 min
- Only progress if no pain or swelling during or after
- Run on flat soft surface (grass/track) initially
🏏 Sport Progression
- Month 3–4: Straight-line running, wide agility arcs
- Month 4–5: Cutting and pivoting drills with good control
- Month 5–6: Non-contact sport-specific practice
- Month 6+: Full practice and match play: surgeon clearance
- Cricket, badminton: Month 5–6 with clearance
- Contact sports: Month 6+ with surgeon clearance
Activity Guide
| Activity | Allowed? | When | Notes |
|---|---|---|---|
| Walking (flat) | YES | Immediately | Crutches and brace initially; progress as tolerated |
| Stairs | CAUTION | Week 1 | Good leg up first, operated leg down first; hold railing |
| Driving | CAUTION | Week 6 | Off crutches, full quad control, off strong painkillers |
| Two-wheeler | WAIT | 3 months+ | Risk of fall; confirm with surgeon |
| Office/desk work | YES | Week 3–4 | Leg elevated when seated; hourly movement breaks |
| Stationary cycling | YES | Week 3 | No resistance initially; excellent for recovery |
| Swimming | YES | Week 6–8 | After wound healed; avoid breaststroke kick early |
| Jogging | CAUTION | Month 3 | Only after Phase 4 criteria met; use return-to-run program |
| Cricket / badminton | WAIT | Month 5–6 | Surgeon clearance required |
| Contact sports | WAIT | Month 6+ | Full clearance protocol must be completed |
| Squatting / kneeling | CAUTION | Month 2–3 | Avoid deep squatting early; progress gradually |
| Indian toilet / floor sitting | AVOID | Month 3+ | Only if ROM adequate; avoid prolonged deep flexion |
🚨 When to Contact Us
🔴 Come to Hospital Immediately
- Sudden pop or locking of the knee
- Massive sudden swelling after a twist or fall
- High fever with wound redness or discharge
- Leg becomes cold, pale or numb
- Severe calf pain or breathlessness
🟡 Call Clinic Within 24 Hours
- Swelling increases significantly after exercise
- Knee locks or won't fully straighten or bend
- Pain not settling with rest and ice
- Wound not healing or looks infected
- Knee feels less stable than before
📅 Follow-up Schedule
🗓 Clinic Reviews
- 2 weeks: Wound check, suture removal
- 6 weeks: ROM, brace review, weight-bearing progression
- 3 months: Strength, running clearance
- 6 months: Sport clearance
⚠️ Re-injury Prevention
- Always warm up before sport: 10 min minimum
- Continue hip and thigh strengthening lifelong
- Land with knees bent: never stiff-legged
- Stop if knee swells after activity: report early
🏠 Daily Life Tips
- Avoid sitting with knee fully bent for long periods early on
- Keep leg elevated when resting in early weeks
- Non-slip mat in bathroom: fall prevention
- Do not rush progression: re-tear risk is real