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What physiotherapy and rehab to expect after a meniscus repair surgery: Part 3 of 3

Wilma Kotze Photography Dr Hardcastle

In part two of this series, we looked at the different types of meniscus tears and how we diagnose and treat them.

In this article, physiotherapist Heléne Swanepoel, explains what physiotherapy and rehabilitation entails after meniscus repair surgery.

Rehab after a meniscus repair should be taken seriously

A meniscus repair is a major operation that requires at least nine months of rehabilitation post-surgery. Despite the substantial commitment required, it is worth it, as you should be able to return to your normal level of activity, provided that you adhere to your rehab programme diligently.

Two weeks of important rest

For the first two weeks after meniscus repair surgery, it’s important to rest your knee as much as possible and give your body time to recover. The more strictly you adhere to this period of rest, the quicker your overall recovery is likely to be and the more likely you are to be able to return to your normal level of activity.

During this time, it is likely that your knee will be considerably swollen. It is advisable to elevate your leg, apply ice to the affected area, and take the prescribed pain medication. In case you experience any concerning symptoms such as pain that does not go away after taking pain medication, loose stitches, blood soaking through your bandages, or signs of a infection – do not hesitate to reach out to your surgeon for further guidance.

What will physiotherapy entail and how often will I go?

Your first physiotherapy session will be two weeks after your operation. You will see your physiotherapist every two weeks for at least four to six months after the surgery (which works out to between 10 to 14 sessions), depending on the type of injury you had. However, if a patient experiences severe pain or swelling or struggles to do their rehab exercises on their own, the physiotherapist may need to see them more regularly.

During sessions with patients, I normally do hands on therapy, releases on the tight muscles and work to reduce your swelling.

Each time you come for a session I will give you new rehab exercises to do at home.

Using a brace and crutches

The rehabilitation protocol for meniscus repair surgery differs depending on the type of injury you had.

You will wear a brace for 10 to 12 weeks and use crutches for six to eight weeks after your operation.

From six weeks post-operation, the physiotherapist will adjust the settings on your brace every two weeks to change the degree to which you are able to bend your knee.

Doing rehab exercises at home

After your surgery, it is important that we get you to a point where you can completely straighten your knee again.

For this reason, you will be given exercises to strengthen your quadriceps (the muscle in the front of your thighs) and gluteus medius (a muscle in your buttock).

At around six weeks post-surgery, when you stop using crutches, the physiotherapist will start doing balance and proprioception exercises with you. You will also be able to drive again. Most patients also start feeling more normal without the crutches.

After eight weeks, you will start exercising on a stationary bicycle.

From here on, the types of exercises you are given will differ depending on the type of meniscus repair you underwent.

The return to activity and limitations on activities

There are certain activities you won’t be able to do after surgery to protect your knee and ensure you recover fully.

You won’t be able to go on your haunches for six months or kneel on your knees for four to six months.

After four months, you should be able to return to most normal activities. For example, many patients will be easily walking 5 km or doing a 45-minute spinning class by this time. However, you still won’t be able to run, jump or do deep squats.

Depending on the type of injury you had, you might be able to take up running and cycling around nine months after your operation. It will take about a year before you can return to other high impact sports such as rugby or netball.

In the case of high-level sports people, we will refer you to a biokineticist after four to five months to continue your rehabilitation.

What rehabilitation can I expect after a meniscectomy?

Patients who had a meniscectomy rather than meniscus repair surgery, will need six weeks to three months to recover after the procedure. Very active patients will be required to come for around three sessions of physiotherapy.

Patients will use crutches for two weeks or until they are able to walk without limping. This is also when they will be able to resume driving.

We start with proprioception, balance and strengthening exercises two weeks after surgery. You will be given rehab exercises to do at home.

In most cases, patients will be able to start exercising on a stationary bicycle four to six weeks after the procedure, and start running again about two months post-op.

Once you have completed your rehabilitation period, you will truly be able to reap the benefits of your meniscus repair surgery and return to your normal activity levels.

Contact your orthopaedic surgeon or physiotherapist if you have questions or would like more information.

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