Blog #14 - Rehab after Meniscus Surgery: What to expect and how to recover.
- Brent Kelly
- Oct 31
- 4 min read
The meniscus is a crucial piece of cartilage in your knee that acts as a shock
absorber between your thighbone (femur) and shinbone (tibia). It plays a vital role in stabilising the joint, distributing weight, and allowing smooth movement.
Unfortunately, it’s also one of the most commonly injured structures in the knee — especially among athletes and active individuals. But can also be a large cause of knee pain among older individuals.
If you've recently undergone meniscus surgery or are preparing for it, understanding the recovery and rehab
process is essential for getting back to full function.
Types of Meniscus Tears
Meniscus tears can vary in shape, size, and severity. The type of tear often can contribute to the decision-making process as to whether surgery is needed and what the rehab journey will look like.
Common types include:
Longitudinal Tear: Runs along the length of the meniscus.
Radial Tear: Starts at the inner edge and extends outward.
Horizontal Tear: Splits the meniscus into top and bottom halves. Can be associated with cysts.
Flap (Bucket Handle) Tear: A piece of the meniscus is displaced, often catching in the joint.
Complex Tear: A combination of the above types, often in older patients or with degenerative knees.
The location of the tear also matters. Tears in the outer third have a better blood supply and have a better affinity for healing on their own. Tears in the inner two-thirds often lack blood flow and may not heal without surgical intervention.
Common Symptoms of a Meniscus Tear
A torn meniscus can present in various ways, depending on the severity and type of tear.
Common symptoms include:
Pain, especially along the joint line
Swelling that may increase over several days
Clicking or popping sounds
Locking or catching sensation in the knee
Limited range of motion
Knee instability or the feeling that it may “give out”
These symptoms may be sudden after a specific injury or develop gradually, especially in degenerative tears.
Management: Surgery & Rehab
If conservative treatment (e.g. manual therapy, education, load management, and a graded exercise plan) fails, meniscus surgery may be recommended. The decision of which surgical intervention will depend on the type and location of the tear.
There are two main surgical options:
Meniscectomy – Debridement (removal) of the damaged portion of the meniscus - Rehab timeframe ~2-3months
Meniscus Repair – Suturing the torn pieces back together, which requires a longer recovery time but preserves more of the natural cartilage - Rehab timeframe ~4-6months
Rehab Timeline Overview
Phase 1 - Acute repair phase
This phase will differ depending on the type of surgery that you had but regardless can be started day 1 post op. Following a surgical repair you will often be required to be in a hinge brace for the first 4-6 weeks and on crutches to reduce the loading on the repair site to optimise healing. Following a meniscectomy you’ll often be weight-bearing as tolerated.
Our main goals of this phase are to:
Reduce pain and swelling
Re-activation of the muscle around the knee - minimise muscle atrophy post op
Restoring range of motion
Maintaining strength around the hip and ankle
Normalise your gait (walking) pattern
Energy system maintenance and development - via off-feet modalities i.e bike, arm erg
Phase 2 - Reloading Phase
Once cleared to transition into the reload phase we aim to restore functional movement patterns - e.g. squatting, hinging and lunging. Progressing from bilateral (double leg) to unilateral (single leg) loading. The main focus of this phase is to improve lower body strength and capacity in preparation of return to running.
Main goals of this phase are to:
Quadriceps strengthening through open and closed chain exercises
Foot, Knee, Hip and core strengthening.
Introduction of plyometric loading and run drilling
Energy system development
Phase 3 - Rebuild:
The main progression in this phase of rehabilitation is the the graded return to running which is done on field and supervised by one of our physiotherapists. The severity of your injury will determine the length of this phase, but you will progress through the different stages of:
Linear running volume & speed
Deceleration and planned change of direction
Reactive change of direction and sports specific conditioning
Our rehab goals for this phase are:
Building running loads
Consolidating strength and power
Normalising plyometric profiling
Progression of sports specific skills in a controlled environment
Phase 4 and 5 - Return to Training and Sport
Our final two phases are aimed at a staged return to training, building from controlled to chaos, before a return to competition and full functional participation. Our goal during this phase is to ensure you return to your sport at a level greater than pre-injury and are ready to return to performance.
Our rehab goals for this phase are:
Progressing team training loads from controlled to chaos
Maintaining strength, power and plyometric loading
Education on ongoing resilience exercises to help prevent re-injury
Following your return to play, our physiotherapist will provide you with an ongoing knee resilience program aimed at reducing you risk of re-injury through ongoing strength and plyometric training.
Conclusion
Meniscus injuries are debilitating and a common cause of ongoing knee pain and substantial time away from sport when inappropriately managed. Early intervention and management both conservatively or post- operatively is crucial in optimising recovery time-frames and reduce long-term disability. If you think you have a meniscus injury don’t just wait and hope it gets better on its own, get it assessed by your healthcare provider who will guide you in the right direction and get you back to sport.