Physical Therapy Exercises for a Knee Meniscus Tear

If you have a knee meniscus tear, you may benefit from a physical therapy exercise program to rehabilitate your knee. Working with a physical therapist can help you regain maximal knee range of motion and strength and can help you return to your normal optimal level of activity. Research even shows that participating in PT for a meniscus injury may help you avoid surgery for your knee.

Your PT may use various modalities and treatments to control your pain or knee swelling or to improve the way the muscles around your knee contracts and supports the joint. Exercises should be a major component of your knee rehab program after a meniscus tear. Physical therapy exercises in the clinic, and as part of a home exercise program, can help you recover fully from your meniscus injury.

But which exercises are best for your specific condition? The only way to know is to work with your PT; he or she can prescribe the right exercises for your specific condition.

Here is a sample exercise program that you may be prescribed for your knee meniscus injury. The exercises focus on improving knee range of motion and strength and improving the overall function of your knee joint. Exercises should not cause any extra pain in your knee.

Before starting this, or any other knee meniscus exercise program, check in with your doctor and physical therapist to be sure exercise is safe for you to do.

1
Knee Range of Motion Exercises

Photo of a physical therapist working with a woman's knee.
Your PT can help you recover fully after a knee meniscus tear. UpperCut Images / Getty Images

Your knee meniscus tear may cause you to have limited knee range of motion. Your ability to full bend or straighten your knee may become painful or limited. Restoring normal and pain-free knee range of motion should be one of the goals of your rehab.

Performing heel slides is a great way to improve your knee flexion range of motion. (Flexion is the ability for your knee to bend fully.) To perform the heel slide exercise, lie on your back, and then slowly slide your heel up towards your bottom, allowing your knee to bend as far as possible. Then slowly allow your heel to slide back to the straight-knee position. Repeat the exercise 10 times, moving slowly as you bend and straighten your knee.

To improve knee extension (straightening) range of motion, you can perform the prone hang exercise. Simply lie on your stomach with your leg over the end of your bed, allowing gravity to slowly pull your knee into full extension. Hold this position for 15 to 30 seconds, and then bend your knee up. Repeat 3 times.

If any of the range of motion exercises cause increased knee pain, stop and check in with your PT.

2
Quadriceps Exercises

Woman stretching her quad muscle.
Youru PT can show you how to strengthen your quad after a knee meniscus tear. Getty Images

 Your quadriceps muscle, or "the quad," straightens your knee, and it supports the joint and your kneecap. After a knee meniscus tear or injury, your physical therapist will likely have you work to improve your quadriceps function so your knee joint is adequately supported.

Exercises to improve your quads may include:

  • Quad sets: Lie on your back with your knee out straight. Place a small rolled up towel underneath your knee. Press the back of your knee down into the towel while tightening your quad muscle. Hold it for 5 seconds, and then slowly release the contraction. Repeat 10 times.
  • The Short Arc Quad (SAQ) exercise: Place a rolled up bath towel or soccer ball underneath your injured knee. Tighten your quad and straighten your knee out all the way. Hold your knee straight for 3 seconds, and then slowly lower down. Repeat 10 times.
  • Mini squats in a modified position: Standing with your legs shoulder width apart, bend your knees to about a 45 degree angle. Hold this mini squat position for 3 seconds, and then slowly stand back up straight. Repeat 10 times.

Perform each exercise slowly and carefully, and be sure to stop if your knee pain increases.

3
Straight Leg Raises

Engage the abdominals and slowly raise your straight leg about 12-15 inches. Brett Sears, PT, 2011

Research indicates that hip strength can have a direct effect on knee position. Weak hips can cause your knees to move out of proper alignment, so your PT may prescribe hip strengthening exercises to help keep your knees in the best position possible, and thus minimizing stress to your meniscus.

Straight leg raises are a great way to improve your hip strength to help your knees. Here is how you do them:

  1. Lie on your back with your injured knee out straight and your other knee bent.
  2. Tighten your quad muscle on your straight leg, and raise the leg up about 12 to 15 inches. Be sure to keep your knee straight the entire time.
  3. Hold your straight leg up for a few seconds, and then lower it down slowly.
  4. Repeat the exercise 15 times.

You can perform the straight leg raises in different positions. If you are lying on your side while doing it, your gluteus medius muscles will be working, and your gluteus maximus, the big muscle that extends your hip, will be working if you do the prone straight leg raise.

Hip strengthening can also be accomplished with advanced hip exercises like the single leg bridge or with ball bridges. These advanced exercises may be combined as part of your balance and proprioception exercises for your meniscus rehab.

4
Balance and Proprioception

Photo of a girl balancing on a log.
Build Better Balance with this Advanced Balance Exercise Program. Don Mason/Getty Images

Proprioception is your body's ability to understand where it is in your environment. How much pressure is on a joint, and what position is the muscle in? Your body's joints and muscles communicate with your brain, telling it where things are. That's proprioception.

Sometimes after a knee meniscus injury, your proprioception becomes impaired. This may occur due to a period of immobilization after your injury. Working with your PT on balance and proprioception exercises may be an important component of your rehab program.

Some balance exercises to do may include:

Balance and proprioception exercises should be challenging, but you should always remain safe while performing them. Be sure you have a safe environment to exercise in and make sure you have something to hold onto while doing balance exercises. Your PT is a great resource to use while learning new balance and proprioception exercises after a meniscus injury.

5
Plyometrics and Neuromuscular Training

Photo of an athlete doing a box jump.
Plyometric training may be a part of your ankle fracture rehab. John Fredele/Getty Images

After a few weeks of working on restoring normal range of motion, strength and balance, it may be time to start to recover your ability to run, jump, and land properly. This can help you return to high-level work and athletic activities.

Plyometrics is a type of exercise that involves learning to jump and land properly. This can help you restore optimal neuromuscular recruitment of the muscles around your hips and knees. Working on plyometrics as part of your knee meniscus rehab can help minimize stress and strain around your knee when running, jumping, and performing cutting maneuvers during sports.

Plyometric exercises and neuromuscular training for your knees may include:

One important caveat when working on plyometrics for your knee: be sure your knee is in alignment with your ankle when jumping and landing. A good rule of thumb is to always maintain your knee over your second toe to be sure it is in alignment while jumping. Your PT can make sure you are doing it correctly.

6
Bicycling

Photo of active older couple riding bicycles.
Riding a bicycle can help you prepare for your total knee replacement surgery. Paul Bradbury/Getty Images

Riding a stationary bike may be an important component of your knee meniscus tear exercise program. Bike riding can have many benefits, including:

  • It can improve your knee range of motion
  • It can improve muscular endurance in you legs
  • It is a non-weightbearing exercise, which can limit stress and strain through your knee and injured meniscus.

Your physical therapist can help determine the amount of time you should ride and the right amount of resistance for your specific condition. In general, it is recommended you ride for 20 to 30 minutes, several days each week.

A meniscus tear can be a painful and scary injury that can prevent you from enjoying your normal work and recreational activity. By working with your doctor and PT and by engaging in an active exercise program, you can quickly and safely return to your optimal level of activity and function.

Source:

Katz, JN, etal. Surgery versus Phyiscal Therapy for a Meniscal Tear and Osteoarthritis. NEngl J Med, 2013; 368: 1675-84.

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