There are a number of options for physical therapy, when we're having a meniscus patient, if it's torn, if the meniscus is torn, the likelihood of them having it repaired is pretty strong, so the doctor will often provide a protocol-based therapy program after surgery, in the case of surgery.
But if it's a tear to the meniscus that does not require surgery, the patient wants to try to get on with conservative management or the doctor doesn't think it's necessary to do surgery, then there are a few things you have to consider. First of all, the fact that there is a tear in there, you've got to be real careful and conservative in the beginning.
We typically use as therapists, an acronym called RICE, which is rest, ice, compression and elevation. Usually these patients have are having a lot of pain and a lot of swelling and those first few days are crucial to turn off some of that pain and swelling. So with the rest, the ice, the compression and the elevation that will really be helpful for a few days. Once there is an improvement in range of motion, once there's an improvement in the swelling and the pain you're going to move on to some exercises.
And the first couple of exercises are going to to be trying to start pumping the actual muscles of your knee. So we're talking about isometric exercises for your quadriceps, isometric exercises for your hamstrings. These are easily done on the floor or in bed and you can be doing these at home. There is no reason to be going to a gym for this. Once you've done the isometric exercises, you can then move on to your heel slide, which is an exercise you can do on the floor or in bed as well.
This is a simple bending and straightening exercise, very little friction and very little resistance at all with the exercise. After a few days of doing that, you can then move on to doing these same heel slides, but maybe using your hand to assist and create some over-pressure to the pressure. That stage can last someone between one and three weeks. Somewhere in the middle of that stage though however, you can start to do some biking, some cycling at the gym, as well as doing some leg curls and some leg extension exercises, without any weight and then moving on with some weight.
And then lastly, when you're dealing with a meniscus tear, you're going to want to start retraining on functional exercises, like your squats and your lunges and even your split squats. This is a higher level exercise that you want to wait until the end of the recovery process to work on. It really challenges the muscles of your leg to work in a functional manner, because we spend most of our day either getting up from chairs or going down stairs. These exercises really allow the muscles to work functionally.
So it's a four to six week process whether you are doing it on your own or in a physical therapy office, depending on the level of the injury. And again, if it's a post-operative person, then usually the doctor will tell us sort of where to go and when, in terms of how to time it and how to proceed and these are the options for a meniscus tear.