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Tears of Meniscus Rehabilitation
 * Rehabilitation programs for patients with meniscus tears are highly individualized. A physical therapist can select a traditional
 * conservative rehabilitation protocol or an accelerated program. Barber’s research in 1994 reported that healing rates are the same between the two approaches. Factors that influence considerations for an appropriate rehabilitation program include the patient pre-injury status, patient’s expectation and tolerance for activity modification.
 * Other important factors are the types of treatment received (non-operative, meniscectomy, meniscal transplantation or implantation), the types and locations of tears, evaluation of patient current joint condition, age, etc.
 * Rehabilitation for non-operative treatment:
 * For patients with non-operative treatment, rehabilitation program is designed to reduce symptoms of pain and swelling at the affected joint. This type of rehabilitation focuses on maintenance of full range of motion and functional progression without aggravating the symptoms Physical therapists can utilize modalities such as electric stimulation (Figure 1), cold therapy and ultrasonography, etc.
 * Rehabilitation for operative treatment
 * For patients who underwent operative treatments such as meniscal repair, or recent advanced transplantation and implantation, a more conservative rehabilitation regimen is recommended for successful healing . Although the rehabilitation program is highly individualized, a general protocol can be derived. It consists of 3 main phases before the patients can come back to their desired normal activities and sports.


 * Phase 1: the initial first 4 to 6 weeks immediately after surgery treatment. Balance exercises.jpg
 * The rehabilitation strategies in this phase involve using a passive continuous motion machine during the first 5 days following the surgery. Prolonged period of immobilization can lead to muscular atrophy and delay functional recovery During the 4-6 weeks post-surgical, they recommend active and passive non-weight bearing motions which flex the knee up to 90ᵒ. If any weight-bearing exercises are applied, a controlled brace should be worn on the knee to keep the knee at near (<10ᵒ) or full extension. Further knee flexion can damage the meniscal allograft because of the increased shear forces and stresses. Exercises such as stretching, straight leg raising, aquatic exercises (pool ambulation, swimming) are excellent in terms of reducing load stress and promoting range of motion.


 * Phase 2: the 6th to 14th week after surgery
 * The second phase is to focus on improving for full range of motion, restore normal gait. Also, muscular strengthening and neuromuscular training are emphasized using progressive weight bearing and balance exercises. Exercises in this phase includes increased knee flexion (>90ᵒ), stretching, squats, forward step up and down, stair master, standing on foam surface with one or two legs (Figure 2&3), etc.
 * Phase 3: the 14th to 22th after surgery Step exercises.jpg
 * The third phase includes exercises for maximal strength and flexibility to meet the demands of the activities the patients desire to return to. Exercises in this phase improve limb symmetry, agility, and cardiovascular fitness. Examples are step exercise (Figure 4), hopping, squats, lunges, treadmill running, and sport/work specific movements, etc. This phase prepares patients to come back to full sport/work without restrictions.
 * The third phase includes exercises for maximal strength and flexibility to meet the demands of the activities the patients desire to return to. Exercises in this phase improve limb symmetry, agility, and cardiovascular fitness. Examples are step exercise (Figure 4), hopping, squats, lunges, treadmill running, and sport/work specific movements, etc. This phase prepares patients to come back to full sport/work without restrictions.