Day 1 to 4 Weeks After ACLR + Meniscus Repair
The first four weeks are the most protected part of this protocol. The repaired meniscus needs protection while the knee also begins ACL reconstruction rehabilitation. Weight bearing and knee bending are deliberately restricted during this stage.
- PARTIAL WEIGHT BEARING (for 6 WEEKS)
- KNEE BENDING (0-2 WEEKS): UP TO 30°
- AT 2 WEEKS (Suture Removal): KNEE BENDING (2-4 WEEKS): UP TO 90°
- FULL KNEE BENDING THEREAFTER
- STRAIGHT LEG RAISING (AS ACLR FROM DAY ONE)
- STATIC QUADRICEPS (FROM DAY ONE)
Partial Weight Bearing
Partial weight bearing means only placing the permitted amount of body weight through the operated leg while walking. Use your prescribed walking aid and follow the exact weight-bearing instructions given after surgery. This restriction continues for 6 weeks in this protocol to protect the meniscus repair.
Partial weight bearing • For 6 weeksKnee Bending: 0–2 Weeks
During the first two weeks, knee flexion is limited to 30°. This means the knee should not be bent beyond the prescribed angle. Move gently and in a controlled manner rather than forcing the knee into deeper bending.
Day 1–14 • Maximum 30° knee bendingKnee Bending: 2–4 Weeks
At approximately 2 weeks, after suture removal, the permitted knee bending increases to 90°. The increase is gradual and should remain within the prescribed limit during this stage.
At 2 weeks after suture removal • Up to 90°Full Knee Bending Thereafter
After the protected bending period, full knee flexion can be worked toward as prescribed. The goal is to progressively restore the ability to bend the knee for daily activities and later strengthening exercises.
Straight Leg Raising
Straight leg raising is started from Day 1, following the same ACL reconstruction rehabilitation approach. Keep the knee controlled and straight while lifting the leg. This helps maintain quadriceps activation and control of the operated limb.
From Day 1 • As per ACLR protocolStatic Quadriceps
Tighten the front thigh muscle without moving the knee. This is an isometric exercise that helps maintain quadriceps activation after surgery and prepares the leg for later strengthening.
From Day 1At 6 Weeks & Beyond
At 6 weeks, the protocol moves beyond the protected meniscus-repair phase. The following exercises are added while continuing the earlier rehabilitation work as appropriate.
- AFTER 6 WEEKS
- TOE STANDING
- STATIC CYCLING
- CROSS TRAINER
- LEG PRESS
- REST AS ISOLATED ACLR (See Column 3 & 4)
Toe Standing
Rise onto the toes and then lower the heels in a controlled manner. This works the calf muscles and helps rebuild lower-limb strength needed for walking and later running activities.
Static Cycling
Stationary cycling provides controlled knee movement and low-impact cardiovascular exercise. Start with the range and resistance that can be performed comfortably within the prescribed rehabilitation progression.
Cross Trainer
The cross trainer provides a low-impact, repetitive lower-limb movement pattern. It can help improve endurance and coordinated leg movement as strength and knee motion improve.
Leg Press
Leg press progressively strengthens the muscles around the knee and hip. Perform it with controlled movement and the resistance prescribed during rehabilitation rather than chasing heavier weights.
Continue Isolated ACLR Rehabilitation
“Rest as isolated ACLR” means continue the rehabilitation progression prescribed for isolated ACL reconstruction, including the later stages listed in this guide, while respecting the meniscus-repair restrictions that applied earlier.
3 Months to 6 Months
This stage adds functional strengthening and controlled running. These activities should be introduced only according to the prescribed timeline and when the knee is ready for the progression.
- ALL ABOVE +
- HALF SQUATS
- THERABAND EXERCISE
- JOGGING (with SLOW ACCELERATION AND DECELERATION)
Half Squats
Half squats strengthen the thigh, hip and buttock muscles through a controlled partial squat. Keep the movement steady and avoid sudden dropping or twisting of the knee.
Theraband Exercise
Resistance-band exercises provide progressive strengthening for the muscles controlling the hip and knee. The band resistance and specific exercises should follow your rehabilitation plan.
Jogging
Jogging is introduced with slow acceleration and deceleration. The focus is on controlled loading, good alignment and gradually developing confidence in the operated leg.
Running & Change-of-Direction Training
At 5 months, the protocol progresses from straight-line jogging toward more demanding movement patterns that require control in different directions.
- FULL SQUAT
- SIDE RUNNING
- BACK RUNNING
- ZIG ZAG RUNNING
- FIGURE OF 8 RUNNING
Full Squat
Full squats train deeper knee flexion and lower-limb strength for functional activities. Perform with controlled technique and without forcing painful movement.
Side Running
Side running introduces lateral movement and trains the leg to control forces from the side.
Back Running
Back running challenges coordination and controlled movement while travelling backwards. Begin slowly and in a safe, open area.
Zig-Zag Running
Zig-zag running adds repeated changes of direction. The emphasis is on gradual, controlled direction changes rather than speed.
Figure-of-8 Running
Figure-of-8 running combines curved running and repeated changes in direction, helping develop control during more complex movement.
Jumping
Jumping is added at 6 months according to the prescribed protocol. It introduces higher-impact loading and requires good control of the operated limb during take-off and landing.
- JUMPING
Jumping & Landing Control
Jumping requires coordinated strength and control. Focus on soft, controlled landings with the knee aligned with the foot and hip, and progress only within the rehabilitation plan.
Return to Normal Sports Activities
The prescribed protocol allows normal sports activities after 9 months. Return to sport should be gradual and should follow the surgeon/physiotherapy team's assessment of knee function, strength, control and readiness.
- NORMAL SPORTS ACTIVITIES — AFTER 9 MONTHS
Frequently Asked Questions
Why is weight bearing restricted after meniscus repair?
The combined protocol protects the repaired meniscus during the early healing period. In this protocol, partial weight bearing is maintained for 6 weeks.
How much can I bend my knee after ACLR with meniscus repair?
The prescribed limit is up to 30° during weeks 0–2, up to 90° during weeks 2–4 after suture removal, and full knee bending thereafter.
Can I start straight leg raising immediately?
Yes. The prescribed protocol starts straight leg raising from Day 1, following the ACLR rehabilitation approach.
When can I start jogging?
Jogging is introduced from 3 months to 6 months, with slow acceleration and deceleration, according to the prescribed progression.
When can I return to sports?
The prescribed protocol lists normal sports activities after 9 months, with gradual return and clinical clearance recommended.