The ability to bend your knee after arthroscopic meniscus surgery depends largely on the specific procedure performed and the protocol set by your surgeon. The surgery involves repairing or removing the damaged C-shaped cartilage, and controlling movement is the primary factor in the initial recovery period. The biological healing process dictates how quickly and how far the knee can be flexed without risking damage to the surgical site.
Understanding Initial Movement Restrictions
The first one to two weeks following surgery involve strict precautions. Patients who undergo a partial meniscectomy, which involves removing only the torn fragment, generally have more freedom of movement sooner. Since no tissue was sutured, the primary concern is managing post-operative swelling and pain, allowing for an earlier return to gentle bending.
A meniscus repair, where the torn tissue is stitched back together, requires a cautious approach to protect the healing sutures. Excessive knee flexion places stress on the repaired tissue, risking failure. The knee is often immobilized in a brace locked in full extension (0 degrees) for ambulation. Weight-bearing is frequently restricted to “toe-touch” or is completely non-weight-bearing to avoid compressive forces.
The immediate goal for a repair patient is to ensure the repaired tissue remains undisturbed, meaning immediate bending is highly restricted. The brace helps maintain a straight leg. Meniscectomy patients are typically permitted to bear weight as tolerated and begin gentle range-of-motion exercises almost immediately.
The Phased Progression of Knee Flexion
Following the initial period, the progression of knee flexion is phased, extending from approximately week two through week six. The timeline differs for meniscectomy and repair patients, with repair patients moving slower. Meniscectomy patients are encouraged to work toward full, pain-free range of motion within the first four to six weeks.
For a meniscus repair, the range of motion is increased incrementally based on the surgeon’s guidance and the repair location. Initial goals often restrict passive flexion to 90 degrees, maintained for the first four to six weeks to prevent tension on the healing site. Tears located in the posterior horn may have a stricter limit, such as 70 degrees, because deeper bending applies greater force.
Achieving full knee flexion (typically around 135 degrees) is generally not permitted until after the primary healing phase has concluded. This milestone is often targeted between six and twelve weeks post-operation for a repair. Progression is contingent on minimal pain and controlled swelling. An increase in discomfort or joint fluid accumulation signals that the progression is moving too quickly.
Physical Therapy: Your Guide to Safe Bending
Physical therapy safely restores the knee’s capacity to bend. The therapist guides the patient through two primary types of movement: Passive Range of Motion (PROM) and Active Range of Motion (AROM). PROM involves an external force, such as the therapist’s hand or the patient’s opposite leg, moving the joint without engaging the muscles.
PROM is often introduced first, particularly after a repair, to gently mobilize the joint and prevent stiffness without stressing the healing meniscus. A common early exercise is the heel slide, performed while lying down, where the heel is slowly slid toward the buttocks. This controlled motion helps the knee regain flexibility within the prescribed degree limits.
As recovery advances, the stationary bicycle becomes a standard low-impact exercise used to promote continuous, non-weight-bearing flexion. The seat height is initially set high to limit the required bend, and as range of motion improves, the seat is gradually lowered. The physical therapist monitors the patient’s technique, ensuring that the quadriceps and hamstring muscles are not forcefully contracting in a way that could compromise the repair.
Signs That You Are Bending Too Much or Too Soon
Ignoring post-operative instructions or pushing the knee past its healing capacity can lead to complications. The most immediate warning sign of overextension is the onset of sudden, sharp pain that does not resolve quickly with rest and ice.
Another indicator that the knee is being pushed too hard is an increase in swelling (effusion) that persists for more than a few hours after activity. While mild swelling is expected, a flare-up indicates that the activity level or range of motion was excessive for the joint. Excessive warmth and redness around the incision sites can signal inflammation or infection, requiring immediate medical attention.
A concerning sign is feeling a distinct popping, clicking, or catching sensation within the joint during movement. This mechanical symptom could suggest that the meniscal repair has failed or that a new tear has occurred, requiring immediate communication with the surgical team. Pushing through pain or attempting high-impact activities prematurely can lead to re-injury and necessitate further surgery.