Dr Mak Protocol™

Partial Medial Meniscectomy Rehabilitation Protocol (Athlete – Fast Track Version)

Overview

Partial meniscectomy does not require biological healing of meniscal tissue. Rehabilitation progression is primarily guided by:

Pain response

Joint effusion

Quadriceps activation

Neuromuscular control

Expected return to sport: 4–8 weeks (elite athletes: 4–6 weeks)

Phase 1 — Immediate Post-Operative Phase

Timeframe: Day 0 – Day 5

Goals

Eliminate joint effusion

Restore full knee extension immediately

Initiate quadriceps activation

Normalize gait pattern

Weight Bearing

Full weight bearing as tolerated

Crutches only if required for comfort

Interventions

Activation

Quadriceps sets

Straight leg raise

Terminal knee extension with resistance band

Mobility

Passive and active knee extension (priority)

Heel slides within tolerance

Manual Therapy

Patellar mobilization (superior, inferior, medial, lateral)

Tibiofemoral Grade I–II mobilization if indicated

Criteria to Progress

Full passive knee extension

Minimal effusion

Independent ambulation without gait deviation

Phase 2 — Early Strengthening Phase

Timeframe: Week 1 – Week 2

Goals

Restore full knee range of motion

Improve quadriceps and gluteal activation

Establish baseline neuromuscular control

Interventions

Strength Training

Mini squat (0–45°)

Leg press (0–60°)

Step-ups (low height)

Glute bridge

Mobility

Stationary cycling (low resistance)

Neuromuscular Training

Single-leg stance (stable surface)

Balance with perturbation

Criteria to Progress

Full pain-free range of motion

No reactive effusion following exercise

Normal gait pattern

Phase 3 — Strength and Neuromuscular Restoration Phase

Timeframe: Week 2 – Week 4

Goals

Restore muscular strength symmetry

Improve dynamic knee stability

Prepare for impact loading

Interventions

Strength Training

Squat progression

Bulgarian split squat

Romanian deadlift

Single-leg squat

Neuromuscular Training

Single-leg balance (unstable surface)

Lateral step-downs

Movement control drills

Criteria to Progress

Strength ≥ 80% of contralateral limb

No post-exercise swelling

Pain-free functional movement

Phase 4 — Running and Dynamic Loading Phase

Timeframe: Week 3 – Week 5

Goals

Restore load tolerance

Prepare athlete for sport-specific activities

Interventions

Jogging progression

Acceleration and deceleration drills

Light agility drills

Criteria to Progress

Pain-free running

No joint effusion after activity

Phase 5 — Return to Sport Phase

Timeframe: Week 4 – Week 8

Goals

Safe return to unrestricted athletic participation

Interventions

Cutting drills

Pivoting drills

Plyometric exercises

Sport-specific movement training

Return to Sport Criteria (Dr Mak Standard)

Athlete must demonstrate:

Full knee range of motion

No joint effusion

Quadriceps strength ≥ 90–95% of contralateral side

Pain-free jumping and landing

Pain-free cutting and pivoting

Full confidence during sport-specific movement