Meniscal Injuries: Phase 5 - Return to Sport or Higher Activity
Exercise should include.
Change of direction training
Acceleration work
Deceleration drills
Cutting mechanics
Sport-specific loading
Dosage
| Exercise | Reps | Sets | Times a week |
|---|---|---|---|
| Change of direction training | 4–6 | 3–4 | 2–3 |
| Acceleration work | 1 effort (5–20 m) | 4–6 | 1–2 |
| Deceleration drills | 3–5 | 3–5 | 2–3 |
| Cutting mechanics | 4–6 per side | 3–4 | 2–3 |
| Sport-specific loading | Progressive | Progressive | 2–3 |
Return to sport rehabilitation should progressively prepare the athlete for the physical demands of competition by exposing the body to speed, force, change of direction, and sport-specific movement patterns. This phase focuses on improving movement quality, confidence, and resilience while gradually increasing intensity and complexity.
Change of direction training may include cone drills such as 45° and 90° cuts, shuttle runs, lateral bounds, and figure-of-8 running patterns. These drills help retrain coordination, knee control, and body positioning during directional changes. A typical starting point may be 3–4 sets of 4–6 repetitions, performed 2–3 times per week with adequate recovery between efforts.
Acceleration work focuses on rebuilding explosive power and sprint mechanics. Examples include resisted sled marches, short sprints over 5–20 metres, wall drills, and band-resisted accelerations. Sessions are usually performed at high quality with full recovery periods, using 4–6 sets of short efforts, 1–2 times per week.
Deceleration drills are essential for teaching the body how to absorb force safely and efficiently. These may include sprint-to-stick landings, controlled stop drills, drop lunges, and deceleration runs where the athlete must slow down rapidly within a designated zone. These are often programmed as 3–5 sets of 3–5 repetitions, focusing on control, knee alignment, and trunk stability.
Cutting mechanics are introduced progressively using planned movement patterns before advancing to reactive drills. Exercises such as side-step cuts, crossover cuts, single-leg hop-and-stick drills, and reactive cone changes help improve rotational control and reduce unwanted knee movement under load. Drills are commonly completed for 3–4 sets of 4–6 repetitions per side.
Finally, sport-specific loading gradually exposes the athlete to the demands of their sport. This may include repeated sprint efforts for field sports, jumping and landing drills for court sports, or reactive agility tasks that mimic game situations. Training intensity, speed, and volume are progressively increased over several weeks to ensure the athlete can tolerate competition demands while maintaining good movement quality and confidence throughout.
Many patients return successfully without surgery!!!
