Returning to sport after arthroscopy

After arthroscopy (keyhole surgery) the pain usually settles quickly and you feel you are well. This is where the biggest risk begins: going back too early. This article says how long it generally takes and what should be in place before sport.

The timings are not all the same

How long it takes to return to sport depends on what was done inside the knee:

• Removal of the torn part of the meniscus. Recovery is usually shorter. The source gives about three to six weeks.
• Stitching the meniscus. Because the tissue has to knit together, rehabilitation is longer. The source gives about three to six months.
• Cruciate ligament reconstruction. In the source, most patients return to full sport between six and twelve months.
• A minor operation without repair. The source gives about six to eight weeks, or sooner, for a return to most activities, but this is only for cases where no meniscus repair, ligament reconstruction or cartilage repair was done.

These ranges are only a guide. Your surgeon sets your time based on the type of operation and the state of the knee. High-impact sport or heavy work may be allowed later.

The measure of return is not the calendar

Sport is safe when the body is ready, not just when a few weeks have passed. In sources, the criteria for returning are:

• No pain and no swelling
• Full movement of the knee (full straightening and bending)
• Strength and endurance of the thigh muscles, especially the front thigh muscle, close to the other leg
• Balance and movement control

The physiotherapist and surgeon can check with simple tests whether you have reached this stage.

The general stages

The stages differ for each patient, but usually go in this order:

1. First weeks. Controlling swelling, getting movement back, walking properly. Rest, keeping the leg raised and ice as directed.
2. Strengthening. With physiotherapy exercises, muscle strength returns. Swimming and a stationary bike are often allowed sooner.
3. Light, controlled exercise. Brisker walking and simple movements. Still no jumping or twisting.
4. Sport-specific training. Movements specific to your sport (running, changing direction, landing) under the physiotherapist’s supervision.
5. Return to sport. Training first, then competition, with a gradual increase.

Start each stage only when you have got through the previous one without pain or swelling.

Common mistakes

• Going back early because I have no pain. No pain does not mean the tissue has healed. A repaired meniscus or a new ligament needs months to knit and grow strong.
• Not training. Without physiotherapy the muscle stays weak and the risk of injuring it again is higher.
• Carrying on with swelling. Swelling after exercise means the knee is not yet ready. In that case, raise the leg, apply ice and reduce the intensity. If it does not settle, tell the doctor.
• Comparing with others. Your friend may have had a different recovery.
• Dropping the doctor’s instructions. Do not put aside the knee brace, crutches or restrictions without permission.

Some people need to change their sport

The source says that some people need to change their lifestyle or sport to protect the joint. For example, moving from running on hard surfaces to swimming or cycling. If your knee has a lot of damage or osteoarthritis, the surgeon may suggest this. It does not mean failure; it means you are protecting your joint.

When to tell the doctor

• Knee swelling or pain suddenly increases or does not settle with rest
• The knee catches, locks or gives way
• Fever, redness or discharge at the cut
• Cramp-like pain and new swelling in the calf (it may be a sign of a clot)

If leg swelling or pain comes with shortness of breath or chest pain, call 115 (the emergency number in Iran) at once.

Summary

After arthroscopy, with patience and the right programme, most athletes come close to their previous level. But your exact time depends on the type of operation and your progress, and you should ask your surgeon and physiotherapist.