07/31/2025
🪜 PSA -- SHARE THIS Recovery Ladder to Help Your Friends in Pain!
Last week, I worked with someone who had a fresh (3-week) meniscus injury — just three weeks old. Unfortunately, they had done just about everything wrong in their recovery journey.
Here’s what they misunderstood:
❌ They didn’t know the source of their pain — confusing their meniscus with their ACL and patellar tendon.
❌ They believed ice wouldn’t help, not realizing it can reduce swelling by constricting blood vessels.
❌ They tried to “walk it off,” when in fact, a few days of reduced pressure (bracing + crutches) would’ve accelerated healing.
🧠 So I introduced them to my Recovery Ladder.
This isn’t an acronym. It’s a model to help guide recovery from injury in the right sequence — from passive healing to full function. Now, I reference this model to all of my patients, so let me explain how this model was used in just the first session with this patient with a 3-week old meniscal irritation.
🪜 Bottom Rung: Modalities
Ice, compression, rest, bracing, red light, e-stim, assistive devices
Passive tools to reduce pain/inflammation when movement isn’t yet possible.
In this case: Ice + crutches + brace for 3–4 days.
🪜 Next Rung: Manual Therapy
Massage, myofascial release, joint mobilization
Prepares the body for motion, but doesn’t create long-term change alone.
In this case: I gently massaged fluid out of the knee and reinforced elevation + bracing.
🪜 Next: Stretching
Restores range of motion. Not too much, not too little.
In this case: Direct knee stretching wasn’t tolerated, so we worked on hamstrings, ankles, and the opposite leg to offset gait issues.
🪜 Then: Exercise
Build strength, motor control, balance, endurance.
In this case: We activated quad, hamstring, glute, and calf muscles progressively.
🪜 Top Rung: Function
Return to walking, lifting, squatting, living.
In this case: After 5–6 days, they were walking pain-free — inflammation gone, strength returning, confidence restored.
The Big Idea:
🧭 When you're injured, climb up the ladder.
Start passive. Move toward active. End in freedom.
🔥 When you're healthy, work down the ladder every day.
Start with your function. Train strength. Finish with recovery.
