You have both an inner medial and outer lateral meniscus that help distribute the forces in the knee when you are weightbearing. The menisci are wedge shaped and are thinner toward the center of the knee and thicker toward the periphery of the knee joint figures 1 and 3. The aim of phase 3 of a meniscus tear rehabilitation program is to ensure full range of movement in the knee, regain normal strength with the ability to perform a full squat and start to return to running and normal training. Nov 15, 2019 if your knee remains painful despite rehabilitative therapy or if your knee locks, your doctor might recommend surgery. Once thought to be a vescgial muscle remnant with no known purpose, now known to be.
Evidence based management of meniscal tears kenneth g. It is held together by several important ligaments. Rehabilitation guidelines for knee arthroscopy arthroscopy is a common surgical procedure in which a joint is viewed using a small camera. Department of exercise, health, and sports science. Internal rotation tests the lateral meniscus while. You may do the rest of the exercises when the pain in your knee has decreased.
The majority of the load is transmitted through the posterior horns with flexion past 90 degrees. Methods for coping with the pain and problems that arise from a meniscus tear vary depending on the diagnosis from your. While lying on your back, place a rolledup towel under the heel of your. Meniscal cartilage tear exercises summit medical group. If you just found out that the pain and swelling in your knee is a torn meniscus, you probably have a decision to make about how to treat it. Because of this, it is less prone to tears than the medial meniscus just. For most tears, some simple exercises can help maintain muscle strength in the front of the thigh quadriceps, back of the thigh hamstr. If a tear is causing pain and impaired function, removal of that tear is the treatment of choice. Sometimes we might not even notice that weve done anything to cause the tear. Pain during knee flexion implicates the posterior horns. The last 25 years have produced an enormous amount of research that highlights the importance of the meniscus to the function of the knee. If the tear is large however, the meniscus may be left only slightly intact. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much strength and flexibility in your knee as possible. The meniscus can be torn anterior to posterior, radially parrot beak, or can have a bucket handle appearance.
Brett sears, pt, mdt, is a physical therapist with over 15 years of experience in orthopedic and hospitalbased therapy. This handout describes details of the postoperative care of your knee. Best compression knee sleeves and braces for meniscus. You can expect to achieve full knee rom and strength and regain painfree functional mobility. Jan 21, 20 if the meniscus is cut through its periphery, its load distribution function will probably be completely disrupted. In fact, a meniscal tear is one of the most frequently occurring cartilage injuries. When people tear it, they usually have swelling or pain in the knee. If you have knee pain due to a meniscus tear, you may.
Generally, when someone has a torn meniscus there is significant pain at the joint line. The knee is also cushioned during weight bearing by two cartilaginous discs, called the medial inside and lateral outside menisci. Knee meniscus tear the meniscus is a type of cartilage cushion in the knee that protects the true joint cartilage from injury as the thigh bone moves over the top of the leg bone. Athletes, particularly those who play contact sports, are at risk for meniscus tears.
You have two menisci thats the plural for meniscus in each knee. Similarly, a major difference was found between the presence of a medial meniscal extrusion and loss of medial compartment cartilage volume. Along with the type of tear you have, your age, activity level, and any related injuries will factor into your treatment plan. From your starting position, slowly lower your body down and hold. To reduce knee pain and recurrent knee swelling to protect the knee from accelerated knee osteoarthritis to improve the knee stability especially in acl reconstructed knee as an intact meniscus protects the graft placing a stitch across a. Physical therapy for a knee meniscus tear verywell. Theyre basically shock absorbers that keep your thighbone in the upper leg from pounding on the shinbone in the lower leg. The meniscus is a rubbery, cshaped disk that acts as a shock absorber between the thighbone and shinbone. Knee meniscus repair post operative rehabilitation protocol. Jan 16, 2016 postoperative knee meniscus repair rehabilitation protocol from san francisco orthopaedic sports medicine surgeon dr. Sports injury medicine department 9250 sw hall blvd. If the meniscus is cut through its periphery, its load distribution function will probably be completely disrupted.
Your knee meniscus is fibrocartilage that separates thigh bone femur from your shin bone tibia. Hold for 35 seconds, then return the leg to the ground and repeat with the opposite leg. The role of the meniscus in the knee has previously been grossly underestimated. Read about exercises for knee injury, and learn about symptoms, signs, treatment, home remedies, recovery times and prevention of knee injuries. The knee is a hinge joint at the connection point between the femur and tibia bones. When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus. Knee specific pain scale at one and twoyear followup. Clearly, the meniscus does play an important role in the human knee, but once torn and unable to be repaired, many of the beneficial effects of that structure are lost. Rehabilitation exercises a meniscus tear is a common knee joint injury. As long as your symptoms do not persist and your knee is stable, nonsurgical treat ment may be all you. If the tear is tiny, the meniscus stays connected to the front and back of the knee.
The results of meniscus repair are more successful when the acl is also reconstructed simultaneously. The primary role of the meniscus is load bearing in order to decrease the forces on the articular surface of the femur and tibia. The big thing to differentiate meniscus tears from arthritis is that arthritis pain is typically in the front of the knee whereas a meniscus tear is typically on the side of the knee. While lying on your back, place a rolledup towel under the heel of your injured leg so the heel is about 6 inches off the ground. Its sometimes possible to repair a torn meniscus, especially in children and young adults. Management of traumatic tears and degenerative lesions.
Like a lot of knee injuries, a meniscus tear can be painful and debilitating. Discover common causes of knee injuries and what a meniscus tear feels like. The meniscus cartilage in the knee includes a medial inside part of the knee meniscus and a lateral outside part of the knee meniscus figures 1 and 2. Try to have the knee track toward your second toe to insure proper alignment of the knees. Remember that everyone and every injury is different, and your course of pt may be shorter or longer. Kneespecific pain scale at one and twoyear followup. The treatment chosen will depend on the location of the tear, the athletes sport, ligamentous stability of the knee and any associated injury. If the tear cant be repaired, the meniscus might be surgically trimmed, possibly through tiny incisions using an arthroscope. Understanding meniscal injuries changi general hospital. For people under the age of 30, the meniscus is fairly tough and rubbery.
Recovery time for your knee depends on a number of factors, including how severe your meniscus tear is. The menisci transmit approximately 50% of the load in weight bearing extension and 90% of the load at 90 degrees of knee flexion. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. A meniscus tear can happen when playing sports and commonly occurs in children. Mri and knee arthroscopy surgery are used for diagnosis. There is a higher rate of healing in the medial meniscus then in the lateral. How well the knee will heal and whether surgery will be needed depends in large part on the type of tear and how bad the tear is. Full recovery from surgery may take 4 to 6 weeks, depending on the type of procedure. Each knee has two meniscione on the outside of the knee and one on the inside. Each knee joint has a medial meniscus and a lateral meniscus. The meniscus is a cshaped piece of cartilage in the knee that cushions and acts as a shock absorber between your thigh bone femur and shin bone tibia.
There are actually two menisci in your knee, one is on the inner medial side of your knee and the other is on the outer lateral side of your knee. How well the knee will heal and whether surgery will be needed depends in large part on the type of tear see figure in appendix and how bad the tear is. Irreparable meniscus tear with friable tissue that will need a partial repair of complex radial meniscus tear with allinside meniscus repair device why we should repair the meniscus. How well the knee will heal and whether surgery will. In the younger population, your knee meniscus is usually torn traumatically, by twisting on a slightly flexed knee. Diagnosis and management of meniscal injury rhode island. The main role of the meniscus is to act as a cushion and protect the bones from grinding together. Internal rotation tests the lateral meniscus while external rotation tests the medial meniscus. Fogoros, md, is a retired professor of medicine and boardcertified internal medicine physician and cardiologist. Physical therapy exercises for a knee meniscus tear. In fact, a meniscal tear is one of the most frequently occurring cartilage injuries of the knee.
Meniscus tears are among the most common knee injuries. Early after surgery, 92% of patients had excellent or good results, in term of knee pain, swelling, rom, squatting, but at a mean of eight years after surgery, only 62% of the patients rated their knees as excellent or good50. The traumatic type of meniscal injuries is most often sportsrelated. Best compression knee sleeves and braces for meniscus tears. The nature of the injury, and a persons symptoms, help a doctor determine treatments for a meniscus tear.
Rehabilitation guidelines for meniscal repair uw health. Meniscal tear and extrusion are strongly associated with. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much strength. The meniscus cartilage in the knee includes a medial inside meniscus and a lateral outside meniscus. Methods for coping with the pain and problems that arise from a meniscus tear vary depending on the diagnosis from your doctor. Knee rehabilitation exercises to ensure that this program is safe and effective for you, it should be performed under your doctors supervision. Injuries to the meniscus are usually called tears and they can happen to anyone. The meniscus is a crescentshaped piece of cartilage that is located between the femur and the tibia. A tear in the meniscus occurs when a piece of the tissue is sliced or ripped.
Pdf medial and lateral knee joint menisci serve to transfer load and absorb shock, aid joint stability and provide lubrication. The pain is typically worse with squatting or twisting the leg. Keep your pelvis level as you lift your hipspelvis and buttocks into the air. If a degenerative tear is symptomatic it is usually surgically removed. Read about meniscus tear surgery and recovery time and other forms of treatment. The knee may lock, and you may have trouble moving it. Lay on your back with your knees bent to prepare for the bridge exercise. A typical course of physical therapy for knee pain caused by a meniscus tear lasts about 4 to 6 weeks. One function of the meniscus is to distribute loads across the knee joint. The meniscus is the most commonly injured structure in the knee joint. Conservative treatment for meniscus rehabilitation. If you tear one, your doctor probably will suggest that you rest. Any sudden twisting or blunt forces exerted onto the meniscus can result in damage.
A meniscus tear is a common knee injury for athletes such as weight lifters, basketball players, and runners. Do this exercise if you are unable to extend your knee fully. Symptoms of a torn meniscus include popping, clicking, and joint pain. If your tear is small and on the outer edge of the meniscus, it may not require surgery. Medial and lateral knee joint menisci serve to transfer load and absorb shock, aid joint stability and provide lubrication. Meniscus rehab exercises the physical therapy advisor. Meniscus tears symptoms and treatment orthoinfo aaos. Located between the femur and the tibia, the meniscus is a crescentshaped rubbery structure that cushions the knee. Theyre made of cartilage, a tough, rubbery substance. Pain is usually experienced when a meniscus is injured, particularly when trying to straighten, bend or twist the knee. If you hear a popping sound from your knee, that can be a first sign of a tear. Postoperative knee meniscus repair rehabilitation protocol from san francisco orthopaedic sports medicine surgeon dr. Apr 21, 2017 when people tear it, they usually have swelling or pain in the knee. There are 2 meniscus located in the knee joint between the femur thigh bone and tibia shin bone.
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