Nose Creek Physical Therapy Information on Knee (Meniscal) Injuries
CLICK HERE FOR KNEE INJURY EXERCISES
What is a Knee Maniscal Injury?
Physiotherapists describe knee maniscal injuries as tears in the tough, 'c' shaped cartilage that acts as a cushion between the thigh bone (femur) and the shin bone (tibia). These tears can be partial or complete. They are commonly referred to as a torn cartilage. Although they are slightly different in shape, the types of injuries they receive are the same. Physiotherapists often see these injuries accompanied by pain, swelling or locking of the knee joint.
What causes Meniscal Injuries?
When a meniscus is torn, the knee becomes painful and swollen. Pain is often well localized and made worse by specific movements such as bending or pivoting. There may be tenderness around the joint line of the knee and certain maneuvers of the knee (like compression tests) may produce clicking and pain. Swelling is caused by the irritation of the joint lining by the torn cartilage. If a piece of the meniscus is caught in the joint, it may prevent the knee from fully extending (this is known as locking). Locking can be intermittent (lasting several minutes), or persistent (lasting weeks).
The above collection of signs and symptoms can correctly diagnose meniscal injuries most of the time. Occasionally, in complicated cases, special tests care needed such as magnetic resonance imaging (MRI). Arthroscopic surgery is now being used more for a treatment than a diagnosis.
How are Meniscal Injuries Treated?
Each treatment plan is individualized through discussions with your physician and physical therapist, and progress should be monitored regularly. Physical Therapy treatment is administered in three phases.
Physical Therapy Phase l Ð Control Pain And Inflammation
Following a meniscal injury, reduction of pain and inflammation is achieved with ice and physiotherapy modalities such as ultrasound. Anti-inflammatory medications may also be helpful. It is important to modify activity during this acute phase.
Physical Therapy Phase 2 Ð Restore Strength And Function
Once the knee is moving normally and the swelling has gone, a gradual return-to-activity program begins. Physiotherapists advise the gentlest activities to be started first, which include cycling and non-weight bearing exercises. Finally, a gradual return to sports involving twisting and pivoting is added.
If the above measures do not prove successful, or if the knee remains locked, arthroscopic surgery may be required. With arthroscopy, the torn portion of the meniscus may be removed or repaired. Most commonly, the fragment is removed (called partial menisectomy) and the edges are smoothed. Every attempt is made to retain as much of the meniscus as possible, since it is an important structure for protecting the knee from stresses. Sometimes, there is a tear in the outer edge of the meniscus that can be treated by stitching (suturing) the meniscus back together.
Can Meniscal Injuries Be Prevented?
Some meniscal tears result from abnormal shear forces that occur in an unstable knee joint. For example, with anterior cruciate ligament (ACL) tears, the unstable knee can give way or buckle if not supported. Repeated episodes produce forces that may eventually cause a meniscal tear. Therefore physiotherapists believe appropriate treatment of the unstable joint will help prevent tears of the menisci.
Are There Any Special Considerations?
In most cases, if the physical therapy plan is followed, a full return to all sporting activity is possible. However, arthroscopy may be appropriate if the swelling is keeping you from completing full rehabilitation.
