An mri may be used to assist in making the diagnosis. Torn knee meniscus exercises mobility, strengthening. If you have any questions, please speak to your physiotherapist. This handout describes details of the postoperative care of your knee. This tear required multiple superior and inferior vertical divergent sutures to achieve an anatomic reduction upper right and left. Do this exercise if you are unable to extend your knee. The meniscus is a piece of cartilage in the middle of your knee. Lesions in the redred zone have the highest cure rate, while for redwhite tears is also necessary to evaluate other parameters such as length, type, quality of the meniscal tissue and the injurysurgery interval before proceeding to. Also great exercises to do if you have a meniscus tear and want to strengthen your legs in general.
The success of meniscus repair depends on tear pattern recognition and location for the capacity to heal. Meniscal tear pattern, geometry, site, vascularity, size, stability, tissue viability or quality, as well as associated pathology, are all taken into account when determining whether to resect or repair a meniscal lesion. Acute, traumatic tears tend to have higher healing rates than chronic, atraumatic tears. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. Meniscus rehab exercises the physical therapy advisor. The timing and type of meniscal tear may also impact healing.
Specific changes in the program will be made by the. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much. Your physiotherapist has diagnosed you with a degenerative meniscal tear. If you have knee pain due to a meniscus tear, you may. A longitudinal meniscal tear site demonstrating some fragmentation inferiorly lower left. Also great exercises to do if you have a meniscus tear. Axial view of the tibial plateau demonstrating the anatomic relationship. Conclusions there is a lack of consensus regarding the optimal postoperative protocol following meniscal repair. Meniscal cartilage tear exercises summit medical group. Figure 5 mri images of an intact and torn meniscal root.
Additional studies are needed to better clarify the interplay between tear type, repair method and optimal rehabilitation. To ensure that this program is safe and effective for you, it should be performed under your doctors supervision. 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. Cartilage is tough, smooth, rubbery tissue that lines.
Meniscal tears can occur when the knee is forcefully twisted, sustains a direct blow, deep squatting or during activities that require changing directions. Physical therapy pt can be useful for a torn meniscus whether or not you have surgery. Find out when it helps, what to expect, and how long youll need to do it for. 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.
Meniscus tear treatment with 4 exercises to avoid surgery. Shift your weight onto the injured leg on the support. Common tears include longitudinal, parrotbeak, flap, bucket handle, and mixedcomplex. Dependent upon the location and size of the repair, weight bearing status postoperatively as well as the intensity and time frame of functional activities may vary. Type of meniscal tear, patients functional needs, state of the joint before surgery, recovery time and compliancemotivation of the patient are factors that. Introduction to meniscus tear rehabilitation exercises. Reprinted with permission from mclaughlin j and noyes fr.
Knee arthroscopy with meniscus repair rehab protocol longitudinal bucket handle tears this protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement. These meniscus tear stretches and exercises should help if youve had a meniscal tear. Physical therapy pt and exercises for a meniscus tear rehab. Mobility or range of motion exercises which can be used in the early stages of a rehab program for a medial cartilage meniscus injury to. For most tears, some simple exercises can help maintain muscle strength in the front of the thigh quadriceps, back of the thigh hamstr. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a meniscal repair.
Symptoms of a degenerative meniscus tear include swelling, pain along the joint line, catching and locking. Pain and swelling are the most common signs of an injury to your meniscus. The size and location of the meniscal tear may also affect the rate of postoperative progression. Consider taking a more conservative approach to range of motion, weight bearing, and rehab progression with more complex tears, allinside meniscal repairs, and meniscal transplants. Most studies investigating rehabilitation after meniscal repair have included patients with a longitudinal tear. Often people also experience popping and clicking in. Small clinical studies support rehabilitation protocols that allow early motion. Sports injury medicine department 9250 sw hall blvd. Do this exercise if you are unable to extend your knee fully.
For most tears, some simple exercises can help maintain muscle strength in the front of the thigh quadriceps, back of. Meniscal tears are common, and surgery to treat meniscal tears is one of the most frequently performed orthopaedic procedures. Jan 21, 20 ideally, meniscal repair should result in healing of the tear and reestablishment of normal meniscal functions. There have been multiple studies that have demonstrated the clinical success of meniscal repair. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much strength and flexibility in your knee as possible. Athletes, particularly those who play contact sports, are at risk for meniscus tears. If an athlete suffers a meniscal root tear, the three options for treatment. Meniscus repair rehabilitation program gundersen health system. A torn meniscus is damage from a tear in the cartilage that is positioned on top of the tibia to allows the femur to glide when the knee joint moves. Medial meniscus tear brace wearing a rehabilitative knee brace will help recover from a torn meniscus by adding support to the joint and limiting the.
Knee arthroscopy with meniscus repair rehab protocol. Often times these tears can be diagnosed by taking a thorough history and completing a physical examination. Knee meniscal root repair 1 overview this is a protocol that provides you with general information and guidelines for the initial stage and progression of rehabilitation according to the listed timeframes. With that, i decided to do a literature to see what the latest research is telling us.
The physical health, activity level and aspirations of the patient may be taken into consideration during the management. Rehabilitation guidelines for meniscal repair of root and. Cole,md,mba weight bearing brace rom exercises phase i 02 weeks full in brace locked in extension locked in full extension for sleeping and all activity off for exercises and hygiene 090 when nonweight bearing heel slides, quad sets. How well the knee will heal and whether surgery will be needed depends in large part on the. When you tear your meniscus, your knee becomes unstable. Knee technique guide meniscal root repair using a two. Most often degenerative tears are surgically removed. Brett sears, pt, mdt, is a physical therapist with over 15 years of experience in orthopedic and hospitalbased therapy. Be sure to rotate your leg outward laterally slightly to gain a better activation of the medial inner side of the quadriceps. Rehabilitation exercises a meniscus tear is a common knee joint injury. There are two types of cartilage in the knee, articular cartilage and meniscus cartilage.
Tears are usually described by where they are located anatomically in the c shape and by their appearance for example, bucket handle tear, longitudinal, parrot beak, and transverse. Many different factors influence the postoperative meniscal repair rehabilitation outcomes, including type and location of the meniscal tear and repair. Manual stretching for extension with overpressure or recurvatum. The treatment chosen will depend on the location of the tear, the athletes sport, ligamentous stability of the. Ideally, meniscal repair should result in healing of the tear and reestablishment of normal meniscal functions. The gundersen sports medicine meniscus repair rehabilitation program is an. The medial meniscus is semicircular in shape and the lateral meniscus is. Fogoros, md, is a retired professor of medicine and boardcertified internal medicine physician and cardiologist. If an athlete suffers a meniscal tear, the three options for treatment include.
Recommended surgical techniques for complex meniscal tears. The decision by the surgeon to repair or remove is based primarily on the location of the meniscal tear. Variants of these bony avulsions have previously been identified as meniscal ossicles. Straighten your injured leg as the other leg comes off the floor. Department of rehabilitation services physical therapy standard of care. Racgp meniscal tear presentation, diagnosis and management.
As shown in this article, after meniscal tear, there are varied surgical and rehabilitation treatments and the timing of recovery from meniscal injuries after surgery is very different. Meniscal root tears can be diagnosed on sagittal, coronal, and axial mri images figure 2. It is important to know the difference between these two types of injuries, because the way we treat them. In particular, meniscal root repairs can be especially beneficial to patients with fairly normal articular cartilage and who have evidence of spontaneous osteonecrosis of the knee sonk medial femoral condyle. Four authors of this guideline revision completed the appraisal of guidelines for research and evaluation agree ii tool to assess the quality and reporting of the cpg published in. Knee rehabilitation exercises to ensure that this program is safe and effective for you, it should be performed under your doctors supervision. May 30, 2016 these meniscus tear stretches and exercises should help if youve had a meniscal tear. Rehabilitation guidelines for meniscal repair uw health. Sep 17, 2018 meniscus tear rehab best exercises best exercises to strengthen your legs after a menisectomy. Jul 18, 2014 treatment options for meniscal tears fall into three broad categories. Some people may do better with physical therapy, while others may do better with meniscal tear surgery. Meniscus tear rehab best exercises best exercises to strengthen your legs after a menisectomy. This booklet gives information on the different types of meniscus problems, the evidencebased management options, and how physiotherapy can help.
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. It is no means intended to be a substitute for ones clinical decision making regarding the. Meniscus tears are among the most common knee injuries. Medial meniscus tear brace wearing a rehabilitative knee brace will help recover from a torn meniscus by adding support to the joint and limiting the wearer from provoking the injury even further. Meniscal tear incidence may be as high as six per population 6 with a 2.
Reprinted with permission from noyes fr, barberwestin sd. Tears are noted by how they look, as well as where the tear occurs in the meniscus. Stand with the foot of your injured leg on a support 3 to 5 inches 8 to centimeters high like a small step or block of wood. As we age, this cartilage begins to lose elasticity and can easily be torn without any type of trauma. You may do the rest of the exercises when the pain in your knee has decreased. When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus. Selecting the most appropriate treatment for a given patient involves both patient factors e.
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