To understand meniscus injuries we first need to have a look at what the meniscus is. The most commonly injured meniscus is in the knee between then femur and tibia.

The knee meniscus is formed from two c-shaped fibrocartilage discs, a medial and lateral disc. The function of the discs is to be a buffer between the femur and tibia and reduce the stresses of walking, running, jumping etc.

The most common mechanism of injury is because of the anatomy of the knee and musculature on attach to the knee is a forceful twisting of the upper leg while the foot is anchored to the ground or in an hyperextended position.

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In an extreme case you will find the Anterior Cruciate Ligament(ACL) will strain or tear. The injury is common with sports like football and rugby players who receive a hit in the knee from the outside like what would happen in a tackle, other sports like golf that has a rotational element to it is also vulnerable.

The symptoms of a torn meniscus are…

1) An increase in pain and swelling over 24-48 hours with minor tears of the meniscus.

2) Pain and restriction of movement is normally associated with more severe tears (long radial and bucket handle tears) as part of the meniscus stop the leg from full extension. The leg might unlock with a clicking sensation.

3) Tenderness over he joint line.

Meniscus tear rehab_2

The rehabilitation of meniscus tears is guided by how severe the actual tear is. The only way to gauge with a degree of accuracy on how severe the tear is, is with an MRI.

A small tear can be treated conservatively while a big tear that limits range of motion should be treated surgically and go through a full meniscus tear rehabilitation program.

Whether you have suffered from a small or a large tear the rehabilitation process should start as soon as possible. In the case of surgery, rehabilitation will minimise muscle wasting and also speed up the recovery process. The precise course of rehabilitation will depend on the severity of the tear, if someone has pain weight bearing it is not a good idea having him weight bearing on that specific leg.

The principals that needs to be built into a rehabilitation program are as follows:

1) Control pain and swelling, starting with manual physiotherapy.

2) Regain pain free active range of motion… i.e. Patient is able to move the knee unassisted through full range of motion without pain.

3) Gradual weight bearing exercises including proprioceptive feedback training through all three planes

4) Progressive strength and conditioning through a full pain freelance of motion.

5) Task specific drills, if someone is a rugby player mimic the moments he will have to perform during his game.

Some exercises to perform if a minor tear is suspected are:

1) Seated knee extension on a knee extension machine starting with both legs then one as pain allows

2) Leg press, like above start with both and switch to single leg if pain allows it.

3) Step down. One foot on a raised platform step down with the other lightly touching the floor then back up to the starting position. The difficulty level can be altered by increasing or decreasing the night of the platform.

4) Half squat against the wall. Stand side on to a wall, the leg closest to the wall bring the knee up and squeeze a small medicine ball against the wall with your knee. Now perform half squats with the leg on the ground taking care to push the hips back and down in the squat.

Please note all exercises should be done pain free and the above mentioned exercises are only examples of what to do.

Before embarking on a rehabilitation regime please consult a professional first, every body has different needs and should be reflected in your rehabilitation journey.

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