Physical Therapy Treatment After a Mensicus Tear
A meniscal tear is a common injury in athletes that involves the tearing of the knee’s cartilage. The meniscus is a disc of cartilage that cushions and stabilizes the knee and allows for fluid movements in various directions. Physical therapy is critical following a meniscal tear and surgery in order to heal properly and restore strength and movement to the knee for a safe return to sport. In this blog, we share a video of a student athlete’s progress during physical therapy following a meniscal tear and meniscectomy.
What is the meniscus?
The meniscus is the shock-absorbing pad of cartilage in the knee that lubricates, protects, and supports the bones of the knee joint. There are two menisci in each knee: the inner (medial) part of the knee and the lateral (outer) part of the knee. The menisci stabilize the knee by equally distributing one’s weight on the bones of the knee for balance and allow for smooth movements in various directions.
Meniscus Tear & Surgery
Meniscal tears are common in contact sports as the menisci are vulnerable to injury, especially when the knee is compressed and twisted. A meniscus tear, which involves the tearing of the knee’s cartilage, can be acute or degenerative. Degenerative meniscal tears happen over time due to repetitive stress on the knee. For athletes, acute tears are most common, resulting from a particular movement, such as twisting and turning quickly on a bent knee when the foot is planted on the ground.
Symptoms of a meniscus tear include:
Sharp, intense pain in the knee
Pop or tearing sensation in knee at the time of the acute injury
Swelling within the first 24 hours of injury
Difficulty walking or going up and down stairs due to pain
Catching or locking sensation in the knee
Difficulty straightening or bending the knee fully
One meniscal tear that occurs more frequently in young men, as in the case of our patient included in this blog, is the bucket handle tear to the meniscus. A bucket handle meniscal tear occurs on the outer portion of the meniscus and creates a vertical slice through the meniscus. The torn portion of the meniscus pulls away, forming a handle-shaped segment of the damaged tissue and is displaced into the front of the knee joint. Surgery, known as a meniscectomy, is generally needed to address a bucket handle tear and remove the damaged portion of the meniscus. Following surgery, physical therapy is highly recommended in order to safely return to sport.
Physical Therapy Treatment for Meniscus Tears
Following a meniscus tear and surgery, it is essential to begin physical therapy to heal properly and restore strength and movement to the knee for a safe return to sport. Initially, the physical therapist conducts a thorough evaluation, performing specific tests to measure range of motion in the knee and determine which movements and positions increase symptoms. Following a partial meniscectomy, patients generally engage in physical therapy for 7-9 weeks and return to sport at that time. Physical therapy helps the athlete regain strength, endurance, flexibility, and coordination in order to maximize their return to sport and prevent re-injury.
Physical therapy treatment for a meniscal tear:
Ice and compression to reduce swelling and control pain
Manual therapy involving stretching and joint mobilization to reduce stiffness and restore muscle function
Neuromuscular electrical stimulation to gently stimulate and contract muscles around knee to improve strength
Strengthening exercises to build and maintain strength in the knee and restore full movement in the knee. The muscles around the knee and throughout the leg are also strengthened specifically to help ease pressure on the healing knee tissues.
In the video below, Mangiarelli Rehabilitation physical therapist Mike works with student athlete Luca on jumping, loading, and changes in direction drills. Luca is five-to-six weeks post-meniscectomy on his right knee following a right bucket handle meniscal tear. Congratulations to Luca on his progress!
Video and patient information are presented with the written permission of the patient.
