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Physical Therapy for a Torn Meniscus

by Jaydee Vykoukal, PT, DPT February 21, 2020 0 Comments

Wearing Knee Ice Wrap

Meniscal tears in the knee joint can lead to frustrating changes in function due to pain, swelling, and decreases in overall flexibility and strength. Luckily, Physical therapy for a torn meniscus is available for healing and getting on with your normal life. Keep reading to learn more.

Physical Therapy or Surgery?

The two top options for addressing a torn meniscus are physical therapy and/or surgery. Which one is best for you depends on the severity of your injury and the symptoms that occur. Discuss your options with your doctor. Surgery or not, physical therapy is always useful to restore your confidence in your knee while regaining range of motion, strength, and coordination.

For more information on the recovery process, see Meniscus Tear Treatment and Recovery.

How Physical Therapy Helps Knee Pain

A meniscus tear results in knee pain due to the physical changes that occur within the knee, swelling, and resulting in poor biomechanics of the lower body. A physical therapist is well trained in how to address these injured tissues to maximize recovery. Together, you will be able address localized pain with modalities such as ice, heat, ultrasound, massage and TENS while creating a personalized home exercise program that fits your needs.

Physical Therapy Without Surgery

Conservative treatment should always be the first step in treating a knee injury. Physical therapy is all about restoring maximal function to your knee while keeping it relevant to your own lifestyle and activities.

Rehabilitations Goals

Here is what you can expect when going through a rehab program.

  • In-depth education regarding your injury, the recovery process, and how to prevent future injuries.
  • A pain and swelling assessment followed by personalized tactics for managing and decreasing it.
  • Strength and range of motion assessment and a program for improving any deficits.
  • A full biomechanics screen to address any faulty movement patterns contributing to your injury. Then, addressing any issues found with education and proper exercise.
  • A discussion of your daily activities and lifestyle to optimize your plan and make it as personalized and effective as possible.

Precautions

What precautions you need to follow after a meniscus injury depends on your symptoms and the ability to use your knee. Generally, putting full weight through your knee and using it normally are allowed, even encouraged. Restrictions are usually based on your tolerance for activity and movement.

Any movements that exacerbate your symptoms should be modified to allow healing, such as deep knee flexion, twisting, jumping, and putting all your weight through your knee. Talk to your physical therapist for personalized recommendations.

Learning How to Use Crutches

Use of crutches following a meniscus tear is not common. However, if the pain is severe or there is a significant limp. crutches may be utilized for a short amount of time. Here is a quick guide to using crutches:

  • Adjust the crutches so that the wrists line up with the handles. 
  • Make sure the upper arm pads are 1-3 inches below the armpit to minimize arm discomfort and decrease the risk of nerve injury. 
  • Keep a good upright posture while using crutches, avoid leaning on them when resting.
  • Keep the crutches at a 20-30 degree angle from the body.
  • If you are not putting any weight through your knee, sequence bringing both crutches in front of you before swinging forward with your good leg.
  • If you are putting some weight through your knee, keep both crutches in sequence with the injured leg to provide adequate support as you walk. 

Physical Therapy After Surgery

If you choose to undergo knee surgery for a meniscus tear, physical therapy is even more important for restoring function. Cutting into the knee for any reason, whether it's a meniscus repair or total knee replacement, compromises the innate integrity and stability of the knee. Thus, learning how to optimize knee health through flexibility, strength, coordination and more is key to reduce the risk of future knee osteoarthritis.

Rehabilitations Goals

There are three main types of arthroscopic surgeries done for a meniscus tear, either a repair, removal of the damaged area or reconstruction of the meniscus (via options like synthetic grafts, autografts, or even stem cells). Which option is best for you depends on the injury, your health and lifestyle, and the surgeon. Regardless, there are three main phases that you will go through when recovering from a meniscus tear. They are outlined below.

Phase 1

For the first 1-4 weeks, the focus will be on protecting the knee as it heals. This will include addressing swelling and pain and beginning gentle knee range of motion and strengthening as tolerated (focusing on quadriceps and hamstrings use to start). You may need an assistive device like crutches and be restricted with how much weight you can put through your knee at first.

Phase 2

For the next 4-8 weeks, you will start focusing on gradually restoring function to your knee. This includes knee flexibility, strength, coordination, and your ability to walk without pain or a limp.

Phase 3

From around 8 weeks and beyond, you will now focus on with your physical therapist on returning to your activities of daily living (and sports, if applicable). Your program will be progressed to exercises that specifically address your deficits and restore your full knee function. This will help optimize use of the knee and prevent future injuries or complications.

Precautions

What precautions you need to follow will depend on the phase that you are currently in. Discuss what you need to do with your surgeon and physical therapist, as it will vary with each specific case.

Phase 1

Limit weight-bearing and forcing knee range of motion that is painful. Do not force use of the knee. If applicable, continue using crutches or any other assistive device until you can walk comfortably with a minimal limp.

Phase 2

Progress your program with caution. Continue avoiding extreme ranges of movement, especially flexion and twisting the leg while the foot is planted. Use your swelling, pain, and ability to coordinate movement as gauges for how quickly, or slowly, you can move forward with your program.

Phase 3

In the last stage of healing, you will be pushing yourself while staying fully aware of your symptoms. Limit any movements that exacerbate any lingering symptoms.

Physical Therapy Exercises

What exercises you will complete during your physical therapy sessions will vary depending on the stage of healing you are in and what you are comfortable completing. Your physical therapist will help you create a curated program that fits your specific needs. You can expect the program to start simply and build in complexity as your knee can handle more stress.

Exercises for Torn Meniscus

How Long Will I Need to do PT?

The amount of time spent in physical therapy can vary a lot. Your learning style, motivation and accountability level, and the severity of the injury will help you and your therapist decide how often and for how long will give you the best results. This generally ranges from several weeks to up to three months, especially with surgery.

You might need to start with a higher frequency of visits at first (up to 3 times per week) and then decrease then gradually (1 time per week or even every other week) as you transition to an independent home exercise program.

Effective Physical Therapy for a Meniscus Tear

When recovering from a meniscus tear, always follow recommendations from your doctor or physical therapist for calibrating weight-bearing and range of motion. If at any time you are feeling unsure, make sure to discuss your concerns with your therapist so that your treatment program can be adjusted accordingly. If you experience any exacerbation of symptoms, such as severe knee pain, increased swelling, or changes in weight-bearing tolerance, bring it to your doctor’s attention immediately.

Sources:

http://www.apta.org/PTinMotion/News/2018/10/31/MeniscalTearsNoninferiority/

https://www.uwhealth.org/files/uwhealth/docs/pdf/SM14890_Meniscus_Repair8.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5994634/

SHOP TORN MENISCUS PRODUCTS

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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.



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