So your doc said you have a meniscus tear? Ouch! And now you are wondering what rehabilitation will be like. This is going to depend on whether or not you had surgery and how bad the tear is. Small meniscus tears are common and can even heal on their own if in the right place, which is the outside one-third of the meniscus. This is due to the rich blood supply in that area. So if you are lucky enough to have chosen this place to tear it you are in better shape. Other meniscus tears, even small tears, that occur in regions without such a blood supply will not heal or may take extensive time to heal if they do. This is when your doctor may tell you surgery is your best option.
So, what is rehabilitation like following a meniscus tear?
As with everything about our bodies, it is difficult to compare one person to another due to our composition and genetic makeup. If you are a fit athlete who is in great shape chances are you will have a much faster recovery time than the couch potato. Rehabilitation following a meniscus tear begins with a baseline assessment of how much you are limited. Can you squat? Descend stairs without pain? Walk or stand for > 10 minutes? The answers to these will allow us to establish where in the rehabilitation plan you will begin.
Baseline rehabilitation will start with improving your strength and range of motion (ROM), typically in a non-weight-bearing manner. For strengthening we will have you do isometrics (a fancy way of saying contracting your muscle without movement), seated knee extensions to improve quad strength, and hip exercises that will improve the stability of your knee. To improve your ROM we may have you start on a stationary bike, lay down and then pull your foot toward you using a strap, ball, or slide it along the table, and/or manually stretch your knee for you.
Patients who are farther along in the middle stages of rehab may begin with light-weight bearing options such as small squats, stepping up and/or down on a small step, balance activities, leg presses and resistance exercises for the hip and knee. This will include the greater use of weights, elastic bands, and machines. We typically won’t be pushing you through any painful activities that are in the moderate to severe levels, especially if you have not had the knee surgery. And at this phase we will also be more aggressive with our ROM activities. In order to walk properly you will need 60-70 degrees of knee flexion, but for descending stairs (which is the most common complaint with a meniscus tear) you will need 110-120 degrees. Note: between 130-145 degrees is a normal ROM for the average person.
Advanced stages of recovery will focus on function, function, function – doing the things you need to be able to do to perform your activities of daily living or when returning to your sport. Of course, if you are returning to a sport it may take longer and be more intense than an individual just looking to return to walking and a desk job. Activities at this stage will be things such as walking on the treadmill, advanced stability exercises, running or jumping activities, stair or ladder climbing, squatting and lifting items off of the floor. This is when we try to make sure you are ready for any of the challenges you may face after you are discharged.
Meniscal tears are extremely common knee injuries, and with proper diagnosis, treatment, and rehabilitation patients often return to their pre-injury abilities. Even if you elect to try physiotherapy first and your meniscus tear does not heal, you will be in a better position following your surgery. Recovery also depends on the motivation of the patient, so listen to your physiotherapist and do your homework….. yes, you WILL have homework! You can also find out more about meniscus tears by clicking this link.
I wish you a great recovery and remember we at Elite Sports Injury are always here to provide excellent rehab and answer any questions you may have.