Meniscus tears are one of the most common causes of knee pain and instability. Traumatic tears may happen playing sports, while degenerative tears happen slowly over time. Severe or unstable tears require surgery. While it is possible to rehabilitate these injuries yourself, it is wise to consult with a physical therapist to design a program to meet your specific needs. According to eOrthopod.com, the return to sport time for nonsurgical tears is six to eight weeks. Surgical cases are variable, and the return to play time is determined by the surgeon.
Anatomy
There are two menisci in the knee, medial and lateral. Made up of fibrocartilage, their main functions are to absorb shock, limit extreme range of motion and lubricate the joint. Traumatic meniscus tears occur when the knee is twisted suddenly in a flexed position, with the foot on the ground. Nontraumatic, degenerative tears are common in older people. The medial meniscus is torn more often because it is larger, thinner and less mobile than the lateral meniscus.
Acute Care
The immediate treatment consists of rest, ice, compression and elevation. Some doctors recommend using crutches during the acute phase.
Acute exercises include ankle pumps and gentle active range of motion of the knee. After two to three days, patients can begin quadriceps sets (flexing the anterior thigh muscles with the knee straight), straight leg raises and hamstring sets (flexing the muscles of the posterior thigh with the knee slightly bent).
Most surgeons have their own guidelines for rehabilitation to ensure a good outcome from surgery. For knees treated nonsurgically, the main goals are to restore range of motion, improve flexibility and strength, and to retrain balance to prevent future injuries.
Range of Motion
Continue the range of motion exercises begun in the acute phase, not causing pain in the knee, until full flexion (bending) and extension (straightening) are achieved.
Stretching is important to ensure full range of motion of all the joints in the leg so they can function optimally. MayoClinic.com recommends that you stretch each muscle group at a moderate, pain-free intensity, hold 30 seconds and repeat each stretch three to four times. Stretch all the muscles of the leg including the hamstrings, quadriceps, hip flexors, hip abductors (groin muscles), gluteal muscles and calf muscles.
Strengthening
In "Journal of Orthopaedic & Sports Physical Therapy," researchers from the University of Southern California reported that weakness of the trunk and hip muscles may predispose athletes to knee injuries. They recommend strengthening these areas as part of knee rehabilitation programs.
Crunches and obliques strengthen the abdominals. Hip-strengthening exercises include side-lying leg lifts, prone leg lifts and kickbacks, and bridging with a rolled towel squeezed between the knees. Holding plank position on elbows strengthens many of the core muscles at once.
Strengthening and Balance
After the acute phase, the program should consist mostly of "closed chain" exercises, in which the foot is on the ground. In the journal "Medicine & Science in Sports & Exercise," researchers from Umea University in Sweden report that closed chain exercises promote normal quadriceps muscle function, while open chain exercises do not.
Closed chain exercises include lunges, step-ups, squats and calf raises. Stationary bicycling and the elliptical machine build endurance. Retrain your balance by doing agility exercises such as side stepping, cutting and hopping.
