The meniscus is a cartilage structure that sits on top of your tibial plateau in your knee and provides a cushion for the end of your femur to sit in. The purpose of your meniscus is to hold your femur in place on top of your tibia and to provide a shock-absorbing cushion for your knee capsule during impact, such as walking, running, and jumping. Your meniscus is vulnerable to tearing during high-impact movements that usually involve a twisting of the knee. Your meniscus is largely avascular, meaning it has a very poor blood supply. As a result, your meniscus is slow to heal itself. In many cases, the tear is severe enough to require surgery, which may involve repairing the meniscus or removing the damaged section altogether.
Inflammation Control
Physical therapy following surgery to repair a meniscus tear begins immediately after surgery. In this phase, pain management and inflammation control are the focus. After surgery, your knee joint capsule will swell significantly, which hinders your body's natural healing process. Cryotherapy, or ice therapy, is used at this stage to reduce swelling. Anti-inflammatory medications may also be prescribed to you by your physician and can help to reduce inflammation and control pain. Reducing pain and inflammation in the acute stage of physical therapy after a meniscus tear surgery must be completed before you can move on to the next stage of therapy.
Range of Motion Exercise
Once the inflammation and pain around your knee joint capsule has been adequately reduced, your doctor may clear you to begin range of motion exercises with the guide of a physical therapist. The purpose of range of motion exercises is to increase your flexibility at your knee joint. After surgery, it may be painful to flex and extend your lower leg at the knee. Your physical therapist may provide you with passive and active flexibility exercises designed to slowly increase your ability to flex and extend your knee.
Strength Training Exercise
As you regain flexibility and increase the range of motion in your knee, it is then necessary to begin strengthening the muscles that support your knee joint. After surgery, the muscles that stabilize your knee will atrophy, or lose size and strength. With a recently repaired meniscus, weak muscles significantly increase the likelihood of reinjury. Every muscle that crosses your knee joint should be strengthened to increase the stability of your joint capsule. Your physical therapist will direct you through the proper strengthening exercises that are specific to your needs.
Long-Term Maintenance
Once your physical therapist has determined that you are ready to return to normal activity following rehabilitation from a meniscus tear surgery, you may be given a long-term maintenance therapy program. This can include some of the flexibility and strength training exercises you were given earlier in your rehabilitation, as well as some other exercise guidelines as directed by your physical therapist. The purpose of long-term rehabilitation is to ensure that the muscles that support your knee joint remain strong enough to reduce pressure placed on your meniscus during normal daily activity. This will significantly reduce the risk of reinjury to your meniscus.
References
- JointHealing.com: Meniscus Tear Trearment
- "Therapeutic Exercise: Foundations and Techniques (5th edition)"; Carolyn Kisner and Lynn Colby; 2007
