Meniscus injury / tear
Rehab training of the injury
Rehab 1 – Rehab 2 – Rehab 3 – Rehab 4
Focus on training the rest of the body, so you do not lose your current mobility, stability and strength. Then find out what you can do from workout programs and work out according to the level you have. Exercise of the rest of the body accelerates healing of your injury, among other things due to increased nerve activity and circuits.
Description of meniscus injury in the knee
The meniscus in the knee is a C shaped disc that forms a kind of “pillow” in the knee joint, between the thigh and lower leg. It is atypical to see a really fresh, isolated tear of the meniscus created by a single trauma. Normally, this type of injury is associated with acute ligament rupture, which means that this type of injury most often affects the outermost part of the meniscus, towards the deeper part which is less often exposed to injuries. The outer part of the meniscus, also called the red part, can regenerate much better.
A meniscus becomes increasingly rigid as the tissue changes, which is completely normal in the aging process. As the tissue becomes stiffer and less flexible, you are more exposed to meniscal tears, which are most often seen in the horizontal plane. Nevertheless, young people who fall victim to a rotational trauma of the knee, primarily under compression (weight bearing), will destroy the meniscus in the outermost part; either in the horizontal, vertical or longitudinal plane. The piece of the broken meniscus that faces the knee joint (internal part) can create a wedge in the joints and may cause a locking effect. This kind of internal damage is called “Bucket Handle” tear. Other forms of damage to the meniscus may be cracks in either front or back horn, which is a more classic form of meniscus injury. However, the most frequent meniscus injury is damage to the medial meniscus’ peripheral red part (most outer part of the inside of the knee). The reason for this must be that the entire knee’s inner ligament structure (the medial ligament complex) is attached to the meniscus, thereby causing the meniscus to be exposed to severe pressure on the outside of the knee (valgus trauma), where either ligaments and / or joint capsules becomes damaged. The injury percentage is approximately 60 per 100,000 inhabitants, which is very high for an isolated damage; and most often women are affected (1:3). For some individuals who are hypermobile in the knee joint, especially the inner ligament of the knee will increase the mobility of the medial meniscus (at the most outer part of the inside of the knee), thereby significantly increasing the risk of injury.
Summary of meniscus classification:
Degenerative meniscus injuries usually affect older men where horizontal meniscus tears occur.
The younger age group is most commonly affected by meniscus injuries on the most outer part of the knee along with ligaments and / or joint capsules. Trauma on the front or rear horns will cause a reduced mechanical effect in the knee.
Meniscus shock absorption:
Without a normal meniscus, the knee joint will be severely strained and the degenerative rate significantly increased. Normal menisci absorb between 40-70% of the tension of the knee. After a partial meniscal removal, the contact surfaces will lose 10% shock absorption and increase the tension by 50-60%. By removing the entire meniscus, you will lose 75% of the shock absorption in the knee and increase the tension by 235%. For this reason, we today avoid removing the entire meniscus at all costs and instead try to suture, pinch or remove at least the broken meniscus.
Symptoms of meniscus injuries in the knee
The meniscus has a small sensory section with nerve supply in its outer part. Therefore, you will see far more symptoms in this part than the deeper part, despite the fact that the deeper meniscus injuries are more serious as it rarely can regenerate itself. This also works as a signal to the therapist that if you diagnose based on pain alone many meniscus lesions could be overlooked. The deeper “painless” damage could potentially give rise to classical problems; Often lock-up symptoms in the knee, irritation of the joint by the meniscus center, which will result in swelling.
- Pain proportional to activity level. (constant pain at 51%)
- Pain in rotation or knee bending, primarily near full flexion (knee bending.)
- Pain along the edge of the joint. (60% have pain along the joint line.)
- Weakness or instability of the knee.
- The leg “gives in”.
- Leg locking-up.
- General knee pain.
- Swelling / effusion. (Seen out at approximately 43% of patients with meniscus injuries on the inner side of the knee.
Examining meniscus injuries in the knee
Meniscus injuries are common, and yet the clinical diagnosis is relatively difficult even for experienced orthopedic surgeons. One must be very careful and examine the knee with many tests; If the diagnosis is made based on lock-up symptoms alone then only 40% of meniscus damage will be detected. There is therefore a very wide selection of tests for various meniscus injuries in the clinical literature.
A therapist will often use the following:
- Analysis / Inspection / Palpation / ROM, visual and physical comparison with opposite knee.
- Signs of swelling.
- Inflammatory signs.
- Hyperflexion.
- Hyperextension.
- McMurray test.
- Steinmann test.
- Apley test.
- Atrophy measurement (> 14 days).
Treatment of meniscus injury in the knee
White / white damage
White/white sections or chronic meniscus symptoms should always be examined by the orthopedic surgeon who will do a more specific study, possibly supplemented by MRI or ultrasound scanning. After this, it will be determined whether arthroscopy is necessary to remove sutures or remove the damaged part. Before surgery, the patient must always have a rehabilitation program (Rehab 1), which the patient should do at home every day from day 7 until full ROM is achieved without pain.
Red / red damage.
In severe cases, therapy-resistant injuries or, if in doubt, send the patient to their own doctor for further examination.
- Active rest.
- Rehab 1.
- Cryotherapy (ice massage for 9 min).
- Ultrasound (continuous / pulsating), Mhz depends on which part is injured.
- Kinesiology tape
- K-laser
- NSAID medication
- Traumeel (2 tablets 3 g. daily for 9 days)
- TNS.
Course of healing and complications for meniscus injuries
An athlete who’s had an operation for a meniscus injury should not resume his usual exercise before he / she has recovered full movement and strength in the knee, which usually takes 4-6 weeks after surgery. Even though the sports activity has been fully resumed, the rehab training should continue.
In the months following a meniscus operation, a new meniscus is formed from connective tissue. This meniscus may also burst and then give symptoms as a common meniscus injury. People who are operated for a meniscus injury often times suffer from osteoarthritis after many years of use of the operated part of the knee.
Social Medier