If you play sports, you’ll know that knee injuries are always a concern. Famous athletes are frequently in the news for missing a part of a season due to a knee injury or knee surgery. Indeed, certain types of knee surgeries can take months to years to recover from, depending on the extent of injury and the type of surgical intervention used. However, for some injuries, surgery isn’t always necessary, and a good treatment plan combined with an optimized physical therapy regimen can allow a full recovery without having to go under the knife. Once example of a common knee injury for which this applies is a meniscus tear, which we’ll discuss here.
A meniscus is a tough, rubbery tissue cover that forms a gasket between two bones within a joint. It functions as a shock absorber when weight or pressure is placed on the joint, and as a cushion that keeps the ends of the bones from grinding against each other.
There are two menisci in your knee between your femur (thigh bone) and tibia (shin bone). Either one can be torn during sports or physical strain, or due to repetitive wear and tear, especially in older adults or those with osteoarthritis. Signs that a meniscus tear may have occurred include knee pain, especially when placing weight on the leg or stretching the leg out straight, a clicking sound when bending the knee, and the sensation of the knee “giving out.”
Studies have suggested that surgeries to repair a torn meniscus don’t actually lead to a fuller or quicker recovery than non-surgical treatments. Rather, a combination of anti-inflammatory medications or corticosteroid shots, knee brace use, and physical therapy will provide sufficient healing. This typically takes between six and eight weeks.
Initial non-surgical, or “conservative” treatments focus on reducing the pain and swelling that accompanies a meniscus tear. Icing the joint and taking an anti-inflammatory drug such as aspirin, acetaminophen (Tylenol), or ibuprofen can help with this. Rest your leg as much as you can, and periodically prop it up with a couple of pillows to further reduce swelling. If the pain is bad enough, you may need to walk with crutches until you can place more weight on your leg.
At Blue Hills Sports & Spine Rehabilitation, physical therapy for a patient begins with treating the pain and inflammation through icing, electrical stimulation, and elevating the leg while resting for periods of time. A knee brace may be prescribed to provide stabilization and support. When those symptoms diminish, exercises are added to help you regain motion and control in your knee and leg. If you are unable to fully extend your leg after the injury, you should work on slowly stretching your leg out straight to avoid muscle contraction which will make recovery more difficult down the line. As you regain flexibility and strength, more challenging exercises will be added to your routine to fully restore joint rotation, muscle strength, and fine motor control.
As a part of your rehabilitation, you may need to perform some exercises and stretches at home, as directed by your physical therapist. Exercises that work the different muscle sets are important for maintaining muscle structure as your joint heals. Make sure to include sets for your quadriceps (front of the thigh), hamstrings (back of the thigh), calves, and hips in your routine. Examples include shallow squats, straight-leg forward and reverse raises, heel raises, hamstring curls, clam openings, and bridge pose. An exercise ball can be useful, especially in the early stages of recovery. Developing stronger and bigger muscles will absorb some of the force of body weight and walking, placing less stress on the meniscus. Good stretches to include are standing calf stretches, wall hamstring stretches, and hip extensions. Standing on a balance board can help with building strength and developing fine neuromuscular control.
Gradually you will be able to perform weight-bearing exercises with your injured leg. Using ankle weights of increasing size, or resistance bands, can be helpful in building strength until you are ready to place your full weight back on your leg and begin walking normally. Once you have regained your full range of motion in your joints, the swelling and the pain have gone, and you are able to place your full weight on your leg again, you are ready to begin easing back into your regular physical activities!
It is highly recommended that you come see us for a professional evaluation of your injury. Schedule an appointment online to see one of our physical therapists in Boston, Weymouth, Plymouth, or Braintree at Blue Hills Sports & Spine Rehabilitation.