Tearing your meniscus cartilage in the knee can be a very painful and debilitating injury. We know this first hand, as we have a severe and a moderate tear in each knee. It does not always mean surgery is required, even when it is recommended to us by our Specialist. Read on and get down to your Sports Physiotherapist for some assistance.
Meniscus Tear Rehabilitation
In the first instance of a tear, you will need to get medical assistance for a correct diagnosis and advice for the best way forward. Treatment can involve surgery if the knee is locking or there is advanced age/activity related degeneration. Loose cartilage can be trimmed and in some advanced more costly operations, some replacement can be made (just think of some of our elite athletes especially in first division football) .
The first port of call is to reduce inflammation.
Ice 3 times a day for 10 minutes at a time across the front of the knee. Wrap a pack of frozen peas in a damp tea towel. Never ice around the entire knee. Never exceed 10 minutes of icing at a time. Repeat as much as you like, as long as the tissue has returned to its original colour and tone. If you have access to a swimming pool, water walking is great for reducing inflammation. Keep repeating until swelling subsides completely. Repeat as needed if swelling returns.
2. Tape the patella if it is suspected of mis-tracking. When the knee is injured, the quad muscles often lose their ability to anchor the patella adequately. Taping the knee cap to anchor it more medially is often a good idea. Use elastic therapeutic taping as it still allows unrestricted movement. Kinesiology taping can be used for up to 5 days at a time if no allergy is present. Remove the tape slowly and carefully to avoided irritating the skin. Aim for two weeks of taping with a couple of days off to let the skin recover when the tape is due for a change. Stop if the skin is irritated.
3. Quadriceps stretch (front of thighs)
Grab hold of your ankle, take heel to bottom and keep your knees together. Repeat for other side. Perform again for the tighter quad. Do this stretch 5 X a day for two weeks and then review. We need to keep the quad muscles supple. If you find it hard to kneel, you need to keep practising this stretch.
Hold stretches for 20 seconds. If one side feels tighter than the other, perform the stretch again on the tighter side. When you feel symmetry, perform the stretch once per side.
Only perform when warmed up later on in the day. Modify if discomfort is present and stop if there is pain. Stretches should feel comfortable. If there is any shaking, release the stretch and attempt again with less effort.
4. Strengthen the medial quad muscle with wide legged squats. Perform two sets of 10 twice a day for two weeks. Get a PT instructor to check your form if you are unsure, but aim to keep knees over the feet. A small range of movement is acceptable until you are able to get a little lower (never lower than 90 degrees however).
5. Try a single leg squat for the affected leg with a support strap to take most of your weight. Only do this if you have a strong and supportive strap/anchor. 2-5 X single leg squats once per day for two weeks.
6. If you have access to a gym, try a single leg press with the affected leg. Keep your foot flat against the platform and keep the weight very light indeed. 5-10 presses per day for two weeks, or for at least three days per week until you gain strength.
If there is pain, modify a technique or stop using the technique.
7. Practise flexing and extending the knee. Start off by sitting on a tallish stool, and straighten and then bend the knee in a slow and controlled manner. Perform 2-4 times a day for two weeks. This can be done whilst standing and holding on to a surface for support.
8. Develop your proprioception by standing on one leg for 10-20 seconds. When this is easy, try it with your eyes closed; but have something to steady you close-by, in case you lose balance. This exercise will strengthen your leg/ankle and re-develop any balance issues arising from the injury.
9. Other tips
The overall aim of the programme is to:
This combination of flexibility and strength is key to managing most injuries. After two weeks of rehab review your progress. Is there any lingering inflammation? If so, continue with the icing and water walking. Is your knee feeling more comfortable? Can you feel the quad muscle on the inner knee getting stronger? Add another set of quad squat repetitions as long as there is no increase in pain. Continue for another two weeks and then review progress again. It can take three months of rehab to get to a more functional knee position once again. Then it will be a juggling act to maintain your progress, by keeping the quad strong and flexible, and being super vigilant for any inflammation flare ups or aggravating activities. Be aware that when you do return to activity, build up slowly and carefully so that your body adapts without any issues.
Eva Evangelou, BA Hons, PGCE, Adv Diploma, ITEC & IFA Dips, is the UK Qualified Sports Massage Therapist behind Limassol Sports Massage. Being a Qualified Sports Massage Therapist has given her extensive training and experience in Injury Prevention, the Theory of Training and Injury Rehabilitation. She has been a Body Worker since 2004. Eva has run 3 full Marathons including Nicosia, Rome and the Limassol Marathon. She is usually injury free and believes that prevention via education is better than cure. She is the Author behind 'Say No! To Neck and Shoulder Pain' and she is a Qualified Teacher. Learn more about her by clicking here and contact her via email by clicking here.
We just read a fantastic , and quite alarming, article written by a leading Medical Journal about our heart and how it is impacted by stress.
Stress and the risk of a heart attack, or cardio vascular disease is a subject close to my heart. Massage Therapy and Aromatherapy are good stress reducers. I see many people who are dealing with high levels of stress. Many of my Clients have had issues with their cardiovascular system. So many of my Clients are subjected to long periods of stress. As a Massage Therapist, I am well aware of the fact that stress can release bad cholesterol in to the blood stream. The pains we feel in the chest during long stressful periods, can in fact be linked to the blood vessels constricting; probably due to our fight or flight mechanism, but none-the-less being in a constant state of high adrenaline is wearing on the body and leaves it very confused. When we are constantly stressed, we can not sleep well, we tend to drop exercise as we are too exhausted, or we exercise and feel even more exhausted, we stop eating so well, we can not relax effectively, all our worries seem worse, our body is in a constant state of red alert and we let go of the support systems that can help us ease the burden of our stress.
Over the years I have had more than my fair share of stress. I have even witnessed heart related issues within my family. There seems to be pattern linked to cardiovascular disease; the common pattern of elevated blood pressure, a reduction in stamina and heart rhythm alterations. I have often wondered why? Could it be due to bad genetics? Poor diets? Perhaps a lack of exercise? I have often pondered this question and now I have the answer. We are all great thinkers, or should I say worriers. We tend to worry about situations that we often have little control over. There have also been prolonged periods of stress in our lives. This can be quite a subjective issue and I believe that there are gender differences in how we perceive and deal with stress.
I was most intrigued to find this article about stress click here and new evidence to link it with an increased risk of an heart attack. There was a study by a Harvard Medical School team of nearly 300 participants. Their amygdala activity was monitored. In the patients with higher activity in the amygdala, they were shown to be more at risk of developing heart disease. The amygdala processes fear and anger emotions. Heart attack risk factors were thought to be increased by the usual culprits of smoking and elevated blood pressure. The study now added a new factor to that list, stress. Stress including emotional stress. Chronic stress can be induced through over work, living in poverty, work-related issues and so on. Emotional stress affects the cardiovascular system by affecting the heart and the blood vessels.
The Lancet Medical Journal studied 293 people over 4 years. 22 of these people developed cardiovascular disease. All of these people showed higher activity in the amygdala. Those that reported higher levels of stress in their lives, had higher levels of activity in the amygdala and more inflammation in their blood and arteries.
If stress can be reduced however, there is a lower chance of cardiovascular disease developing - that is now a fact. How can we reduce our levels of stress? We can have Massage Therapy, develop a regular exercise regime, take up meditation, spend time outdoors, find a good non-judgmental listening ear when we have issues and make lifestyle changes. Eat natural foods, drink less or avoid alcohol, make work less stressful, get your finances in order, associate with friends that are good for you, get enough sleep and keep healthy relationships. Aside from all of this tips, I guess we need to adopt a bit of a lighter attitude towards life too!
va Evangelou, BA Hons, PGCE, Adv Diploma, ITEC & IFA Dips, is the UK Qualified Sports Massage Therapist behind Limassol Sports Massage. Being a Qualified Sports Massage Therapist has given her extensive training and experience in Injury Prevention, the Theory of Training and Injury Rehabilitation. She has been a Body Worker since 2004. Eva has run 3 full Marathons including Nicosia, Rome and the Limassol Marathon. She is usually injury free and believes that prevention via education is better than cure. She is the Author behind 'Say No! To Neck and Shoulder Pain' and she is a Qualified Teacher. Learn more about her by clicking here and contact her via email by clicking here.
Sports Massage Therapist, Wellness Advocate, Sports Enthusiast, Teacher, Nutritarian, Blogger, Artist and much more...