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.
Fed up of being in pain?
A long time ago, we had pain that originated from boney changes in our spine. We had physiotherapy and a long, long course of osteopathy. We felt better, but we were still having to take pain killers. We had to stop doing what we loved. Our martial arts practise was over after 7 years of dedicated practise - we were not going to reach our second Dan black belt and this was sad. We were avid horse riders and now we were being told to stop this activity too. Our visit to the Doctor and the tests that followed confirmed that the athletic life I had led had started to take its toll on my skeletal system. The Doctor told me that it was time to give up my sports and lead a more sedentary life.
As far as I was concerned, my life felt like it was over. I was not ready to give up on my pained, but otherwise strong body. Nights passed and sleep eluded me due to pain. Pain killers became my best way through this period. I asked the physiotherapists what I was supposed to do. How would I manage my pain levels? They recommended a Pain Management Clinic.
The truth is, when we are in pain, we can become locked in to a pain cycle. Pain becomes the norm for your body. Seeking assistance in the early stages of pain offers better results for pain management.
What can we do to minimise pain? We have to look for the pain triggers and we have to deal with them. This may mean modifying or getting rid of an activity that causes us pain. It may even be necessary to stop some activities altogether; this should be avoided, but may be an option for activities we do not like anyhow.
Our latest book takes you through the stages necessary to identify your pain triggers. We learnt these technique when we were managing our own pain and during the 12 years plus that we have been specialist Sports Massage Therapists. 'Say No! To Neck & Shoulder Pain' is an info-book, work-book guide that shows you how to log your activities and pain levels. It teaches you to be in control and find your own pain triggers. Why suffer in silence and be sentenced to a life full of pain killers? Take control and use this new book to help yourself recover and lead a fulfilling life again.
For your copy of 'Say No! To Neck & Shoulder Pain' drop us an email and ask to pick up your copy in our Limassol Sports Massage Clinic for just €10. International deliveries are available within the EU and for the Rest of the World via PayPal for €15 and €20 respectively - including VAT along with Packing and Postage fees. Please be advised that you are liable for any import fee or Tax in to your own Country.
Eva Evangelou, BA Hons, PGCE, Adv Post Grad Dip, IFA Dip & ITEC Dips, is the Author of Say No! To Neck & Shoulder Pain and the owner of Limassol Sports Massage in Cyprus. She has been a body worker for over 12 years and was a teacher prior to this. Contact her here.
Sports Massage Therapist, Wellness Advocate, Sports Enthusiast, Teacher, Nutritarian, Blogger, Artist and much more...