Friday, April 19, 2024

Physical Therapy After Meniscus Surgery

Hamstring Curls On An Exercise Ball

Exercises & Rehab after Meniscus Surgery: Strengthening & Stretches

The Hamstring curls on an exercise bike is one of the best ways to strengthen the hamstrings and help with knee flexion range of motion. Start by lying on your back with your feet on top of the exercise ball. Lift your hips up to the ceiling and roll the ball towards your butt. Return to the starting position and repeat at least a few sets of 10. See video: Hamstring culs on Exercise Ball

The Research: Physical Therapy Vs Surgery For A Torn Meniscus

Is surgery absolutely necessary for a torn meniscus in your knee? Maybe not, and here’s why: research shows that the long-term outcome of surgery versus physical therapy for a meniscus tear can yield the same result for some patients.

A study published in the New England Journal of Medicine examined the outcome of a physical therapy program versus surgery and post-operative PT for people with knee osteoarthritis with a meniscus tear. The study included 351 patients with knee OA and meniscus tear. Each patient was randomly selected to have knee meniscus surgery followed by rehab or to simply attend physical therapy without having surgery. The surgery performed was a knee partial meniscectomy, a common surgical procedure used to repair a torn meniscus.

The main outcomes measure of the study was scored on the Western Ontario and McMasters University Osteoarthritis Index , a test of knee function. Higher scores on the WOMAC equate to more severe knee symptoms. The scores were obtained at the start of the study and after 3, 6, and 12 months. This was done to obtain long-term information about the patients’ knee function.

The results of the study show that there was no significant difference in knee function 6 months after randomization into either the surgery group or the physical therapy group. One death occurred in each groupone patient in the surgical group had a pulmonary embolism which was fatal, and one patient in the PT group had a fatal stroke.

Restricted Movement Is Risky If It Goes On For Too Long

There are risks associated with regular use of a knee brace, especially if the brace you are using is not a custom fitted/design. If you are using a standard or “off the shelf” knee brace then it is possible that the brace is not the right size, positioned incorrectly on your knee, or even causing more damage to your injury. Knee braces can also feel heavy or bulky at first if you are not used to wearing one. It is possible that you may not feel the benefits of wearing a knee brace for a month, or however long it takes for you to feel comfortable wearing your brace. Skin irritation can also occur under the brace depending on the breath-ability of the material you are using for your knee brace and the overall fit. One important thing to be aware of is the amount of restriction you are placing on your knee while wearing a knee brace. Too much restriction in movement for an extended period of time can result in stiffness of your joint, chronic pain, or wasting away of the ligaments, tendons and muscles in your knee and leg.

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What Are The Risk Factors Associated With Runners Meniscus Tears And Those Who Develop Arthritis At The Knee

Research has not settled on one particular factor but instead a list of factors that will increase the likelihood of arthritic development following meniscus surgery:

  • Degenerative meniscus tear versus traumatic
  • Previous history of osteoarthritis, per X-ray, prior to the meniscus injury
  • Amount of meniscus removed > 1/3
  • lateral part of the knee affected
  • Knee turning out or turning in with dynamic activities

The highest correlated factor for development of arthritis with running following meniscus surgery is presence of arthritis prior to the surgery. To state it another way, if you have arthritis before surgery you will have it after and the surgery and therefore running is likely to progress the arthritis . From looking at the list one can glean that many of the risk factors are unchangeable such as amount of meniscus torn, gender, and trauma and side of the tear. There are other factors that are in ones control to improve upon such as BMI and lower extremity alignment. By decreasing your overall weight and seeing a physical therapist who will help you correct your lower extremity control you will decrease the chances of developing knee arthritis with running.

Proper Biomechanical Hip And Knee Motion With Squatting

Foot slides is a good way to increase knee flexion after a torn ...

This is some serious criteria but we have to keep in mind the nature of running itself. If we look at the biomechanics of running we realize that running is just a bounding single leg squat performed over and over again. At no point during running are both feet on the ground. That is the reason single leg squatting and step down tests are important to check since it has the most specificity of training to running. Likewise, running is ballistic in nature and therefore mini jumping is needed to prepare the articular cartilage of the knee for increased impact forces. If available, it is important to compare your loading rates using a force plate. By jumping onto the force plate with each leg you can determine whether you are absorbing shock with your active system, the muscles, or the passive system the bony anatomy. It takes many repetitions and time for your body to learn the motor control necessary to actively absorb shock. Passive shock absorption leads to joint break down, arthritis, and potentially ligamentous injury.

Once you have passed the above testing you are ready to begin your return to running progression. Just like large jumps in mileage during non-injured training will likely cause damage it is important not to progress back to pre-injury mileage too quickly. Most studies suggest a run-walk program to gradually increase tissue loading in a predictable and progressive fashion.

  • Does running itself cause arthritic changes at the knee?
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    Is Running Safe After Meniscus Surgery

    For those who call themselves runners the thought of doing a different form of exercise after meniscus surgery sounds like an impossible request. Truly, there seems to be a unique and special bond runners have with hitting the road, finding their stride, getting away from it all, and achieving the euphoria of the runners high. To ask someone to give up their stress relief and passion is advice I am hesitant to give unless I have concrete facts to back up my claims. Additionally, if runners out there are being truthful, they rarely listen to advice if it pertains to cessation of running for even 1 day, let alone the rest of their lives. Therefore, the goal of this post is to bring awareness, not ultimatums, to runners about the current research following meniscus surgery, rehabilitation, and the biomechanics associated with return to running.

    Meniscus Tear & Surgery

    Meniscal tears are common in contact sports as the menisci are vulnerable to injury, especially when the knee is compressed and twisted. A meniscus tear, which involves the tearing of the knees cartilage, can be acute or degenerative. Degenerative meniscal tears happen over time due to repetitive stress on the knee. For athletes, acute tears are most common, resulting from a particular movement, such as twisting and turning quickly on a bent knee when the foot is planted on the ground.

    • Sharp, intense pain in the knee

    • Pop or tearing sensation in knee at the time of the acute injury

    • Swelling within the first 24 hours of injury

    • Difficulty walking or going up and down stairs due to pain

    • Catching or locking sensation in the knee

    • Difficulty straightening or bending the knee fully

    One meniscal tear that occurs more frequently in young men, as in the case of our patient included in this blog, is the bucket handle tear to the meniscus. A bucket handle meniscal tear occurs on the outer portion of the meniscus and creates a vertical slice through the meniscus. The torn portion of the meniscus pulls away, forming a handle-shaped segment of the damaged tissue and is displaced into the front of the knee joint. Surgery, known as a meniscectomy, is generally needed to address a bucket handle tear and remove the damaged portion of the meniscus. Following surgery, physical therapy is highly recommended in order to safely return to sport.

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    Using Physical Therapy To Ease Pain

    Your therapist may choose from one or more of the following tools, or modalities, to help control the symptoms you may have from your knee surgery.

    Rest: Rest is an important part of treatment after surgery. If you are having pain with an activity or movement, it should be a signal that there is still irritation going on. You should try to avoid all movements and activities that increase your pain. Be sure to use your crutches as assigned by your doctor, and put only the amount of weight on your leg as approved by your doctor.

    Ice: Ice makes the blood vessels in the sore area become more narrow, called vasoconstriction. This helps control inflammation that is causing pain and can easily be done as part of a home program. Some ways to put ice on include cold packs, ice bags, or ice massage. Cold packs or ice bags are generally put on the sore area for 10 to 15 minutes.

    Heat: Heat makes blood vessels get larger, which is called vasodilation. This action helps to flush away chemicals that are making your knee hurt. It also helps to bring in nutrients and oxygen which help the area heal. True heat in the form of a moist hot pack, a heating pad, or warm shower or bath is more beneficial than creams that merely give the feeling of heat. Hot packs are usually placed on the sore area for 15 to 20 minutes. Special care must be taken to make sure your skin doesnt overheat and burn. Its also not a good idea to sleep with an electric hot pad at night.

    Find Effective Physical Therapy After Meniscus Surgery At Excel Pt

    Top 7 Exercises after Meniscus Tear (Decrease Pain & Increase Strength)

    Need to get in some physical therapy after a meniscus surgery? Our Excel Sports & Physical Therapy team is primed to help you find effective post-surgical rehab. We can build you a therapy plan thats personalized to your needs. This plan will also be designed to reduce your pain and speed up your post-surgery recovery. In addition, we offer pre-surgical rehab that can help prepare your knee for surgery.

    Contact our team today for more information about how we can help you before and after your surgery or to schedule your initial appointment.

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    Initial Exercises After Knee Arthroscopy

    After knee arthroscopy, patients can expect less pain and a faster recovery period. However, you have to be committed to your rehabilitation program. Exercises are part of rehabilitation and should begin soon after knee arthroscopy to build strength and restore mobility to the knee.

    Exercise programs are tailored to the patients needs. If you are recovering from surgery, you can expect initial exercises to be gentle, with a special focus on controlling pain and swelling, maintaining knee motion, and activating the quadriceps muscles.

    Here are some exercises that are typically recommended for knee arthroscopy patients. Do not start these exercises without the supervision of a physical therapist . A PT will teach you how to do each exercise correctly to avoid injury and reach your rehabilitation goals.

    Restore Your Range Of Motion

    After your swelling is nearly gone and your pain is minimal, you are ready to push your range of motion a little more. Getting your knee fully straight is extremely important. Heel propping exercises and quadriceps isometrics are very useful. Perform these at least 3 times per day until your knee is fully straight. You must have a straight knee to walk properly.

    You do not want to be overly aggressive with bending your knee. It takes a little longer to regain full knee bending. If you are too aggressive you can irritate your meniscus and stir up the swelling again. Heel Slides and quadriceps stretching exercises will get the job done. Be consistent with daily stretching. But also be patient.

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    Phase I Of Rehab: Surgery Until 8 Weeks

    • Typically begins 3-5 days after surgery
    • Toe touch weight bearing with brace
    • Gradually unlock brace for 6 weeks after 6 weeks no brace
  • Goal to restore range of motion from 0-90 degrees, decrease leg swelling, and restore control
  • Knee extension on bolster, prone hangs, quadricep sets, hamstring sets, straight leg raises, heel slides to 90 degrees
  • Progression to next phase
  • 8-10 weeks after surgery, pain free gait , no swelling
  • The Licensed Physical Therapists At Pro~pt Are Here For Your Physio After Knee Surgery Needs

    Meniscus Repair Surgery

    The physical therapists at PRO~PT not only specialize in physical therapy after knee surgery, but they can also work with you on pre-therapy to help you prepare for knee surgery.

    Well customize a treatment plan that is specific to both your condition and your goals, and well get you back to doing the things you love to do ASAP.

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    Meniscus Zones: Red Zone Versus White Zone

    Doctors call the outer third area of the meniscus the Red Zone. This is the area of the meniscus that receives the most blood flow. The inner two-thirds area of the meniscus is deemed the White Zone and this is the area of the meniscus that receives very little blood flow. If you have read through this website, you will know that blood flow is essential for healing – as such, the White Zone of the meniscus is troublesome as this area does not heal very well.

    Physical Therapy Treatment After A Mensicus Tear

    A meniscal tear is a common injury in athletes that involves the tearing of the knees cartilage. The meniscus is a disc of cartilage that cushions and stabilizes the knee and allows for fluid movements in various directions. Physical therapy is critical following a meniscal tear and surgery in order to heal properly and restore strength and movement to the knee for a safe return to sport. In this blog, we share a video of a student athletes progress during physical therapy following a meniscal tear and meniscectomy.

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    Exercises After Meniscus Repair

    All about meniscus tears: Meniscus tear and treatment Anatomy:

    The menisci are the wedge shaped cushion like discs that are sandwiched between the opposing thigh and leg bones. There are two menisci in the each knee joint, outer and inner . These menisci derive their nutrition primarily from synovial fluid . Each meniscus has three parts namely a posterior horn, a body and an anterior horn. The inner meniscus is elliptical and larger in size than the outer meniscus which is more circular in shape and has the greater surface area.

    Why these menisci are important: Menisci are elastic structures and they act as shock absorbers in the knee joint and protect the joint cartilage . They are also important in keeping the thigh bone fit into leg bone. Menisci help in maintaining joint congruity and maximize contact area between leg bone and thigh bone .

    What causes a meniscus tear?

    In young patients meniscus tear are mostly due to twisting injury to the knee joint. In old persons these are mostly due to age related degenerative changes. Abnormalities of meniscus like abnormal shape or meniscal cyst also make menisci more prone to injury. Inner meniscus is less mobile than outer hence tear of inner meniscus are more common.

    Can all meniscus tear be repaired?

    Arthroscopic Knee Surgery In North Dakota

    The Best Knee Strengthening Exercise After Surgery (Total Knee, Meniscus, or ACL) Giveaway!

    More and more doctors and patients prefer minimally invasive surgeries like knee arthroscopy to treat knee pain. At The Bone & Joint Center, our orthopedic surgeons are highly skilled in minimally invasive procedures. We have Dr. Timothy J. Bopp, Dr. Joseph W. Carlson, and Dr. Brian P. Dahl who all specialize in knee surgery.

    If you want to know whether your knee problem can be treated using a minimally invasive technique, schedule a consultation with our experts. at 424-2663. We look forward to providing you with excellent options to fix your knee!

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    What Is A Meniscus Tear

    A meniscus tear is a common knee injury that often affects people who play contact sports. It can also be caused by wear and tear and doing everyday activities that put pressure on the knee joint, such as squatting to pick something up or getting in and out of a car.

    This injury occurs when a person tears the protective cartilage in the knee.

    A meniscus tear isnt always painful, but it can cause swelling and instability in the knee. The knee may lock, and you may have trouble moving it.

    The nature of the injury, and a persons symptoms, help a doctor determine treatments for a meniscus tear. For example, younger people and those whove experienced a traumatic injury are more likely to require surgery than older people who have a chronic meniscus injury.

    Doctors will often recommend physical therapy exercises to help stabilize the joint.

    Once you have your doctors approval to begin exercising, try some of these exercises to enhance your strength and stability following a meniscus tear.

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