Tearing a Meniscus can be daunting. One day you’re moving freely, the next you’re battling with pain, struggling to move, and trying to figure out if your life will be the same again. If you’re going through this, you’re part of millions of people across the globe battling with the challenges that come with sustaining a meniscal Tear. In fact, Meniscal Tears constitute up to 20% of all sports injuries.
However, the good news is that most people get back to their lives with the right rehabilitation program. Exercise is a huge part of this, often coming in as a part of a comprehensive program to get you back on your feet. This article will look at the key things you need to know about Meniscal Tears. We’ll look at their nature, causes, treatment options, and some of the best exercises you can use to get back on track.
What Exactly is a Meniscus Tear?
Your Menisci are two crescent-shaped structures on top of your Tibia(Shinbone).
Here’s what they look like:
They are mainly responsible for absorbing shock or forces imposed in the knee joint. Like a suspension system, their unique structure allows them to deform under pressure and absorb energy.
Apart from being a shock absorber, they help with enhancing stability of the knee joint, and facilitating movement between the Femur(thigh bone) and Tibia.
Each menisci is divided into two zones based on extent of blood supply:
- Red zone: The red outer area along the length of the menisci. The red color is due to a rich supply of blood vessels.
- White Zone: White inner area with limited supply of blood vessels. Injuries in this zone are generally difficult to heal due to limited nourishment for proper healing.
However, menisci have their limits despite having an incredibly resilient structure. A sudden twist or heavy load can tear the meniscus. These tears come in different shapes and sizes depending on severity, pattern, and location:
What Causes Meniscal Tears?
- Excessive loading: The biggest culprit is excessive twisting forces in the knee joint, especially when the Femur twists on top of the Tibia. Sometimes, tears happen when the femur moves forwards or backwards excessively.
- Degeneration: In other cases, degenerative disease processes in the knee joint may extend to the menisci. This is common in severe cases of Osteoarthritis: a degenerative disease that involves breakdown of joint cartilage and surrounding structures, including the Meniscus.
What Does Treatment Look Like?
Management may take the conservative or surgical route depending on factors such as severity and location. Your medical team should identify the best possible approach after careful consideration of these factors.
Conservative
This involves non-invasive approaches aimed at facilitating the healing process, restoration of optimal function, and prevention of further injuries. Conservative management is often the first-line of care for small to medium tears within the “Red Zone”, which has a richer supply of blood vessels.
At Healthy Movements Physiotherapy, we’ve seen this first hand through one of the dozens of Meniscal injury patients we’ve seen over the past few years.
About 5 months ago, Derrick, a 23 year old football player, limped into our clinic. He complained of a sharp pain in the inner side of the knee, which started right after a quick turn during a training session. He felt a click in the knee joint, followed by a sharp pain which got unbearable whenever he tried putting some weight through it.
Our clinical orthopedic tests on the affected knee suggested a Meniscus injury. We referred him for further review by an orthopedic specialist and further imaging to get a more detailed picture on the injury.
The results confirmed our suspicions of a Meniscal Tear in the red zone. It was surgically repaired, followed by a referral for proper rehabilitation.
We took over and progressed him through the required rehabilitation phases judiciously. Exercise coupled with a variety of passive techniques made all the difference throughout the recovery period.
He is now back to what he loves to do: chasing his dreams of becoming a professional football player at the highest level.
Physiotherapy
Physiotherapy combines a number of passive and active methods to promote healing, prevent potential complications, and restore physical function.
- Passive methods: Include manual therapy techniques and electrotherapy devices, which play a critical role in managing symptoms and facilitating early mobility.
- Active Methods: This involves various forms of exercise aimed at enhancing joint flexibility and restoring muscle strength and dynamic control around the knee joint. For instance, stretches help with improving joint and soft tissue flexibility while strength training exercises help with enhancing muscle function.
Surgery
Surgical interventions are reserved for more extensive tears which involve the undernourished “white zones”. The choice of surgery is determined by the surgical team depending on a variety of factors. Key surgical procedures include:
- Meniscal Repair: Torn parts are sutured to promote optimal healing.
- Meniscectomy: Torn parts are removed. This may be followed by a transplantation to make up for the lost part and prevent complications like Osteoarthritis.
Beyond Surgery: How long Does it Usually Take to Recover After Surgery
Surgery is only the initial step in the recovery process. You’ll need a period of rehabilitation to get back on your feet and get back to business as usual. With the guidance of a Physiotherapist, your journey will involve a number of rehabilitation phases spanning a period of 3-4 months if it’s a repair, and 4-6 weeks if it’s a Meniscectomy. Of course the exact length of time varies between individuals due to a range of factors. For instance, you’ll most likely need 6-9 months to fully get back into sports if you’re an athlete.
Meniscus Tear Recovery Exercises to Restore Strength and Improve Movement
Before we dive deep into the exercises, note that exercise programs should be individualized. You’ll need to work with your physiotherapist to carve out what’s best for you, especially in the early phases. Some of the exercises below are meant for general flexibility and strength training for those in advanced phases of recovery. You can use these to build on what you already have established with your physiotherapist.
Quad Stretch
This stretch targets your Quadriceps muscle located on the front portion of the thigh. The Idea is to reduce/prevent tightness and restore knee flexion(bending).
Stage of Recovery: Early(as tolerated)-advanced stages.
How to do it
- Stand up tall, feet placed at shoulder width apart.
- Bend the affected leg, and hold the foot at the back to sustain the position.
- Gently, pull your leg straight backwards until you feel a firm stretch along the front portion of your thigh.
- Hold the position for 15-30 seconds, 3-4 times.
Safety tip: Only go as far as tolerated. Aim to stay within pain limits in terms of range.
Hamstring Stretch
This move targets your Hamstrings: muscles at the back of your thighs, responsible for bending the knee joint. The idea is to improve/prevent tightness and promote full knee joint extension.
Stage of Recovery: Early stages(as tolerated)-advanced.
How to do it
- Lie down on your back.
- Raise the affected leg until your thigh is about 90 degrees to the floor. Hold the back of the thigh to keep things stable.
- Extend your knee.
- Hold the position for 15-30 seconds. Repeat 3-4 times.
Again, keep the movement within the pain-free range, especially in the early stages.
Adductor Stretch
This exercise targets your Adductors: muscles that pull your leg inwards and helps with stabilizing your leg whenever you’re moving. Again, the move is about preventing/reducing tightness.
Stage of recovery: Early(as tolerated)-advanced.
How to do it
- Get into a wide stance, feet wider than shoulder width as much as possible.
- Lunge sideways on the unaffected leg. This should move your pelvis towards the same side, which stretches your inner thigh muscles.
- Hold the position for 1-2 seconds.
- Return to the starting position.
- Repeat the movement for 10-15 times, that’s 1 set. Aim for 2-3 sets.
Squat
This is a classic exercise for building strength and control in your lower body, especially your Quadriceps which play a crucial role in controlling the knee joint. It’s also great for general knee flexibility and balance.
Stage: Intermediate(as tolerated)-advanced.
How to do it
Starting Position
- Stand tall, feet shoulder width apart.
- Keep your back straight, chest slightly drawn outwards.
- Raise your arms to shoulder level.
The Movement
- Lower your body to a squat position, as if you’re sitting down. Your thighs should be parallel to the floor at the bottom position.
- With control, return to the starting position.
- Repeat for 10-15 times, 3-4 sets.
If this proves too difficult, switch to wall slides.
- Lean on a wall, both feet placed at about a step’s distance forward.
- Lower your body down to the bottom squat position while sliding along the wall for extra support.
- Return to the starting position.
- Aim for 10 repetitions of 4 sets.
Safety tip: You don’t have to go all the way to the bottom position of the squat for a start. Start with a partial squat(About 50% of the movement), then progress gradually.
Single-leg Glute Bridge
This is a classic move for building strength in your Hamstrings, Glutes and core muscles.
Stage of recovery: Early(as tolerated)-advanced)
How to do it
- Lie down on the floor, knees bent, arms stretched along the sides.
- Raise your unaffected leg and stretch it at knee level.
- Raise your pelvis to form a bridge.
- Hold for 10-15 seconds.
- Return to the starting position
- Repeat. Aim for 4-5 reps.
Safety: Pay attention to your body’s response, stop if you’re experiencing too much pain in the knee joint.
Looking to find your way through recovery after a meniscal tear? Your journey doesn’t have to be overwhelming. We bring years of experience, expertise, and unwavering dedication to help you reclaim your life. Whether you’re fresh out of surgery or going through conservative care, we’re here to help you navigate every step of the way with evidence-based physiotherapy approaches. Book your appointment today. Let’s get started.
Frequently Asked Questions
How long does it take to fully recover from a Meniscus Tear after surgery?
With a good rehab program, most Meniscus repairs completely heal within 3-4 months. However, the period may be longer if you’re an athlete looking to get back to sports, about 6-9 months. Meniscectomies take a shorter period of time, about 4-6 weeks.
How does Physiotherapy help with Meniscus Tear recovery
Physiotherapists use a variety of techniques to promote healing and optimize movement and function in the affected knee joint. Key treatment methods include various forms of exercise, manual therapy techniques, and a range of adjunct passive treatment methods.
Classic exercises for building strength in the key muscle groups responsible for controlling the knee joint alongside stretches should help at this point. However, always consult your physiotherapist before committing to anything. Examples include Squats, Single-leg bridges, Romanian Deadlifts, Quad stretches and Hamstring stretches. Refer to the exercises section above for more details.
