Today's video covers rehab exercises for a degenerative meniscus tear, which is the most common type of meniscus tear we see in physical therapy. The meniscus is a C-shaped tissue between your femur (thigh bone) and your tibia (shin bone). Each knee has a medial (inner side) meniscus and a lateral (outer side) meniscus. The meniscus is composed of water, collagen, proteins and other cellular elements.
𝐖𝐡𝐚𝐭 𝐢𝐬 𝐭𝐡𝐞 𝐟𝐮𝐧𝐜𝐭𝐢𝐨𝐧 𝐨𝐟 𝐚 𝐦𝐞𝐧𝐢𝐬𝐜𝐮𝐬? The meniscus is a shock absorber that helps optimize force transmission across the knee and protects the cartilage on the end of our femur and tibia. The medial meniscus is also a secondary stabilizer to the ACL as it can prevent anterior translation (forward shifting) of the tibia.
𝐃𝐨𝐞𝐬 𝐭𝐡𝐞 𝐦𝐞𝐧𝐢𝐬𝐜𝐮𝐬 𝐡𝐚𝐯𝐞 𝐠𝐨𝐨𝐝 𝐡𝐞𝐚𝐥𝐢𝐧𝐠 𝐚𝐛𝐢𝐥𝐢𝐭𝐲? Tears in the outer 1/3 of the meniscus have healing potential because there is blood flow to that area. However, tears in the inner 2/3 generally do not heal well as a result of poor circulation.
𝐃𝐨 𝐚𝐥𝐥 𝐦𝐞𝐧𝐢𝐬𝐜𝐮𝐬 𝐭𝐞𝐚𝐫𝐬 𝐧𝐞𝐞𝐝 𝐬𝐮𝐫𝐠𝐞𝐫𝐲? No. All meniscus tears do not require surgery. Surgery is indicated if you have mechanical symptoms such as locking. Otherwise, you should try conservative management first. This includes NSAIDs (anti-inflammatories), physical therapy, and finally, injections. If you fail conservative therapy and do not have arthritis, you may then be a candidate for surgery.
𝐖𝐡𝐢𝐜𝐡 𝐞𝐱𝐞𝐫𝐜𝐢𝐬𝐞𝐬 𝐬𝐡𝐨𝐮𝐥𝐝 𝐈 𝐝𝐨? Exercises that encourage knee mobility, motor control and strength can help to reduce pain and improve function.
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Reference:
Noorduyn JCA, van de Graaf VA, Willigenburg NW, et al. Effect of Physical Therapy vs Arthroscopic Partial Meniscectomy in People With Degenerative Meniscal Tears: Five-Year Follow-up of the ESCAPE Randomized Clinical Trial. JAMA Netw Open. 2022;5(7):e2220394. Published 2022 Jul 1. pubmed.ncbi.nlm.nih.gov/35802...
00:00 Introduction
00:34 What is a degenerative meniscus tear?
02:12 Exercise 1: Heel Slide
04:07 Exercise 2: Short Arc Quad
05:36 Exercise 3: Sidelying Hip Abduction
07:32 My Self-Guided Rehab Book
08:29 Exercise 4: Split Squat