TWO CAUSES OF INJURIES
The meniscus is a crescent-shaped cartilage that is located inside the knee joint to help shock absorption and reduce friction during movement in the knee – we have two meniscii in each knee.
There are mainly 2 ways these structures can be injured:
1. From traumatic incidents such as forcefully twisting or rotating your knee while your foot is planted on the ground, especially if you have your full weight on your leg, for example during a sudden change in direction when running; or
2. From degenerative changes due to aging and certain risk factors.
Symptoms of a meniscus tear can include:
- A locking or clicking sensation in the knee
- Swelling or stiffness
- Pain within the knee joint, especially during twisting movements and when bending the knee fully
- Difficulty straightening the knee
- Feeling of tightness and difficulty bending the knee fully
Evidence has shown that non-surgical treatment, with exercise as the core component, for degenerative meniscus tears is effective in reducing pain and improving function (Sherman et al. 2020). Whilst majority of the literature on knee rehabilitation is derived from ACL research, rehabilitation of a meniscus tear is very similar to rehabilitation of an ACL tear or reconstruction, with the greatest differentiation being the consideration of compressive loading and range of motion in the knee. Meniscus tear type and severity will help to determine the speed of rehabilitation progression, with simple tears recovering faster compared to complex tears that can take more than 6 months for return to sports.
Rehabilitation of meniscus injuries can be split into 4 phases with the following goals:
Phase 1 – Pain control, reduction of swelling, regain full range in the knee joint, reactivate quadriceps muscles.
Phase 2 – Restoration of >70% strength in the hamstring and quadriceps muscles, bodyweight squat to 75 degrees without pain, climb stairs without pain, able to balance on affected leg for >30 seconds
Phase 3 – Strength training to achieve >80% strength of affected leg, dynamic balance and stability training, low speed agility and plyometric drills eg. skips, shuffles, jogging, shallow jumping and landing, gentle change of direction, re-introduction of sport-specific movements.
Phase 4 – Return to sport and >90% strength of affected leg restored.
Progression through the various phases will be dependent on various factors
Physiotherapists are well-trained in injury management and are heavily involved in rehabilitating knee injuries. Do see a physiotherapist for an assessment and treatment if you have any concerns regarding your knee.
Sherman SL, DiPaolo ZJ, Ray TE, Sachs BM, Oladeji LO. Meniscus Injuries: A Review of Rehabilitation and Return to Play. Clin Sports Med. 2020;39(1):165-183. doi:10.1016/j.csm.2019.08.004