UNDERSTANDING PHYSIOTHERAPY AND MENISCUS TEARS
Meniscus tears are among the most common knee injuries, affecting athletes, active individuals, and even those who lead a sedentary lifestyle. While surgery is often seen as the go-to solution, physiotherapy plays a crucial role in both non-surgical management and rehabilitation after surgery. Physiotherapy may help individuals recover from meniscus tears by promoting tissue healing, reducing pain and improving function.
What is a Meniscus Tear? The meniscus is a C-shaped cartilage in the knee joint that acts as a cushion and shock absorber between the thigh bone (femur) and the shin bone (tibia). It also helps stabilize the knee during movement. A meniscus tear occurs when there is a disruption in the cartilage, often due to twisting, turning, or sudden movements during physical activities. The injury may vary in severity, from a small tear to a more extensive, complex one that may require surgical intervention.
Symptoms of a meniscus tear include:
Pain, especially on the inside or outside of the knee
Swelling or stiffness
Limited range of motion
Clicking or locking sensations in the knee
Difficulty bearing weight on the affected leg
While surgery may be required for severe meniscus tears, many people can benefit from physiotherapy either as the primary treatment or as post-surgical rehabilitation. The goal of rehabilitation is to promote healing, reduce pain and restore function all while minimizing the risk of further injury.
Physiotherapists use various techniques when it comes to meniscus injury. Treatment may include joint mobilization and soft tissue treatment, exercise prescription and modalities. These treatments are aimed at reducing pain, restoring mobility and strength and ultimately improving knee stability which can be disrupted in a meniscus injury. Improving these measures allows for confidence with movement to be restored.
Exercise prescribed for this type of rehabilitation may include proprioceptive drills- these exercises help improve balance and coordination. Once the meniscus tear has healed sufficiently, exercise prescription may also include functional training which focuses on proper mechanics and prevention of abnormal stress on the knee with movements that mimic those of our daily lives. For athletes, physiotherapists may incorporate sport-specific drills to ensure the individual can safely return to their activity without overloading the knee.
Not all meniscus tears require surgery. In some cases, a well-structured rehabilitation program can help individuals recover fully or manage their symptoms effectively without the need for surgical intervention (1). This is particularly true for smaller, stable tears or tears that do not affect the knee’s ability to function normally. However, if surgery is necessary, physiotherapy is still crucial in the recovery process, speeding up healing and ensuring the knee regains optimal strength and movement (2).
Physiotherapy is an integral part of managing meniscus tears, whether through non-surgical means or post-surgery rehabilitation. By targeting pain relief, improving mobility, strengthening the knee, and preventing further injury, physiotherapy may help patients return to their normal activities and improve their overall quality of life.
If you or someone you know is suffering from a meniscus tear, consider consulting a physiotherapist to start the healing process. Most individuals can recover fully and return to an active, pain-free lifestyle, we would love to be part of your rehabilitation journey.
Pain is one of the most immediate concerns when dealing with a meniscus tear. Physiotherapists use various techniques to help reduce pain and inflammation. These may include:
Ice and Heat Therapy: Ice helps to reduce swelling, while heat can relax tight muscles and increase blood flow to the affected area.
Electrotherapy: Modalities like TENS (Transcutaneous Electrical Nerve Stimulation) can be used to block pain signals and promote muscle relaxation.
Manual Therapy: Soft tissue massage or joint mobilizations can help alleviate tension and improve mobility in the knee joint.
2. Restoring Mobility and Strength
A meniscus tear often limits the range of motion in the knee. After the acute phase of the injury, physiotherapy focuses on restoring mobility through gentle stretching and joint mobilizations. Physiotherapists use targeted exercises to:
Restore knee flexibility: Gentle movements and stretches help to regain the knee’s normal range of motion, allowing for smoother movement.
Strengthen the muscles around the knee: Strong quadriceps, hamstrings, and calf muscles are vital for stabilizing the knee joint and reducing the risk of further injury. Exercises like squats, leg presses, and step-ups help build muscle strength without putting excessive strain on the knee.
3. Improving Knee Stability
A tear in the meniscus can disrupt the knee’s normal stability, leading to an increased risk of future injuries. Physiotherapy aims to strengthen the muscles that stabilize the knee joint, including:
Proprioceptive exercises: These exercises help improve balance and coordination, which are essential for preventing falls and ensuring safe movement patterns during daily activities.
Functional training: Training movements such as walking, running, or climbing stairs in a controlled manner helps retrain the body for proper mechanics and prevent abnormal stress on the knee.
4. Preventing Further Injury
Once the meniscus tear has healed sufficiently, physiotherapy focuses on teaching techniques to prevent future injuries. This might include:
Sport-specific rehabilitation: For athletes, physiotherapists may incorporate sport-specific drills to ensure the individual can safely return to their activity without overloading the knee.
Ergonomics and movement correction: Physiotherapists assess how an individual moves in daily life, identifying any improper biomechanics or posture that could put the knee at risk. Recommendations may include adjustments in posture, movement strategies, and footwear.
5. Avoiding Surgery (If Possible)
Not all meniscus tears require surgery. In some cases, a well-structured physiotherapy program can help individuals recover fully or manage their symptoms effectively without the need for surgical intervention. This is particularly true for smaller, stable tears or tears that do not affect the knee’s ability to function normally.
However, if surgery is necessary, physiotherapy is still crucial in the recovery process, speeding up healing and ensuring the knee regains optimal strength and movement.
Physiotherapy Post-Meniscus Surgery
If surgery is required to repair a meniscus tear, physiotherapy becomes an essential part of the rehabilitation process. The goals of physiotherapy after surgery are:
Reducing swelling and inflammation
Regaining range of motion as soon as possible
Strengthening the muscles around the knee to support healing
Ensuring a gradual return to activity and sports, while avoiding overloading the knee
A structured rehabilitation program typically progresses in phases, starting with gentle exercises for mobility and gradually advancing to more challenging strength and functional exercises.
Conclusion
Physiotherapy is an integral part of managing meniscus tears, whether through non-surgical means or post-surgery rehabilitation. By targeting pain relief, improving mobility, strengthening the knee, and preventing further injury, physiotherapy helps patients return to their normal activities and improves their overall quality of life.
If you or someone you know is suffering from a meniscus tear, consider consulting a physiotherapist to start the healing process. With the right treatment plan, most individuals can recover fully and return to an active, pain-free lifestyle.
Remember: Always consult a healthcare professional before beginning any rehabilitation program to ensure it’s appropriate for your specific injury.
References
Wright, Rick W. MD. In Patients with Nonobstructive Meniscal Tears, Physiotherapy Was Noninferior to Arthroscopic Partial Meniscectomy for Knee Function Over a 24-Month Period. The Journal of Bone and Joint Surgery 101(10):p 941, May 15, 2019. | DOI: 10.2106/JBJS.19.00177
Vervest, A., Maurer, C., Schambergen, T. et al. Effectiveness of physiotherapy after meniscectomy. Knee Surgery 7, 360–364 (1999)
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