Meniscus Injuries and Physical Therapy
What Causes Meniscus Injuries?
The meniscus is cartilage located between the femur and tibia, which are two primary bones that make up the knee joint. The meniscus adds stability to the knee and acts as a shock absorber. Meniscus injuries are a serious problem that can cause pain, swelling, and limited mobility. Injuries can occur due to slipping/falling and/or quick changes in direction with pivoting, especially when the foot is planted. The meniscus is also often damaged with jumping/landing and direct trauma. Aging and gradual wear and tear of the joint can further lead to meniscus injuries as the tissue becomes weaker over time. These meniscus injuries can affect activities of daily living such as walking, running, or getting up and down stairs. Additionally, meniscus problems can limit performance during higher level competition and sports. However, proper treatment can facilitate decreased pain along with increased range of motion, strength, and function.1
How Do I Know if I Have a Meniscus Injury?
If you are experiencing knee pain, it is best to organize an evaluation by a physical therapist, as there are a variety of pain generators in the knee. However, certain signs and symptoms are consistent with a meniscal injury.1
- Knee pain on the inner or outer side of the joint line.
- A sensation of “catching” or “locking within the knee joint or popping sounds.
- Difficulty fully straightening or bending the knee.
- Pain with standing on the affected side or when twisting the leg if standing up.
In this post, we will explore conservative management of a meniscus injuries.2 We will also review surgical options and postoperative rehabilitation for meniscus injuries.3
How Can Physical Therapy Help With Meniscus Injuries?4
There are many types and grades of meniscus injuries, which help to determine an appropriate course of action. However, physical therapy is an essential component of healing meniscus injuries. In some cases, meniscus tears can be treated by a physical therapist non-operatively, but physical therapy also plays a primary role in post-operative management of a meniscus repair. Here are some key aspects of a comprehensive rehab program for meniscus tears.2
The initial phase focuses on pain management, reducing swelling, and regaining range of motion. Here at Symmetry Physical Therapy in Downtown Miami/Brickell area, we employ modalities such as soft tissue mobilization, electric dry needling, Winback TECAR therapy, and gentle exercises to remove excess inflammation, enhance healing, and prevent stiffness.
As healing progresses, the emphasis shifts towards strengthening the surrounding muscles to provide better support of the knee joint. Exercises targeting the quadriceps, hip muscles and hamstrings are a key to stabilizing the joint in a manner that minimizes pressure of the repaired tissue.
As the patient improves their knee strength, range of motion, and function, rehabilitation goals shift to improving balance and proprioception within the context of dynamic movements so as to facilitate an efficient return to sport. This advanced level training is essential for maintaining stability long term and preventing further injury.
How Can Dry Needling Help With a Meniscus Injury?
Dry needling is a technique that involves inserting thin, monofilament needles into specific anatomical locations that fit with the condition being treated. In case of a meniscus injury, dry needling can assist in a couple of different ways.5, 6
- Pain relief: Dry needling can help reduce pain associated with an injury by increasing the amount of natural opioid-like factors that your body produces which can improve the way that pain is processed both centrally and peripherally.
- Decreasing excess inflammation: When completing needling with electrical stimulation, adenosine increases in the body which helps reduce excess inflammation that may be impeding recovery.
- Increasing blood flow to injured area: Dry needling can increase local blood flow to the affected area which helps to speed up the healing process, especially to areas of poor blood flow in the meniscus. Increased blood flow promotes healing by delivering oxygen and nutrients while removing byproducts of damage and inflammation.
- Muscle relaxation: Dry needling can target tight or hypertonic muscles in the quadriceps or hamstrings due to inappropriate pain compensation strategies. By inserting needles into these muscles, we can remove excessive acetylcholine from neuromuscular junctions, thereby breaking the cycle of hypertonicity associated with trigger points. This may alleviate muscle imbalance and reduce strain on the tendons/ligaments that support the knee.
How Can WinBack TECAR Therapy Help With Meniscus Injuries?
Winback TECAR Therapy increases the internal heat and exchange rate of nutrients among cells in the target tissue, facilitating efficient healing. Here is how Winback TECAR therapy can help Meniscal injuries:7
- Increased blood flow: Depending on where the meniscus injury is, less blood flow may be available to heal the tissue. However, TECAR therapy may help maximize vasodilation in structures that are not typically well innervated with blood vessels.
- Faster healing: Increased blood flow will help to deliver oxygen and nutrients to the affected tissues while removing waste products, thereby facilitating healing.
- Pain reduction: Tecar therapy may help alleviate pain associated with meniscus injuries. The heat generated by the therapy promotes relaxation of muscles and connective tissue associated with the knee. It further helps realign abnormal collagen fibers and break down scar tissue.
What To Do if I Have a Meniscus Injury/Tear?
Meniscus injuries can be debilitating and can significantly impact your daily life and physical abilities, but with the appropriate physical therapy intervention, individuals can regain their knee function and resume an active lifestyle. With the help of physical therapy, you can reduce pain, improve mobility, and prevent future knee issues. By addressing the root causes of the meniscus problem, strengthening muscles, and promoting better movement, physical therapy plays a crucial role in managing meniscus and other knee injuries.
Working closely with healthcare professionals and following a tailored rehabilitation program (i.e. dry-needling, TECAR therapy, soft tissue mobilization and exercise) can optimize recovery and reduce the likelihood of future knee problems, promoting long-term joint health and well-being. If you suspect you have a meniscus tear or have been referred to Physical therapy by your doctor, come see us at Symmetry Physical Therapy (located in Miami/Brickell), and we will provide an in-depth assessment and treatment strategy to help your meniscus injury.
Feel free to give us a call at (305) 331 2277 to schedule an appointment.
Book a session with us in clinic or virtually!
Works Cited
1. Wells ME, Scanaliato JP, Dunn JC, Garcia EJ. Meniscal Injuries: Mechanism and Classification. Sports Med Arthrosc Rev. 2021;29(3):154-7.
2. Luvsannyam E, Jain MS, Leitao AR, Maikawa N, Leitao AE. Meniscus Tear: Pathology, Incidence, and Management. Cureus. 2022;14(5):e25121.
3. Harput G, Guney-Deniz H, Nyland J, Kocabey Y. Postoperative rehabilitation and outcomes following arthroscopic isolated meniscus repairs: A systematic review. Phys Ther Sport. 2020;45:76-85.
4. Wedge C, Crowell M, Mason J, Pitt W. Rehabilitation and Return to Play Following Meniscus Repair. Sports Med Arthrosc Rev. 2021;29(3):173-9.
5. Rahou-El-Bachiri Y, Navarro-Santana MJ, Gomez-Chiguano GF, Cleland JA, Lopez-de-Uralde-Villanueva I, Fernandez-de-Las-Penas C, et al. Effects of Trigger Point Dry Needling for the Management of Knee Pain Syndromes: A Systematic Review and Meta-Analysis. J Clin Med. 2020;9(7).
6. Butts R, Dunning J, Perreault T, Maurad F, Grubb M. Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia: A Clinical Resource Guide for Health Care Professionals. International Journal of Physical Medicine and Rehabilitation. 2016;216(4:2).7. ȘTEFAN N, TOMOZEI R, TANASĂ1 R, MORARU C. STUDY REGARDING INCREASED RANGE OF MOTION AND MUSCULAR FORCE IN KNEE JOINT SPRAINS. Physical Education, Sport and Kinetotherapy Journal. 2021;61(1):143-54.