Meniscus Tears and How We Rehabilitate Them Using Physio

By Caitlan, Skillicorn, Senior Physiotherapist North Sydney   A meniscus tear can be a significant setback for those who live an active lifestyle. Whether it be due to a sudden twist during your social basketball competition midweek or a misstep during your Saturday park run, this injury can cause significant pain, swelling and limited mobility. However, with the right rehabilitation program, you can regain strength, mobility and function in your knee so you can resume your active lifestyle without missing a step. Before moving into the rehabilitation component, let’s first understand what the meniscus is and what it’s role in knee function. The meniscus is a C-shaped piece of cartridge located between the femur and tibia (as shown in the picture). It acts as a shock absorber, providing cushioning and stability to the knee joint during movement. A tear occurs most often due to a sudden forceful twisting motion or can be due to age-related changes. Once diagnosed, either through physical examination and/or imaging. Treatment approach is determined by the severity and location of the tear. More severe tear’s may require surgical intervention, however this is a discussion you would have with you physiotherapist.  

Rehabilitation phases

  Previously rehabilitation had been milestoned by date timelines, more recently rehabilitation protocols have become criteria driven, meaning that instead of waiting for a certain week to pass before you can progress, you can move into the next phase once you have hit the required clinically markers. Our class structure allows a smooth transition between the phases with appropriate intensities to facilitate a successful and long lasting outcome.  

Early Rehabilitation

  • The goals of this phase are to reduce pain and swelling, maintain range of motion and start to strengthen the surrounding muscles with activation and isometric based exercises
  • Through this phase, you will spend one on one time with your physiotherapist to ensure correct movements and reduce any aggravating factors.
  • Exiting this phase requires a reduction in swelling, restoration of full range of pain free knee flexion and extension as well as the ability to activate your quadricep muscle.

Mid-stage Rehabilitation

  • The goals of this phase are to build back your strength through the full range of motion, improve balance and proprioception, as well as beginning to rebuild your cardiovascular fitness though use of bikes, rowers, and swimming. Towards the end of this phase exercises will start to get to ready to return to running.
  • During this phase of rehabilitation, you will see your physiotherapist less one on one and engage more in a rehab group class setting. This provides you with a community of people like you, working together towards improving strength and fitness. We have found that these group classes produce better results than purely one on one care as you are able to increase session numbers to get the required load to build strength in a positive environment.
  • Exiting this phase requires an ability to jump and land with control, a return of quadricep, hamstring and calf strength to that of your non-injured leg as well as a complete reduction in swelling.

End-stage Rehabilitation

  • The goals of this final phase are to prepare you for what activities you are looking to return to, this phase is individualised depending on whether you want to return to tennis, running or just being able to play with the kids. Exercises will be sport-specific and functional to your goals.
  • Gradually we will introduce higher-intensity strength training exercises as well as agility-based drills and plyometrics to enhance dynamic stability.
  • Exiting this phase requires completion of all sport-specific testing to the required level for you as well as your confidence to return to the same level of activity as before.

Key Considerations

  Throughout the rehabilitation process, you must ensure you listen to what your body is telling you, it’s natural to want to get to the end as quick as you can but rushing rehabilitation can be detrimental and potentially further elongate your return. Rest and recovery are just as important as the exercises you complete in the gym. Make sure to be in constant communication with your physiotherapist to voice any concerns you may have, don’t push through pain and modify exercises as required.   By following the principles outlined in this guide and working closely with the team here at Healthfix, you will be able to return to the activities you enjoy and achieve long-lasting success.