Meniscus Tear: Rehabilitation Exercises

A meniscus tear is a common knee joint injury. Meniscus tears commonly occur during sports when the knee is twisted while it is partially flexed and the foot is firmly planted on the ground. But these tears are also common with normal movement in older people whose menisci (plural of meniscus) are worn down. The medial and lateral menisci of the knee are two crescent-moon-shaped disks of tissue (fibrocartilage) that lie between the ends of the upper leg bone and the lower leg bone that form the knee joint. The rubbery tissues act as shock absorbers between the upper and lower leg bones, evenly distributing the load across the knee and helping to keep the knee stable.

Symptoms of a meniscus tear depend on the size and location of the tear and whether other knee injuries occurred along with it. Pain at the inside of the knee can point to a tear to the medial meniscus. Pain at the outer side of the affected knee may point to a tear to the lateral meniscus.

• Symptoms of a small tear include pain at the time of injury, with slight swelling over several days. You are able to walk and your pain is minimal. But your pain may get worse when you squat. Your symptoms usually go away within 2 to 3 weeks. But they may recur with bending or twisting.
• Symptoms of a moderate tear include pain at the side or in the center of your knee, although you may still be able to walk. The swelling increases over 2 to 3 days, and your knee feels stiff. You may have sharp pain when twisting or squatting. The symptoms may diminish in 1 to 2 weeks. But they may recur with twisting or overuse if untreated. The pain may come and go for several months or a year or more if untreated.
• Symptoms of a larger tear include pain, with swelling and stiffness that start right away. Or symptoms can get worse over 2 to 3 days. Your knee may catch, pop, or lock, and you might not be able to straighten your knee. It might also feel "wobbly" or unstable, or it might give way without warning.

Treatment of a meniscus tear depends upon the size, type, and location of the tear, your age, your health status and activity level, and when the injury occurred. Treatment options include:

• Nonsurgical treatment with rest, ice, compression, elevation, and physical therapy. This may include wearing a temporary knee brace.
• Surgical repair to sew the tear together.
• Surgical removal of the torn section (partial meniscectomy). Total meniscectomy, which removes the entire meniscus, is typically avoided because of the increased risk for osteoarthritis.

Continue to Why?

The goals of rehabilitation (rehab) are to restore range of motion, strength, and endurance of your knee. A rehab program usually includes treatment with a physical therapist at a therapy center and home treatment in your home or at a gym or health club. Your physical therapist will design a program that guides you through exercises to reach your rehab goals. Your rehab schedule takes into account your health status, age, and activity expectations. In general, as you see less of your therapist, you do more on your own.

Recovery from a meniscus tear depends on many things. If the tear is minor and your symptoms go away, your doctor may recommend a set of exercises to increase your flexibility and strength.

If you have surgery to repair your meniscus, your surgeon may recommend that you do not move your knee more than absolutely necessary (immobilization) in the days after surgery. This may be followed by a period of limited motion before you are able to resume daily activities. Some doctors believe that it helps to begin a physical therapy and exercise program soon after surgery. Others believe that heavy stresses, such as running and squats, should be postponed for some months. Physical therapy that is guided by your doctor and designed for your individual needs is a key part of regaining strength and flexibility in your leg and helping prevent future degeneration in the knee joint.

Continue to How?

For most tears, some simple exercises can help maintain muscle strength in the front of the thigh (quadriceps), back of the thigh (hamstrings), calf, and hip. All of these areas are important for your overall leg function while your knee heals after an injury or after surgery. Exercises should only be done on the advice of your doctor and only if you feel very minimal or no pain while you do them at home. The list below has links to specific exercises with pictures and instructions.

• Quad sets
• Straight leg raises
  • Straight-leg raise to the front
  • Straight-leg raise to the back
• Hamstring curls
• Heel raises
• Heel dig bridging
• Shallow standing knee bends

Continue to Where?

For more information about rehabilitation for a meniscus tear, talk to:

• Your doctor.
• A sports medicine specialist.
• A physical therapist.
• An occupational therapist for work-related activities.