Rehabilitation is essential, especially for meniscal injuries of the knee. Regaining muscle strength and knee function is key to recovery. Want to know how and when to start?
What is the meniscus of the knee?
The menisci of the knee are two fibrocartilaginous structures located between the tibia and femur that function as cushions. Each knee contains two menisci: a C-shaped medial meniscus and an O-shaped lateral meniscus.“
Its functions are to absorb impacts, preventing direct collisions between bones, distribute body loads evenly, and provide stability during jumps, braking, and turns; it also provides nutrition to the articular cartilage.
What types of meniscus tears exist?
Not all meniscal tears are treated the same. To determine the exact type of meniscal tear, an MRI is necessary for confirmation. There are several classifications:
ACCORDING TO ORIGIN
- DegenerativeThese appear gradually due to tissue wear and tear or repetitive microtrauma. They are common from age 40-45 onwards, even without any prior trauma. They usually occur in internal areas with less vascularization (lower blood flow), which hinders spontaneous healing.
- TraumaticThese injuries occur due to a sudden twisting motion with the foot planted on the ground. They are common in athletes and are often associated with other injuries such as... Anterior Cruciate Ligament rupture.
ACCORDING TO THE SHAPE
- Longitudinal
- Radials
- Across
- Complex
- Radials
- Flap
- Parrot beak
- Bucket handle
ACCORDING TO THE AFFECTED AREA
If the horns (insertion) are affected, the prognosis may be worse. Furthermore, if the innermost area, which has poorer blood supply, is affected, recovery is usually more complex.
If you're interested in this topic, don't hesitate to read this article about the injury suffered by Kilian Jornet, one of the world's best trail runners: Kilian Jornet reveals the extent of his injury: Meniscus tear with Western States on the horizon.
How can I tell if I've torn my meniscus?
There are several symptoms that can help you reach a diagnosis.
- Click: a cracking sensation at a specific moment; usually in twists, forced valgus or varus, or hyperextension (especially in traumatic injuries).
- Pain in the interline between the femur and tibia, that is, in the joint space where the menisci are located.
- Swelling and inflammation.
- Feeling of being blocked: inability to fully extend or bend the knee because a fragment of the meniscus has shifted.
- Instability: feeling that the knee is giving way.
- Pain when bending down or turning, and even when walking.
When is meniscus surgery necessary, and when is it not? What types of surgery are there?
Years ago, almost all injuries required surgery. Today, evidence recommends starting with conservative treatment through physiotherapy, especially for degenerative tears where it is often very successful.
In the case of traumatic injuries, the decision will depend on the patient's stability and symptoms. The criteria typically considered for surgery are:
- Mechanical knee lock
- Failure of conservative treatment
- Young patients or athletes
There are two types of surgery:
- Partial meniscectomyThis procedure involves removing only the torn fragment of the meniscus. Recovery is faster (3 to 6 weeks) as it does not require healing time, but removing cushioning increases the risk of premature osteoarthritis in the long term.
- Meniscal suture: It involves stitching and preserving the torn tissue. It maintains the long-term health of the knee, but recovery is slower (3 to 6 months) and usually requires an initial 3-4 weeks of non-weight-bearing.
Regarding the infiltrations, Corticosteroid treatments are generally not recommended, as they can accelerate degeneration. Hyaluronic acid or PRP (platelet-rich plasma) injections can relieve symptoms, but should be combined with an active physiotherapy program.
It is also advisable to reduce the consumption of anti-inflammatory drugs so as not to interfere with the body's natural repair processes.
When is rehabilitation necessary for a meniscus injury?
It is always essential in 100% cases.
- Pre-surgical rehabilitationPerforming physiotherapy before surgery helps reduce inflammation, restore joint range of motion, and build muscle strength, which facilitates the postoperative period and, in some cases, even avoids surgery.
- Following a partial meniscectomyAlthough recovery is quick, physiotherapy is crucial to accelerate the process. The sooner you start, the better; it promotes muscle recovery and prevents relapses.
- After meniscal sutureAlthough full weight-bearing may not be possible during the first few weeks, it is vital in physiotherapy from day one to prevent quadriceps atrophy, maintain patellar mobility, and work on non-weight-bearing. Furthermore, even though rehabilitation may seem unnecessary during the first month because there is no weight-bearing, it is the most important, as strength in that leg should not be lost.
How to prevent meniscus injuries?
- Weight control: Being overweight increases the load on the knee and therefore causes it to suffer more.
- Muscle strengthening: Maintaining strong glutes, quadriceps, hamstrings, and soleus muscles creates a shield that absorbs impacts.
- Load management: Plan your training volume and avoid sudden peaks in effort to prevent overloading.
- Sedentary lifestyleAn inactive joint weakens and is more prone to injury from unexpected exertion.
- Healthy habits: Prioritize getting enough sleep at night, an anti-inflammatory diet and adequate hydration.
Meniscus rehabilitation in Alcalá de Henares.
Are you having knee meniscus surgery or have you already undergone the procedure? At Evolution Physiotherapy, we can offer you proper pre-surgery preparation and comprehensive rehabilitation from day one so you can make a full recovery and return to your sport safely.
If you are in this situation, don't hesitate to contact us and Book your appointment with us.
