Physiotherapy for Meniscal Tears
Physiotherapy has been shown to be as effective as arthroscopic surgery for meniscal tears of the knee. Given that Physiotherapy is much less invasive, it has become the first line therapy for meniscal tears.
What is the Meniscus
The menisci are crescent shaped cartilaginous structures inside your knee that act as shock absorbers and improve the stability and mobility of the joint.
The most common symptom associated with meniscal tears are:
- Knee pain
- Knee swelling
- Knee locking
- Knee stiffness
How Does the Meniscus Tear?
There are two categories of meniscal tears. Degenerative meniscal tears develop from excessive “wear and tear’ on the knee joint over time. These are seen as part of the typical arthritic process that a knee can go through over time. They become a problem when the tear becomes severe enough to cause pain or limit the function of the knee joint. Acute meniscal tears result from trauma. They usually involve a twisting motion of the knee. The meniscus can get caught between the femur and tibia while in motion causing the structure to tear.
Meniscal Tear Physiotherapy Objectives
The objectives of physiotherapy for meniscal tears are the following;
- Restore full pain free joint range of motion
- Reduce swelling
- Reduce pain
- Restore joint proprioception and balance
- Strengthen all of the muscles that control the hip, knee and ankle.
- Deliver a sensible return to sport/activity plan
A very small percentage of acute meniscal tears need to be managed with arthroscopic surgery. Before making that determination, the patient should do a trail of Physiotherapy for several weeks to ensure that the problem cannot be managed without surgery. In some rare cases a patient will sustain a large meniscal tear and the knee will be “locked” in a bent position. If this is the case the patient should be evaluated and considered for arthroscopic surgery as soon as possible.
Meniscal tears can take weeks to heal, depending on the type of tear. Age plays a role in the healing process, as younger individuals typically show a faster recovery. Individuals with meniscal tears have a high chance of developing osteoarthritis later on. Of the patient that are treated surgically, younger patients do better. Overall, degenerative meniscal tears are associated with a worse prognosis than those created through trauma. Meniscal repairs lead to higher rates of return to sports and lower long-term risk of osteoarthritis compared to partial meniscectomy (partial removal of meniscus). Working with a good physiotherapist can improve the rate of gradual degeneration and reduce the risk of re-injury.