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MENISCAL TEARS

Meniscal tears are common knee injuries that involve damage to the meniscus, which are C-shaped pieces of cartilage that act as shock absorbers between the thighbone (femur) and shinbone (tibia) in the knee joint. Meniscal tears can occur from sudden twisting or rotating movements of the knee, particularly during sports or activities that involve pivoting, squatting, or kneeling. They can also result from degenerative changes over time, especially in older adults.



Understanding Meniscal Tears:

  1. Types of Tears: Meniscal tears can vary in severity and location:

  • Traumatic Tears: Result from sudden twisting or forceful impact on the knee joint, often seen in athletes.

  • Degenerative Tears: Occur due to gradual wear and tear on the meniscus, commonly associated with aging or repetitive stress.

  1. Symptoms:

  • Pain, especially with twisting or squatting motions.

  • Swelling and stiffness in the knee joint.

  • Catching, locking, or popping sensations in the knee.

  • Difficulty fully straightening or bending the knee.

  • Instability or a feeling of the knee giving way.

  1. Diagnosis: Diagnosis of a meniscal tear is typically based on clinical evaluation, including history of the injury, physical examination (e.g. McMurray's test, Apley's compression test), and imaging studies such as MRI to confirm the location and extent of the tear.


How Physiotherapy Can Help with Meniscal Tears:

Physiotherapy plays a crucial role in the management of meniscal tears, focusing on reducing pain, swelling, and inflammation, improving knee joint mobility and restoring strength and function. Here are ways physiotherapy can help:

  1. Initial Management (RICE Protocol):

  • Rest: Protecting the injured knee and avoiding activities that aggravate symptoms.

  • Ice: Applying ice packs to the knee to reduce swelling and inflammation.

  • Compression: Using an elastic bandage or compression sleeve to support the knee and reduce swelling.

  • Elevation: Keeping the knee elevated above heart level to reduce swelling.

  1. Pain and Inflammation Management:

  • Physiotherapists may use modalities such as ultrasound, electrical stimulation or ice therapy to alleviate pain, reduce swelling, and promote healing of the injured meniscus.

  1. Range of Motion Exercises:

  • Gentle knee range of motion exercises help maintain or restore flexibility and mobility in the knee joint. This includes knee bending (flexion) and straightening (extension) exercises to prevent stiffness.

  1. Strengthening Exercises:

  • Progressive strengthening exercises target the muscles around the knee joint, including the quadriceps, hamstrings and calf muscles. Strengthening these muscles helps provide stability and support to the knee joint, reducing strain on the injured meniscus.

  1. Balance and Proprioception Training:

  • Exercises to improve balance, proprioception (awareness of joint position) and neuromuscular control of the knee joint. This includes single-leg balance exercises, stability ball drills and proprioceptive exercises on uneven surfaces.

  1. Manual Therapy:

  • Techniques such as joint mobilisations, soft tissue massage and myofascial release can help reduce muscle tightness, improve tissue mobility, and restore normal joint mechanics in the knee.

  1. Functional Rehabilitation:

  • Gradual progression to functional activities and sport-specific exercises to safely return to previous levels of activity. This includes agility drills, jumping exercises and movements specific to the individual's sport or daily activities.

  1. Education and Prevention:

  • Physiotherapists provide education on proper knee care, including injury prevention strategies, proper techniques for activities and strategies to avoid re-injury. They may also recommend knee braces or supports during activities for added stability.


Benefits of Physiotherapy for Meniscal Tears:

  • Conservative Management: Physiotherapy offers non-surgical treatment options to manage symptoms and promote healing of meniscal tears.

  • Optimised Recovery: Promotes optimal healing of the injured meniscus, reduces recovery time, and improves overall knee function.

  • Preventive Strategies: Education on proper rehabilitation exercises, techniques to improve knee joint mechanics and strategies to minimise the risk of recurrent meniscal tears.


In summary, physiotherapy is essential in the management of meniscal tears, providing comprehensive, personalised treatments aimed at reducing pain, improving knee joint mobility, restoring strength and function and facilitating a safe return to daily activities and sports. Early intervention with physiotherapy can significantly improve outcomes and reduce the need for surgical intervention in many cases of meniscal tears.

Jun 29

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