What are meniscus injuries?

Athletes frequently suffer meniscus injuries as a result of a sports injury. A meniscus can be torn or ruptured completely. An injury can affect the normal biomechanics of the knee joint and produce pain.

A meniscus injury is typically produced by a torsional movement of the femur and tibia under load without contact or by performing an abrupt action such as a squat. Anything that causes the femur to move too far forward or backward in relation to the tibia may cause some of the stresses to be passed to the meniscus, resulting in a rupture of the meniscus.

CLINICAL PRESENTATION:

• Depending on the affected compartment, knee pain might be medial or lateral.
• Tenderness.
• Instability.
• Locking of the knee.
• Popping of the knee.
• Knee clicking, When the torn component of the meniscus travels under the femoral condyle.

MEDICAL MANAGEMENT:

1. Icing, analgesics, & NSAIDs-to alleviate pain and inflammation
2. Meniscal repair surgery by arthroscopy.
3. Physiotherapy management.

PHYSIOTHERAPY MANAGEMENT:

Conservative treatment is an option for some meniscal lesions injury that may not require surgery. One of the most effective conservative treatments is physiotherapy. It focuses on quadriceps muscular strengthening to prevent secondary quadriceps atrophy.

The treatment goal is to improve knee function and reduce joint pain.

RICE (Rest, Ice, Compression, Elevation) is the foundation step of physiotherapy management of meniscal injury. RICE is critical in the first 24 hours following an acute soft tissue injury. Especially when blood vessels are injured. It alleviates pain and swelling. For the first 48 to 72 hours, apply ice for 20 minutes every 2 hours.

Physiotherapy Rehabilitation of meniscal injury consists of:

Quadriceps and hamstring stretching and strengthening exercises are crucial.

Strength Exercises

Isometric exercises for strengthening the quadriceps.

1. Quad set: When the patient is supine, flex your normal knee and keep your other knee straight. The patient tries to lower his knee on the table. Another variation of this exercise is placing a towel roll under the knee and then pressing down.
2. Straight-leg raise.
3. Isometric exercises for strengthening the hamstrings
4. Hamstrings sets: The patient is lying on his back with his uninvolved knee straight and his involved knee in partial flexion. Pushing the heel into the table or pillow.

Non-weight-bearing isotonic exercises

1. Short-arc quad exercise aka terminal knee extensions.
2. Full-arc quad exercise
3. Hamstring curls
4. Weight-bearing resistive exercises
5. Training on a stationary bike.
6. Wall squats, step-ups, step-downs, lunges, lateral step-ups.

Flexibility Exercises

1. Flexibility exercises and joint mobilization are approaches for increasing the range of motion and flexibility.
2. Active stretches for quadriceps, hamstrings, and calf muscles.

Joint Mobilizations

1. Injury, swelling, surgery, and immobilization can all cause decreased joint mobility. If this occurs, it can cause knee pain and possibly impair ankle movement.
2. A physiotherapist will employ joint mobilization as a manual approach to improve the joint range of motion.

Balance & Agility

• Balance and agility exercises begin with weight-bearing activities on two supports and proceed to single-limb static balancing on a solid surface. progress to the unstable surface.

If surgery is required, there are two options: meniscectomy or meniscus repair (partial or full).

Physiotherapy rehabilitation is also necessary following surgery. Full recovery employing a comprehensive rehabilitation program typically takes 3-4 months, and players involved in high-level sports can return to the field 6-8 months after surgery.