Meniscus Tear Rehab & Exercises (Stretching | Strength | Plyometrics)

Summary

This video explores meniscus tears, challenging the conventional wisdom that surgery is always best. It presents a comprehensive rehabilitation program with exercises and progressions for non-surgical cases, emphasizing the importance of knee range of motion, strength, balance, and optional plyometrics. The script questions the necessity of surgery, citing studies that show exercise can be equally effective for both older and younger populations with meniscus issues, advocating for conservative management as the primary treatment.

Takeaways

• 🏥 Meniscus tears are common and can be traumatic or non-traumatic, affecting the shock absorption and stability of the knee joint.
• 🔍 The presence of knee pain and mechanical symptoms like clicking or locking are not definitive indicators of a meniscal tear, as they are prevalent even in those without tears.
• 🧐 Meniscal tears are prevalent in asymptomatic individuals, suggesting that surgery may not always be necessary to address symptoms.
• 📉 Scientific literature does not fully support the idea that surgery for meniscal tears leads to better outcomes compared to other interventions.
• ⚕️ A study compared the outcomes of partial meniscectomy to placebo surgery, finding no significant difference in knee symptoms or function after five years.
• 📚 A Cochrane review concluded that arthroscopic surgery for degenerative meniscal tears provides little to no clinical benefit over placebo surgery.
• 💪 Exercise has been shown to be as effective as surgery in the long term for both younger and older populations with meniscal tears.
• 🧘‍♂️ A comprehensive rehab program is recommended for non-surgical cases, focusing on improving knee range of motion, strength, balance, and optional stretching and plyometrics.
• 🏋️‍♀️ Strengthening exercises for the hip, knee, and ankle are crucial for improving knee function and reducing discomfort.
• 🕺 Balance and proprioception exercises are important for overall knee stability and can be progressed as the individual's condition improves.
• 🤸‍♂️ Plyometric exercises can be included for those looking to return to sports or improve tolerance to jumping and landing.

Q & A

What are meniscus tears and where are they located in the body?

Meniscus tears refer to injuries to the meniscus, a fibrocartilaginous structure situated between the femur (thigh bone) and tibia (shin bone). There are two menisci in each knee: the medial meniscus on the inner side and the lateral meniscus on the outer side. They are crucial for shock absorption, force transmission, and knee joint stability.

What are the different types of meniscus tears?

Meniscus tears can be classified based on their location and orientation into vertical longitudinal, radial, horizontal, oblique, or complex tears. A specific type called a bucket handle tear involves vertical or oblique tears that twist and fold within the joint.

Why might surgery not be the best option for meniscus tears?

Surgery might not be the best option because current scientific literature does not fully support the theory that pain and mechanical symptoms are caused by meniscus tears. Studies have shown that these symptoms are common even in individuals without tears and that surgery has not been proven to lead to better outcomes compared to other interventions.

What does the 2018 study mentioned in the script reveal about mechanical symptoms and meniscal tears?

The 2018 study found that mechanical symptoms such as clicking, catching, and locking of the knee were equally prevalent in patients with and without a meniscal tear, suggesting that these symptoms are common in those with knee problems in general and not specific to meniscal tears.

How common are meniscus tears in asymptomatic individuals?

Meniscus tears are surprisingly common in asymptomatic individuals. One study found that in 230 uninjured knees, 30 percent had meniscal tears, indicating that the presence of a tear does not necessarily correlate with pain or discomfort.

What was the outcome of the study comparing partial meniscectomy to placebo surgery?

The study found that over the course of five years, partial meniscectomy provided no more benefit for knee symptoms or function than placebo surgery. It even led to an increased risk of developing radiographic knee osteoarthritis.

What does the Cochrane review conclude about arthroscopic surgery for degenerative meniscal tears?

The Cochrane review concluded that arthroscopic surgery for degenerative meniscal tears provides little to no clinical benefit for pain, function, and quality of life compared to placebo surgery.

What is the recommended approach for treating knee symptoms related to degenerative meniscal tears?

Conservative management is currently recommended as the first line of treatment for knee symptoms related to degenerative meniscal tears. This approach can be effective for both older and younger populations with traumatic tears.

What is the comprehensive rehab program mentioned in the script and what does it include?

The comprehensive rehab program is a set of exercises aimed at increasing capacity and tolerance to various stressors on the knee. It includes exercises for knee range of motion, hip, knee, and ankle strength, balance or proprioception, optional stretching, and optional plyometrics. The program is designed to be adaptable to individual needs and goals.

How often should the rehab exercises be performed according to the script?

The rehab exercises should be performed two to three times a week, with the aim of gradually increasing volume and tolerance while keeping pain tolerable during exercise.

What are some additional considerations for individuals looking to return to running or playing sports after a meniscus tear?

In addition to the rehab exercises, individuals looking to return to running or playing sports should consider adding sport-specific drills, such as cutting and changing directions, and gradually returning to their preferred activity. Plyometric exercises can also help develop qualities applicable to these activities.