Meniscal injury is the most common knee injury. Its independent restoration is impossible. Fortunately, modern medicine makes it possible to restore (or clear damage from) damaged cartilage surgically.
An important role in the postoperative period is played by rehabilitation, namely the selection of correct and effective exercises that in a short time will help strengthen tendons, ligaments and restore normal function of the meniscus.
Clothes should be loose, it is advisable to remove shoes. Perform all exercises (especially the first days) smoothly and gradually. Remember the important principle: “Endure mild pain, do not allow severe pain.”
You can do the first 7 exercises right away. The rest only after your doctor allows axial loading.
Half squats with resistance
Stand facing the door. Fasten one end of the expander under the knee of the leg being worked out, and the other end to a door or other stationary object at the level of the knee joint. Raise your free leg off the floor; you can hold on to a chair or armchair for balance. Bend the knee you are working on slightly (do a half squat on one leg), then slowly straighten your leg. Repeat 15 times. You can simplify the exercise by not lifting your free leg.
Exercises on a balancing platform
Stand on the balancing platform. Optimal position: feet shoulder-width apart.
Meniscus injury
Meniscus injury
- there is no blockade of the knee or it has been eliminated and does not recur;
- there are no freely located cartilaginous fragments inside the knee;
- the damage is small;
- it is located in the red zone - that is, in the immediate vicinity of the capsule, which provides a good chance of regeneration due to good blood supply.
In this case, the leg is immobilized. A plaster cast is applied to it. A person must wear it for several weeks. Rehabilitation activities include physical therapy, training, massage. Medications are used to relieve symptoms.
Some patients try to find lists of exercises to restore knee menisci. Such training does not exist. Only muscles are trained, not cartilage. Therefore, no matter what exercises you perform, the menisci will heal only if they have adequate blood supply. Exercise partly contributes to this, but there is no guarantee of a positive result. If the meniscus does not recover, or conservative treatment initially seems unpromising, arthroscopy is indicated.
Platform rotation
- Rotate the balancing platform clockwise until its edge is in constant contact with the floor , then counterclockwise. Repeat 30 times in each direction.
- Rotate the balancing platform clockwise until its edge touches the floor , then counterclockwise. Repeat 30 times in each direction.
Postoperative recovery
There are 4 phases of recovery after arthroscopy. Let's consider them from the point of view of events that happen to the human body and its subjective sensations.
Phase 1. Lasts one day after arthroscopy. Knee pain gets worse. The tone of the muscles of the front surface of the thigh, primarily the quadriceps (quadriceps muscle), sharply decreases. During this period, loads on the operated limb are recommended, primarily affecting the hip.
Phase 2. Lasts 3 days after surgery for meniscus damage. The pain decreases. The patient's motor mode is expanded. The range of motion in the knee increases. It is recommended to walk for a few minutes, 3 or 4 times a day.
Phase 3. Continues in the first 3 weeks after surgery. The person does not have pain at this time. Atony of the thigh muscles disappears. Therapeutic gymnastics is used. Isometric exercises are done, an exercise bike is used for 15 minutes, three times a day.
Phase 4. Begins 21 days after surgery for a meniscal injury and lasts an average of 6 weeks. A person can lead a full life. However, full weight-bearing on the operated limb is still not recommended. It will become possible only after the completion of the last phase of rehabilitation.
In addition to this division, concepts such as inpatient and outpatient rehabilitation stages are also used. The first lasts about 2 weeks. The second is from the moment of discharge from the hospital until the ability to carry out maximum load on the knee. Its duration is about 2 months.
First aid to a patient
The victim may experience severe pain from a couple of days to a week. If the severity of pain is moderate, you can do without contacting a traumatologist. To relieve pain and reduce suffering, you need:
- Apply ice to the sore knee. This will relieve swelling. Cold during prolonged contact causes blood vessels to constrict, thereby reducing local hyperthermia.
- You can reduce the intensity of pain with the help of non-steroidal anti-inflammatory drugs, including ibuprofen, diclofenac, analgin.
- To reduce the risk of worsening the situation, it is important to ensure immobility of the injured limb using a splint. It is better if the knee is elevated in relation to the healthy leg.
When the acute period is over and the patient can see a traumatologist, the specialist will assess the extent of the damage and prescribe a course of treatment and care.
rehabilitation
rehabilitation
If the patient is treated with conservative methods after a meniscus injury, the limb must be immobilized. But if he has undergone surgery, this is not always done. There are different opinions among doctors regarding the need to immobilize the leg with bandages. Many people are of the opinion that avoiding immobilization contributes to better preservation of the tone and volume of the thigh muscles.
By refusing immobilization, other effects are achieved:
- trophism of the joint capsule improves;
- less risk of developing degenerative processes of hyaline cartilage;
- there are no degenerative changes in bone tissue.
Physical exercise is a must. They form the basis of the rehabilitation process. Rehabilitation after a meniscus injury involves:
- isometric tension of the quadriceps femoris muscle;
- walking on a flat surface;
- active movements in the operated knee joint, which are performed initially in the unloading position;
- exercises for all muscle groups aimed at maintaining the general physical condition, nonspecific resistance of the body, and the patient’s vitality;
- training on special simulators.
Physiotherapy methods are used. They improve the recovery processes of the meniscus and soft tissues of the knee by improving blood circulation. During the initial recovery period, cooling procedures are used. Cryotherapy, hydromassage, and pneumomassage are widely used.
Thermal procedures begin no earlier than 4 days of rehabilitation. This could be UHF, electrical stimulation of the thigh muscles, magnetic therapy, etc.
Features of early rehabilitation
magnetotherapy
Magnetic therapy
1. In the first days after surgery, a person studies in the ward. He spends about 20 minutes doing the exercises. Movements can be performed on the operated limb only in the ankle and hip joint.
2. No movement during exercise should cause pain. There should be no knee swelling after training. Its formation indicates the development of synovitis. There should be no load on the articular cartilage after removal or suturing of the meniscus. For this purpose, unloading body positions are used when the patient is lying down or sitting. Smooth polished surfaces are used to facilitate movement.
3. The most important feature of early rehabilitation after a meniscus injury remains a gentle attitude towards the extensor apparatus of the knee. This is important for the restoration of patellar cartilage.
4. The duration of training gradually increases. Over the course of 14 days, they increase from 20 minutes to 2 hours a day.
5. From the third day of rehabilitation, drainage massage is indicated. It reduces swelling and improves knee function. The massage effect should not affect the knee joint itself. It is carried out in the thigh area.
6. The main purpose of exposure to cold in the first days after surgery is to eliminate pain, as well as exudation (fluid accumulation in the joint cavity). Due to the low temperature, vasospasm occurs and the release of fluid from the vascular bed into the tissue decreases. Due to this, the swelling goes away.
7. Each patient requires 1 or 2 types of physiotherapy. A total of about 10 sessions are required.
8. On the first day after arthroscopy, you can walk on crutches without leaning on the problematic leg. The total walking duration should not exceed 15 minutes. This takes into account the fact that the patient visits the restroom from time to time and goes to change dressings.
9. Dosed loads on the operated limb are allowed from 3-5 days (depending on the characteristics of the operation performed and the course of the rehabilitation period). The exception is when a person’s articular cartilage is injured along with the menisci. Then loads are prohibited for 4 weeks.
10. If only the menisci are damaged, a person can exercise on an exercise bike within a week after arthroscopy. In case of additional cartilage damage, no earlier than after 4 weeks.
Exercise therapy for rehabilitation after a meniscus tear
- The patient lies on his stomach. Keeps legs straight. The limb with a damaged meniscus should be lifted up carefully and held in the air for about 20-30 seconds. It is necessary to perform this exercise 4-5 times.
- We stretch our arms forward. First, bend your healthy leg 90 degrees at the knee. Raise your bent leg off the floor and hold it there for about 10 seconds. Then repeat the same with the injured limb. Select the angle so that there is no pain. It is necessary to repeat the exercise 2-3 times with each limb.
- The ankle joints must be alternately bent and extended in different directions, as well as made in circular movements.
- You should press your feet against the support, bending your knees. You need to press hard, alternately with increasing pressure. If pain occurs, the exercise should be stopped.
- Lying on your stomach, you need to straighten the injured leg, straining and stretching it for a few seconds, and then relax. If severe pain occurs, exercise should also be stopped.
- In a lying position, the patient tries to grab various objects with his feet and move them from one place to another.
- Lying on his back, the patient takes turns bringing his knee to his chest, bending it and pressing it to the body with his hands.
- Lying on your back, arms are extended along the body at the seams. At the same time, two legs are raised and pressed to the stomach.
- The patient sits down, resting his hands back. In this case, the knees must be brought together and spread apart, bending the legs at an angle of 45 degrees.
After your condition improves, you can add work with exercise equipment. But in this case, it is necessary to maintain constant monitoring by the attending physician, which will reduce the risks of complications.
It is recommended to walk more often, and gradually add light jogging. The most important thing is not to overload the knee in the early rehabilitation period. The load should be given gradually.
The Traumatology and Orthopedics Clinic offers professional services from qualified medical specialists. The resulting injury is diagnosed using modern equipment, so treatment is selected on an individual basis.
The recovery period after treatment plays an important role in an active future. Physical therapy methods have a positive effect on the progress of rehabilitation. It is possible to evaluate the positive results together with specialists from Elena Malysheva’s clinic.
menisci
menisci
The goals of the recovery period are as follows:
- restoration of normal gait;
- adaptation to long or fast walking;
- training the muscles of the lower extremities, restoring their strength and tone;
- adaptation to slow running;
- psychological recovery.
To achieve these goals, training in the gym is used. They should be daily, lasting up to 2 hours. These include walking, running, pool and exercise bike exercises. The total duration of physical activity per day can exceed 3 hours (including those carried out outside the gym).
To increase the volume of the muscles of the lower extremities after a meniscus injury, the following exercises are used:
- leg press – can be used a month after arthroscopy, and the operated leg can be used only after a month and a half;
- climbing stairs – from 7 weeks;
- exercise on an exercise bike begins on the 7th day of recovery, but then the load is increased;
- Half squats are allowed after 2 months.
Running can be started only in the absence of inflammatory changes in the knee, after the complete elimination of the contracture, as well as restoration of the muscle volume of the thigh. In the first 1-2 workouts, the reaction to the load is assessed. If there are no complaints, you can continue running using different techniques.
How to identify a meniscal injury
The reasons why a meniscus injury occurs can be not only falls and other mechanical impacts. Common precursors to damage are:
- gout;
- intoxication of the body of any etiology;
- rheumatism;
- age-related changes.
In addition, minor injuries to the meniscus that do not lead to a tear, but are associated only with its stretching or thinning, will eventually cause a tear. If you do not pay attention to the thinning or gradual breakdown of cartilage tissue in time, this can lead to deformation and arthrosis, which ultimately leads to disability.
Meniscus injury is a common problem that traumatologists encounter in their practice. Men are three times more likely to suffer a torn meniscus than women. The average age at which the peak of knee ligament injury occurs is 23-25 years.
At the time of injury, the victim experiences pain not only in the knee area, but along the entire length of the limb. Only after two weeks the pain will be localized in the sore knee. The main signs of a meniscus tear are:
- acute pain;
- hyperthermia at the site of injury, meaning the knee may become hot compared to the rest of the body;
- enlargement of the knee due to severe swelling;
- a loud crunching sound during flexion and extension of the joint, including without load;
- severe weakness of the femoral muscle;
- lumbago when trying to put pressure on the leg.
Despite the severity of pain in the knee joint, these same signs can indicate not only a meniscus tear. In the same way, ruptures of ligaments and muscles manifest themselves.
Recovery after knee meniscectomy
In the rehabilitation clinic, after removal of the meniscus, patients are prescribed the following physiotherapeutic procedures:
- electromyostimulation;
- laser treatment;
- UHF therapy;
- ion-galvanization;
- extracorporeal shock wave therapy;
- magnetic therapy;
- hot paraffin treatment (in the later stages of rehabilitation).
Exercise therapy and physiotherapy help relieve spasms from tense muscles, increase the tone of atrophied and weakened muscle fibers, and activate blood flow and microcirculation in the lower limb. Under the influence of physiotherapeutic procedures, metabolism in the joint is stimulated, swelling and pain are relieved.
For six weeks after a meniscectomy, there is still a risk of blood clots. In the early postoperative period, specialists at the rehabilitation clinic apply a bandage to the lower extremities with an elastic bandage, and in the later period they recommend that patients use compression stockings. The degree of compression of medical devices is selected by a rehabilitation specialist. It takes into account the extent of surgery and the predisposition to blood clots.