The successful resolution of a knee problem involves a complex understanding of kinetic chain relationships, and a functional understanding of how each body action is related to specific anatomical structures.
Learn more about the knee’s structure and kinetic chain on Dr. Abelson’s blog.
When you observe a deviation from normal motion patterns it is a direct indication of what structures are involved in a specific injury.
This information tells the practitioner that primary muscles that perform the action may be involved (agonists), or their oppositional muscles (antagonists). This, combined with a whole body examination of kinetic chain relationships, provides the practitioner insight into what it will take to resolve a knee injury.
Degree of Injury
How well a meniscus tear responds to non-surgical treatments will depend on the degree of tearing. In most cases the damage is not significant enough for surgery. The following symptom patterns may give you an indication of the severity of a tear. Remember these are just general guidelines, only a medical professional can make a definitive diagnosis.
Minor meniscus tear symptoms
You will experience only minimal pain, and you are still able to walk. Some degree of swelling exists, and increased pain is experienced during squatting motions. Most of these symptoms should diminish within 2-3 weeks.
Moderate meniscus tear symptoms
Pain occurs directly at the site of the meniscus (lateral or medial). Sharp pain occurs with any type of squatting or twisting motion of the knee. Often there is considerable stiffness with this condition. If these symptoms are ignored and rehabilitation is not implemented, it could take several months to a year before they go away.
More severe meniscus tear symptoms
Immediate sharp pain is experienced, including swelling and stiffness. The patient’s knee may lock into position. The patient is often not able to straighten their knee. This is often a case for surgical intervention.
Treatment of Meniscus Injuries
Meniscus injuries can be very painful; the treatment should focus on decreasing swelling, increasing range of motion, and strengthening the knee. Active Release Techniques can be very effective in helping to achieve these goals. That is unless there is a severe tear of the meniscus; this is a case for surgical intervention.
At the initial onset of these injuries it is important to:
Rest – Avoid putting excess stress on the knee. In some cases crutches may be advisable if the injury is more severe.
Ice – Use ice on the knee for 20-30 minutes every 2-3 hours, until swelling is reduced.
Elevate – Elevating your knee will also be of benefit, place your knee on a blanket or pillow.
Compress – An elastic tensor bandage on your knee may also help to reduce swelling.
Manual therapy (including ART, Graston Techniques, and Massage therapy) is a great way to take direct or indirect tension off of the meniscus. This may involve numerous soft tissue restrictions above, below, or in direct contact with the meniscus.
For example, besides the meniscus attaching to your shin bone (tibia – medial and lateral condyles), each meniscus also attaches to the tendons of two muscles. These are the popliteus muscle and the semimembranosis muscle.
Popliteus Muscle (Behind the knee)
This muscle flexes and medially rotates the knee. Tension in this muscle could affect meniscus function.
Semimembranosis (Hamstring muscle)
Inflammation of the semimembranosis is often confused with an injury of the medial meniscus. Removing any restriction from this structure will have a positive effect on meniscus function.
Exercise is Essential
Just as important as removing the restrictions are performing exercises. Initially these exercises should be very simple with a focus on maintaining overall leg strength.
An example would be the Unilateral Partial Squat. Just click on the exercise diagram to see how it is performed. If you are performing this exercise be sure to stay in a pain-free range of motion. This only an example of one exercise recommendation, usually 4 to 6 exercises would be prescribed.