The meniscus is two curved-shaped layers of cartilage in your knee. They act as shock-absorbing pads between the bones and cartilage of your thigh and lower leg. As we age, these pads may begin to wear away or tear over time. These changes are sometimes called degenerative meniscus tears. Meniscus tears can be painful, but not always.¬† Thankfully, exercise is an effective treatment option for people with meniscus injuries.
Hundreds of thousands of people undergo surgery for meniscus tears each year. A type of surgery called arthroscopic partial meniscectomy is the most common. With this surgery, a small incision is made in the knee and the damaged pieces of the meniscus are cut away. However, based on several recent research studies, many doctors are recommending you should not have surgery to remove the damaged meniscus. Instead, exercise, weight management, and education are being prescribed as the first course of treatment.
Research Shows Exercise is Effective for Meniscus Tears
A 2018 study conducted in Europe compared arthroscopic surgery and exercise to a placebo surgery and exercise. Patients receiving placebo surgery had a small camera inserted into their knee joint but the meniscus was left untouched. The camera was removed and the patients were then prescribed an exercise program by a physical therapist. Two years after the surgeries, there were no differences in pain or functional abilities between those who received arthroscopic surgery and the placebo surgery.
Other studies from The Netherlands and Norway have shown equal effectiveness between surgery and physical therapy for treating meniscus tears.¬†These studies were also long-term studies following patients for 2 years.¬†Of course, there are some people with meniscus tears who benefit greatly from surgery.¬†These are typically younger individuals with acute injuries and complaints of knee locking.¬†However, for the large majority of people with meniscus tears, exercise is the first course of treatment.¬†The following 5 exercises are examples of what might be included in a rehabilitation program at our clinics.
Quadriceps Isometric Set
This exercise can minimize quadriceps muscle loss. The quadriceps muscle is important for everyday activities such as standing up from a chair and climbing steps. This exercise also helps restore full knee straightening which is imperative for normal walking. To perform the quadriceps set, begin with the knee straight using a small towel roll placed under your heel. Push the back of your knee down towards the floor while simultaneously tightening the front of your thigh.¬† Hold the contraction for 10 seconds and perform 10 repetitions.
The heel slide helps restore full knee bending which is important to sit comfortably and climb stairs. Begin with the knee extended with a long towel, belt, or stretch-out strap around your foot. Gently slide your heel towards your hip until a mild stretch is felt in your knee. Hold the stretch for 10 seconds and perform 10 repetitions.
Bridge + Hamstring Curl
This exercise strengthens the hamstring muscle on the back of your thigh and knee.¬† Some of the muscle fibers of the hamstrings attach to the meniscus. Begin lying on your back with an exercise ball under your lower legs. Perform a bridge by pushing your buttocks up from the floor.¬† Hold the bridge position and curl your feet towards your hips. Pause 2 seconds. Maintain the bridge as you return your legs to the extended position. Finally, lower the buttocks down to the floor.¬† This completes one repetition. Typically 8 to 10 repetitions are performed for multiple sets each day.
1-Leg Band Kicks
Stability one 1-leg is important for anyone with a meniscus injury.¬†The band kicks train balance and stability on 1-leg.¬†This involves the co-contraction of the quadriceps, hamstrings, and glutes. Begin with a resistance band loop around your ankles. Stand on the injured leg. The other leg performs repeated band kicks to the front, side, and back without touching the foot down. It is important to maintain an upright vertical trunk as you perform the kicks. As your balance and stability improve, increase the speed of each kick.
Difficulty climbing stairs is a common complaint for people with injuries to the meniscus. It is important to retrain muscular control of stepping up and down on the injured leg.¬† Begin by stepping with your injured leg up onto a 6 to 8-inch step. Your uninjured leg is flexed as you bear full weight on your injured leg.¬† Pause 2 seconds at the top. Return your uninjured leg to the floor followed by your injured leg. Perform 8 to 12 repetitions for multiple sets.
Get Started Exercising with a Meniscus Tear
Meniscus tears of the knee can be painful and debilitating. Not everyone has to suffer. These 5 exercises are only a small sample of the types of exercises that can help you. Meet with your physical therapist and get started on your road to recovery. Your physical therapist will continually assess your injury and progress your exercise program based on your goals.¬†The objective is to decrease pain and restore function as quickly and safely as possible. Contact us today if you have knee pain or simply have questions about which treatments are right for you.