Meniscal TearsNovember 20, 2013
The knee joint takes on a lot of force and stress with daily activities as well as with sports and exercise. Meniscal injuries are a common injury at the knee and can occur in many ways. First, there are two menisci in each knee, a medial and lateral meniscus. The meniscus is a wedge shaped piece of cartilage that provides cushioning and shock absorption between your thigh bone and shin bone that is necessary during daily activities.
Meniscal tears can occur during a specific sport injury, through inadequate movements of the leg, or in older adults through degeneration of the cartilage. First, the meniscus can be torn during a sports injury through the impact of the injury itself or position of the leg during injury. Meniscal tears often occur when the leg is planted and then twisted or rotated without movement of the foot. Lastly, as we age, the cartilage in our joints begins to slowly degenerate and with this comes a higher incidence of meniscal tears without a specific injury noted.
The meniscus is divided into two sections, the red zone and the white zone. The outer 1/3 of each meniscus is called the red zone because it has a blood supply. If this area of the meniscus is torn, there is a greater chance that this type of tear will heal on its own due to the blood supply and ability to deliver the necessary healing agents to the site of injury. On the other hand, the white zone comprises the inner 2/3 of each meniscus. This area is called the white zone because there is no blood supply to this area. If this portion is torn, it is less likely to heal on its own because blood is not being delivered to the area of injury.
Symptoms that are typically associated with meniscal tears include knee pain, knee stiffness, swelling, a catching or locking sensation, and the feeling of the knee “giving way.” Occasionally, individuals may hear or feel a “pop” when the meniscus is torn. Stiffness felt after injury is often due to swelling or inflammation in the knee joint. When tissue is injured, swelling or inflammation occurs to carry healing properties to the area so the healing process can begin. If there is significant swelling, it may be limiting your ability to bend or straighten your knee through its full range of motion. The locking sensation noted above is often when the torn piece from the meniscus gets pinched or caught between the two bones in your leg. With this type of injury, your muscles at and around the knee joint may also develop some weakness from the inflammation as well as from resting from any activity that aggravates your pain. Weakness often is the culprit when the sensation of “giving way” occurs. The muscles at and around the knee joint are now weak and cannot adequately support and stabilize the knee, causing this sensation.
Physical therapy is an excellent treatment option if you have a torn meniscus. Your physical therapist will be able to assess and evaluate your knee and the symptoms you have been experiencing and determine any deficits in range of motion, strength, endurance, and balance. Once your limitations are noted, your physical therapist will develop a plan to help reduce pain, reduce swelling, improve range of motion, increase your strength, endurance and balance. Your therapist may also use different treatment techniques and modalities such as ultrasound and electrical stimulation to help reduce your pain. Electrical stimulation uses adhesive electrodes and a small device that delivers an electrical current to your skin and underlying muscle fibers. When applying electrical stimulation, you will initially feel a tingling or pins and needles sensation. This helps to block pain signals and helps your brain and body focus on that sensation instead of the painful sensation. Electrical stimulation also helps to relax the muscles when combined with moist heat and is generally very enjoyable and comfortable. Once your pain has been minimized, your therapist may begin a more intense strengthening program that incorpoates strengthening all the muscles in your legs especially your hip musculature so your knee is adequately supported. You may also begin balance or proprioceptive exercises to help improve your balance and eventually return to your desired sport or exercise routine.
If you are showing the signs and symptoms or have already been diagnosed with a meniscal tear, or for more information on physical therapy services, call Total Performance Physical Therapy and schedule an appointment today!