Meniscal Tear Rehabilitation.

What is meniscus?

 The meniscus act as a cushion between the femur and tibia bones.

There are two menisci in each knee joint.Medial menisci are "c" in shape and the lateral menisci are circular in shape.Lateral menisci bears more weight compare to the medial menisci.

While doing the rehabilitation physiotherapist should take care of some general things.

The physiotherapist should assess the gait pattern regularly to avoid the compensatory gait. After surgery the knee should be placed in a hinged brace with knee in full extension for four weeks. As per the surgeons advice the weight bearing can give. Avoid lateral and twisting movements in the knee for twelve weeks. Surgical wounds and associated tissues should be mobilized manually.

Week- 1

1.Apply ice an elevate the limb in every two hours for 15-20 minutes.
2.Straight leg raising exercises can be given in lying, siting and standing.
3.Ankle pumps, quadriceps, gluteal sets can be given.
4. C.P.M, well leg static cycling and allow the knee to hang in pain free range with light stretch.

Goals:

 Decrease the pain and edema. With in one week the patient should meet a range of  0 to 70 degree.
Crutches can be used for gait and the knee should be in a hinge brace and locked in extension.Around 50% of the weight bearing can be given.


Weeks-2 to 4

1. Continue the same for pain and edema, and continue the previous exercises.
2. Aerobic exercises -unilateral cycling, single leg row machine and Schwinn air dyne with uninvloved leg and arms only.

Goals:

In addition to the 1st week goals the passive range of motion should be in 0-90 degree.

The gait and the walking aid support are same.

Weeks-4 to 6

1.As per the surgeons advice the knee brace can be remove.

2.Continue the same exercise and  incorporate functional exercises like partial squats, calf raises.

3. Treadmill with minimal speed and the static cycle with minimal resistance.

Goals:

  

Wean off crutch and brace and passive range of motion 0 to 120 degrees.

Week- 6 to 8

1. Continue the same for pain, edema and R.O.M and increase the intensity of exercises.

Goals:

Passive range of motion 0 to 135 degree and tolerate squats up to 90 degree.

Gait no limp.

Weeks- 8 to 12

1.Continue the same as above and add lateral training exercises like side step ups and lateral stepping.

Goals.

Full range of motion and initiate lateral training with no resistance.

Weeks- 12 to 16

1. Initiate return to running program 

2.Increase the intensity of strength 

Goals:

Full range of motion and running normally in treadmill.