Rehabilitation following a meniscus injury

REHABILITATION FOLLOWING A MENISCUS INJURY

Introduction:
Meniscus injuries in the knee are common. The meniscus is a crescent-shaped cartilage structure in the knee joint. Its main role is to cushion impacts and distribute the load during movement. In this article, we will take a look at the functions of the meniscus, the most common injuries, the associated symptoms, the treatment options, surgical intervention and the importance of rehabilitation for full recovery.

1. The functions of the meniscus:The meniscus has several functions in the knee joint. These include:
   • Cushioning: The meniscus acts as a cushion that absorbs the impacts and distributes the load in the knee joint during movement. Without the meniscus, the bone surfaces could be in direct contact, causing friction and wear.
   • Stability: The meniscus helps to maintain the stability of the knee joint, reducing the risk of excessive movements or joint instability. It helps to prevent the bones from moving too far from each other.
   • Lubrication: The meniscus helps to lubricate the knee joint, reducing the friction between the joint surfaces and making the knee movement more fluid.
2. The most common meniscus injuriesMeniscus injuries can occur as a result of direct trauma, such as twists or impacts on the knee, or due to sudden, excessive movements of the knee. The most common injuries include:
   • Medial meniscus tear: Affects the meniscus on the inside of the knee. This is the most common meniscus injury.
   • Lateral meniscus tear: Affects the meniscus on the outside of the knee.
   • “Bucket handle” meniscus tear: This occurs when a piece of meniscus becomes detached and moves inside the joint, causing instability.
3. Symptoms on meniscus injury:The symptoms of a meniscus injury may vary depending on the severity and location of the injury. The most common are:
   • Pain in the knee: The pain may be acute or persistent and may occur both during movement and at rest.
   • Swelling and inflammation: The knee joint may swell due to the production of synovial liquid in response to the injury.
   • Catching or locking sensation: The meniscus injury can cause temporary locking or catching sensations in the knee when moving.
   • Limitation of movement: The injury can cause difficulty in bending or completely stretching the knee, limiting the range of movement.
   • Feeling of instability: The knee may feel unstable or give way during movements or stress.
4. Treating a meniscus injuryThe treatment for a meniscus injury depends on the severity and location of the injury, as well as the presence of any other joint problems. The treatment options may include:
   • Conservative treatment: If the injury is minor and does not involve major symptoms, it may be possible to manage it with conservative methods. This may include rest, ice, compression and elevation (RICE), drugs and instrumental therapy to control the pain and reduce inflammation, as well as physiotherapy to strengthen the surrounding muscles and improve the stability of the knee.
   • Arthroscopy: If the meniscus injury is serious, compromises the knee function or does not respond to conservative treatment, arthroscopy may be recommended. During the surgery, small cuts are made in the knee joint using an arthroscope, which is inserted into the joint to repair or remove the damaged meniscus.
5. Surgery following a meniscus injury:If the meniscus injury is severe or does not respond to conservative treatment, surgery may be required. Surgery can be performed in different ways, depending on the location and severity of the injury.
   • Meniscus repair: In some cases, the meniscus can be repaired using sutures or other means to join the injured parts. The procedure is usually preferred when the injury is in a well-vascularised area and can heal well.
   • Resection of the meniscus: If the injury is widespread or cannot be repaired, it may be necessary to remove the damaged part of the meniscus. This procedure is known as partial or total meniscectomy.
6. Rehabilitation of the knee after a meniscus injury:Both following surgery and in the case of conservative treatment, rehabilitation plays a fundamental role in full recovery. The physiotherapist works closely with the patient to define a customised rehabilitation programme, which begins gradually after surgery or immediately after the injury. Some key points of rehabilitation include:
7. Pain and inflammation control: Physical treatments are used, including TECAR, LASER or Cryotherapy, to relieve the pain and reduce inflammation in the knee joint.
8. Recovering mobility and flexibility: Passive joint mobilisation and stretching exercises are introduced to gradually recover knee mobility and flexibility.
9. Muscle strengthening: Once the knee has healed sufficiently, muscle strengthening exercises are prescribed for the quadriceps femoris muscles, the hamstring and the hip and leg muscles, to recover strength and stability in the knee.
10. Proprioceptive re-education and balance: Specific exercises are introduced to improve the balance, coordination and stability of the knee.
11. Physiotherapy:Physiotherapy plays a crucial role in the management of meniscus injuries. The physiotherapist works closely with the patient to assess the type and severity of the injury, customising the treatment plan accordingly.Physiotherapy may include:
    • Manual therapy: The physiotherapist may use manual therapy techniques, including joint mobilisation and myofascial release therapy, to improve mobility and reduce the muscle tension around the knee.
    • Specific exercises: Targeted exercises are prescribed to improve the strength, stability and flexibility of the knee, with a view to full recovery and to prevent any complications.
    • Instrumental therapy such as TECAR, LASER or Ultrasound: These treatments can be used to reduce pain, accelerate tissue healing and improve the circulation around the knee

Conclusions:
Rehabilitation following a meniscus injury is essential for full recovery and restoring the functionality of the knee. In some cases, if the injury is serious, surgery may be required to repair or remove the torn meniscus. Whatever the type of treatment, rehabilitation plays a crucial role in the recovery of the knee functions. Working closely with a physiotherapist, excellent recovery can be achieved, reducing pain and returning to everyday activities and sport with a better quality of life.