Torn Cartilage Knee Injury Rehabilitation
Stage 1
| Common Signs & Symptoms | |||||
| Pain | Swelling | Stiffness | Weakness | Instability | Locking |
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The following programme is that typically used by a professional football player who has undergone an arthroscopic meniscectomy.
If the medial meniscus (inner side compartment of the knee) has been operated on, the rehabilitation time is usually quicker than if the lateral meniscus (outer side compartment of the knee joint) has been operated on. In the case of an arthroscopic meniscal procedure involving the lateral meniscus the rehab will usually take 6 -8 weeks. In the case of the medial compartment it may be possible to return to sport after 3 or 4 weeks.
Ex-Rangers and Scotland player Ally McCoist once famously returned to playing in less than two weeks after arthroscopic meniscal surgery. The length of rehabilitation is dependent upon which meniscus is affected, exactly where the tear is, the size of the tear and the amount of meniscus which is removed by the surgeon.
On discharge from hospital the patient may be on crutches. With the permission of the consultant, the physiotherapist can begin teaching a normal gait pattern so that the patient can resume walking normally. If there is still a limp it is too early to walk without crutches.
Any residual swelling should be controlled with a compression device such as a cryocuff or flowtron pneumatic unit. These both have the effect of squeezing the knee joint, helping the excess fluid within the joint to disperse.
Isometric quadriceps and hamstring exercises should be initiated:
- An isometric quads contraction is achieved by siting on the floor with the legs straight and then pushing the back of the knee down towards the floor. This contraction should be held for 4 seconds and then relaxed.
- To do an isometric hamstring contraction the patient should sit in a chair with the heel to the floor, and then dig the heel into the floor, as if trying to drag the foot backwards. Again this contraction should be held for 4 seconds.
The isometric quads and hamstring work should be done in 5 sets of 10, repeated 3-4 times per day.
Range-of-movement exercises should be initiated as soon as possible. Extension of the knee is achieved via the isometric quads exercises. Knee flexion is regained by sitting on the floor with the knees out straight, and then attempting to bend the knee. This can be made easier by placing something that slides easily, like a plastic bag, under the heel, then sliding the heel up and down. Another method of increasing the knee's range of movement is to sit in a high chair with the feet hanging free. The affected leg should be swung backwards and forwards, with the range of movement gradually increased over time.
