The Knee: The Body’s Shock Absorber
The knee is a stabilizing joint in the lower body that transfers force from the ground up, and the upper body downward. It is this act of force transfer that can often lead to injuries in the knee. The menisci are cartilaginous cushions on either side of the knee joint that help absorb these forces and protect the knee.
The most common mechanism of injury to the menisci are excessive lateral force, often seen in aggressive contact sports, or twisting with weight-bearing, which often occurs when landing during sports such as gymnastics, dance, and snowboarding. There are several different types of meniscal tears that can occur, depending on the mechanism of injury.
While some of the more minor tears can heal with non-surgical intervention, the more severe tears, such as the bucket handle tear, require surgery and rehabilitative exercise. As I have mentioned in previous posts, the primary goal after surgery is to regain range of motion as soon as possible. For meniscal tears, and most other knee injuries, this can be achieved with an exercise called the heel slide. During this exercise the patient lies on the ground with their shoes off so the heel of the affected knee can slide away from and towards the body. This exercise should be repeated multiple times throughout the day for the first 7-10 days of recovery. Once the knee has regained sufficient mobility, the patient can then progress to stabilization exercises using a bosu or wobble board to work on proprioception.
The next step in recovery is strength training, which should begin with non-weight bearing isometric contractions of the quads and slowly progress to weight-bearing exercises for the quads, hamstrings, abductors and adductors, and commence with performing these weight-bearing exercises with resistance. Such exercises include squats, lunges, glute bridge, hip ab/adduction, leg press and leg extension. Only once the knee is COMPLETELY healed and the patient is not experiencing any pain or swelling should you progress to more complex workouts that include plyometrics and agility drills for sport specific training. Rehab can be a long and tedious process, but it is a necessary one in order to heal correctly and reduce the risk of reinjury!