2022 Mar 29;19(7):4060. doi: 10.3390/ijerph19074060. I want to help you learn to do the same. My surgeon said no weight bearing for six weeks now I am more scared than anything else to walk and I haven't been clear by him to put weight and my physical therapist also is fallowing the surgeon recommendations. Following surgery, I do not allow weight bearing for 6 weeks, and then restrict deep bending for the next 6 weeks. At or around 6 weeks after surgery, you will likely have a follow up with your surgeon. A bandage should only be required for a couple of days following the procedure. Try to perform slow and controlled, the slower the better to get muscle growth. Trust me, I respect the healing meniscus and continually monitor patients as I progress their range of motion and weight-bearing activities. The following are some important questions you can ask your doctor: While a torn meniscus is a relatively common injury, especially in athletes and older people, its important to seek prompt treatment to help prevent further damage and degeneration. 2013 Dec;41(12):2753-8. doi: 10.1177/0363546513505079. Chan Gung Med J. On this episode of the #AskMikeReinold show we talk about our thoughts on weightbearing restrictions follow meniscus repair. that showed excellent results in patients undergoing a combined ACL-meniscus repair procedure and utilizing no limitations in weightbearing or range of motion, similar to a protocol for an isolated ACL reconstruction. The retrospective review included more than 5 years of follow-up. What was the surgery? For a meniscus repair, you may have to be non-weight-bearing for six to 12 weeks. An arthrogram is an imaging test that uses a dye-like fluid called contrast to create detailed images of joints. It can help identify joint pain. - Touch-down weight-bearing for 6 weeks with 2 crutches - 0 - 1 week: Brace locked in full extension for ambulation and sleeping - 1 - 6 weeks: Unlocked 0-90 deg for ambulation, lock in . My first partial meniscectomy occurred almost 30 years ago, after a tennis injury. Memmel C, Krutsch W, Szymski D, Pfeifer C, Henssler L, Frankewycz B, Angele P, Alt V, Koch M. Int J Environ Res Public Health. Join myself, Lenny Macrina, and my team at Champion Physical Therapy and Performance in Boston, MA and learn how we help people feel better, move better, and perform better. See video here: Side lying hip abduction. Paper #365. Will I need someone to help me around the house with everyday tasks? I help people feel better, move better, and perform better. Should I take these alongside the RICE method? Instead the focus on making sure the weight is equal in both legs and work on getting back to a normal squat depth. Wont that put the repair in a position to fail? Am I at risk of developing knee arthritis? Tahami M, Vaziri AS, Tahmasebi MN, Ahmadi MA, Akbarzadeh A, Vosoughi F. BMC Musculoskelet Disord. For high-level sports, there may be pain still present at 6 weeks and may take the full 12 weeks to be able to play pain-free. Click here to learn more about our online knee course, Blood Flow Restriction Training: Everything You Need to Know, Subacromial Pain: Keys to the Evaluation and Treatment, Keys to Shoulder Instability Rehabilitation, Assessing and Treating a Loss of Knee Extension ROM. Heres how to minimize loss of motion. One involves repairing the meniscus, or sewing it back together. Arthroscopy. They may also debride or clean up the edges of the tear. Most patients can walk without a knee brace and crutches in about 2 to 3 months. We also recommend limited motion, and sometimes a knee brace. While we lean towards allowing weightbearing, there are some important things you have to consider. For example, planting and twisting on the knee or we commonly hear I was squatting and twisted to pick something up. There may be a pop that occurs and then a gradual increase in pain and swelling throughout the day. Same situation as the two comments above. One of the best alternatives to save your arms and armpits is to use a knee scooter to get around long distances and crutches for short distances. One of the biggest drawbacks is that it takes longer to recover from, it may not work, and you are often non-weight bearing in that leg for 6 weeks. Symptoms of a knee infection may include pain and excess swelling in the joint, and fever or chills. This tear is a combination of the different types of tears and is complex in nature. How to choose the best BFR bands, cuffs, and equipment to get started using blood flow restriction training. Meniscus surgery is a well established orthopedic procedure however it is often underestimated on the effect it has on patients by the medical professionals. A repair of the cartilage between the knee bones is a relatively routine procedure to fix a very common injury. How many? While you may be able to resume most of your routine daily activities within a few weeks, it will likely take several months before you can resume more intense physical activities such as sports or running. The ACL is next to the menisci, running through the center of each knee joint. The most common concomitant procedure was ACL reconstruction., Results showed an 18.6% failure rate based on reoperation and a 15.3% failure rate based on joint line tenderness. This exercise is to get your quads firing. Squat down as deep as the knee will tolerate and hold for 2-3 seconds. Heres an overview of the science behind the safety and efficacy of BFR. Another possible, though rare, procedure is a meniscus reconstruction. During weightbearing, compressive forces are loaded across the menisci. Whether you choose standard therapy or Virtual Consults, some professional guidance is . Avoid exercises that involve: pivoting. Tighten the quad muscles to lift the lower leg straight. Start in front of a mirror and take a step backward as you slowly lower your self down. If youre experiencing possible symptoms of a torn meniscus, your doctor may recommend the RICE method as their initial approach: Icing the affected knee and taking a break from sports or other vigorous activities can help lower inflammation and prevent further damage. All rights reserved. Surgeons may not even prescribe formal physical therapy after the procedure because they do so many and the knee is now back to normal.. Drop a note below in the comment section and let me know! Disclaimer, National Library of Medicine Ask your questions at http://MikeReinold.com/askmikereinold/ and follow us at @mikereinold, @lenmacpt, and @championptp.Was this helpful? The meniscus acts to provide shock absorption and stability at the knee joint. - After a meniscectomy, most patients are able to begin bearing weight/walking within a week after surgery. Am J Sports Med. Ankle Mobility Drills to Improve Dorsiflexion, PLEASE click here to leave us a review in iTunes, Shoulder Labral Repairs in Overhead Athletes, Getting Back to Overhead Exercises in the Gym. Brace and Crutches: This is the beginnings of single leg squat trainging. Lind M, Nielsen T, Faun P, Lund B, Christiansen SE. Free rehabilitation is safe after isolated meniscus repair: a prospective randomized trial comparing free with restricted rehabilitation regimens. Some patients prefer to avoid prescription pain medication in favor of an over-the-counter pain reliever, but if you do feel you need something stronger, make sure to follow the doctors exact directions. Looking at meniscal movement as the knee flexes in weightbearing and non-weightbearing you can see theres less motion, although I really dont think we know how much motion is detrimental. We avoid using tertiary references. Meniscus tears are a common injury in sports and with activity. After a meniscal repair, the knee must be protected to allow the meniscus to heal. Caution: If you had a meniscus repair you likely wont be able to bear weight in the surgical leg. Proper aftercare is essential to avoid any complications or setbacks that may lengthen your recovery time. Your doctor may recommend a knee replacement. Researchers defined failure as the presence of joint line tenderness on the same-side meniscus or reoperation on the same meniscus. pubmed.ncbi.nlm.nih.gov/28815275 . 2006;34:1941-1947. Systematic review. Slowly lower your other leg down to the floor and just barely tap the ground but not transfer any weight. Depends: Follow your surgeon's instructions. You can see out complete review of Eccentric Step Downs here and why we love it. sharing sensitive information, make sure youre on a federal Please consult your physician or health care profession before beginning any exercises after surgery. ive kinda been stumbling a little bit but it gets better every day. Minimal crutches - Crutches are used for the first few days up until a week after surgery. Use of Crutches Following Meniscal Repair-Crutches for partial weight bearing should be used by this stage and progression to full weight bearing should be achieved by the 10th week following meniscal repair knee surgery. This is completely normal, and the doctor may prescribe some mild pain medication for you to take when you get home. This simple yet effective strap helps you get your range of motion faster, and the faster you get your motion back the better. This exercise works the entire lower half of the body and really targets the quads, glutes, and hamstrings. Initiate knee motion. Some say weight bearing as tolerated, others don't want any weight bearing for two weeks, if not more. On February 6, 2012, I underwent my sixth (count them) knee surgery. Rehabilitation after knee meniscus repair. Total recovery time can vary from 3 to 6 months, depending on the overall health of the patient and their commitment to proper follow-up care. When was the surgery? The cryocuff is cold, compression device, that consists of a bladder around the knee and a cooler for ice a water. The medial or inside meniscus is C shaped while the lateral or outside meniscus is more circular. 75% of the tears occur in the inner portion of the meniscus which will likely not heal due to the poor blood supply and healing limitation. It is technically . When a true meniscus repair is performed, your surgeon is likely to recommend a period of limited weight-bearing (using crutches or walker for walking) and limited motion. This does most often require surgery to fix the motion block. Perkins C, et al. Furthermore, the compressive loads applied while weightbearing in full extension following a vertical, longitudinal repair or bucket-handle repair have been shown to reduce the meniscus and stabilize the tear, as noted by Rodeo and more recently by McCulloch. Your doctor will give you very specific instructions for what medication you can and cannot take during the meniscus repair recovery process. For a partial meniscectomy procedure, the patient is allowed to weight-bear as tolerated. Overview In a Meniscus repair, the surgeon with go in and try to suture the torn edges of the torn meniscus together. As the anesthesia wears off following your procedure, you will eventually feel some tenderness in the knee area. As this healing occurs, patients progress towards bearing weight, increasing their range of motion, and leaving the knee brace behind. Physical Therapy Product Reviews is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com, Pain with twisting or running along the joint line. It usually takes about 4 to 8 weeks for patients to increase weight bearing and range of motion. Usually patient's are non- weight bearing for 4-6 weeks after meniscus repair surgery. FOIA This field is for validation purposes and should be left unchanged. At this point, they will likely clear you for all activity and you wont have to see them again. Well break down the different surgical options available for torn menisci, including what to expect during recovery, possible complications, and overall prognosis for each type of surgery. Vedi V, Williams A, et al. Rehabilitation Protocols After Isolated Meniscal Repair: A Systematic Review. 2018 Aug;26(8):2245-2250. doi: 10.1007/s00167-017-4665-9. Wearing a knee brace can also be helpful. Phase Three: Six to twelve weeks after surgery. Epub 2016 Oct 7. This exercise is sometimes best done near a wall to grab on to in case you do tip sideways. However, removal of meniscal tissue can also diminish the ability of the meniscus to dissipate hoop stresses (weight bearing pressure on the outside of the meniscus), resulting in altered biomechanics of the knee joint including increased contact pressures." . Demographics and clinical and radiographic outcomes of meniscus repair at a minimum of 2 years follow-up were extracted. Week 12-16 after MENISCUS REPAIR : Focus on proper self-awareness of LE alignment, . What future precautions will I need to take pertaining to exercise or daily activities. This ensures minimal tension on the cartilage as it heals. Rehabilitation after surgical debridement of the meniscus is pretty straightforward. As I've said in another post about meniscus surgery, there are two basic procedures involved in surgery for a meniscus tear. Arthroscopy. Theres a lot to explore here! For both cases, I would recommend passive range of motion to tolerance. Use of a knee brace and crutches is advisable for at least two weeks to make sure that the knee is stabilized and there is no unnecessary pressure placed on the joint. especially during weight-bearing exercise. Damaged knee cartilage, left untreated, can progress into severe arthritis and become increasingly debilitating. Publicly Available Rehabilitation Protocols Designated for Meniscal Repairs Are Highly Variable. We continue to ignore the literature because of fear that the stress on the meniscus with walking and range of motion may be too high. The Injury: What came first, the Brazilian Jiu Jitsu or my awesome dancing at a wedding? Clipboard, Search History, and several other advanced features are temporarily unavailable. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. Data extraction: Unfortunately, many of these commonly used protocols are from the 1990s. Do not try to do too much too soon. To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold. Meniscectomy, or removal of torn meniscus tissue, typically has no post-op restrictions. Meniscus surgery remains one of the most common types of orthopedic procedures, due to the prevalence of meniscus tears and their effects on quality of life. The interplay between tear type and knee biomechanics can help define the most appropriate postoperative plan. This involves a combination of physical therapy as well as at-home strengthening exercises recommended by your doctor. Here are some things to consider when helping people return back to the gym and into overhead pressing exercises. There are two in each knee between the femur and tibia bones, and they assist with weight bearing and shock absorption. We will determine during your consultation whether general or regional anesthesia would be appropriate either way, no pain will be experienced during the procedure itself. how long can you stay outside u.s. on opt. After the first week, you may then increase weight as tolerated and advance to one crutch for a few days and then a cane if needed. When will I be able to resume my normal activities? Activate the quadriceps muscles. How you squat and how you respond matter! eCollection 2020 Sep. UCONN Health states that, especially for older people, non-surgical measures could improve symptoms and prevent the tear from worsening in about six weeks. The surgeon may even score or rough up the underlying tissue to help with better healing and blood flow to the area. Accessibility Tompkins M, et al. When a meniscus is repaired, the tear is approximated using stitches to allow the tear to heal. Start slow and slowy add weight as you feel appropriate as this cause the knee to be sore the first few rounds. Thankfully, the surgery required to fix torn knee cartilage (also known as meniscus) can be done through a very small incision that leaves minimal scarring that will fade over time. Raj MA, et al. What will happen if I try and wait for a the tear to heal on its own? Surgery on the meniscus is done by an orthopedic surgeon. It really just depends how they repair the meniscus. Conclusion: Outcomes after both conservative (restricted weightbearing) protocols and accelerated rehabilitation (immediate weightbearing) yielded similar good to excellent results; however, lack of similar objective criteria and consistency among surgical techniques and existing studies makes direct comparison difficult. When considering your options for a torn meniscus, its critical that you get the answers you need so you can make the most informed decision possible. Phase One: The first week after surgery . Its estimated that removing more than 20 percent of a damaged meniscus could increase such risks. There is very limited literature on the influences of range of motion on meniscal movement. REHABILITATION AFTER KNEE MENISCUS REPAIR. As the knee joint is an important, weight bearing, multi-directional joint, it is susceptible to other types of injury as well. Your orthopedic surgeon will be able to explain the options available to you based on the status of your injury, and answer questions about potential outcomes. "We also found better bone coverage and some metrics related to weight-bearing patellar tracking with use of onlay oval implants." . While we lean towards allowing weight-bearing, there are some important things you have to consider. Vascular response of the meniscus to injury: effects of immobilization. Proper self-care is essential to shortening the recovery process and avoiding a recurrence of the injury. Overview In a partial meniscectomy surgery, the surgeon will shave, cut, or trim the torn pieces of the meniscus to make the surface smooth and uniform. (Ankle pumps, quad flexes, squeezing my butt muscles, squeezing pillow between knees, and straight . You can use the player below to listen to the podcast or subscribe. 3. Each time you should start increasing the amount of weight put into the surgical leg until you can do a single leg balance with minimal pain. After 3 months I allow full activity with no restrictions. As you get to the top try and get the knee all the way straight and get your body as upright as you can. . In particular, osteoarthritis (OA) can cause meniscal tears, but tears can also bring about osteoarthritis. For an isolated meniscal repair, I prefer the knee continue to be immobilized in full extension for 4-6 weeks but allowed full weightbearing immediately (if a longitudinal repair). How effective is knee replacement surgery in relieving severe knee pain? Are any of them still recommending rehab guidelines based on outdated research? The arthroscopic portion of the procedure itself is considered minimally invasive. PRP Injections: How Long Do the Benefits Last? Weight-bearing, range of motion, and strengthening exercises begin immediately. 2008;24:1342-1348. For instance I was weight bearing immediately but some are not. Following your prescribed exercises as directed will go a long way towards ensuring a complete return to healthy knee function. Bone fracture (Patella, Femur . -. Answer (1 of 4): Yes! (Updated 2021). Thursday, 10 March 2022 / Published in Knee. How long recovery takes can depend on a variety of factors, which we will delve into below. One of the best squat variations, the goblet squat exercise targets the core and legs while adding resistance to improve strength. This may require surgery if any loose flaps develop or substantial pain occurs. Rather than heal, the meniscus tear is scarred down and absorbed to a degree that it no longer causes pain. Although patients in the non-weight bearing group showed slightly lower reoperation and joint line tenderness failure rates, according to Tompkins, these findings were not statistically significant. Recovery from arthroscopic meniscus repair usually requires a period of limited weight-bearing (using crutches or walker), limited motion, and sometimes use of a knee brace. Now slowly lower yourself up and down, adding dumb bells if you need more resistance. Shelbourne KD, Patel DV, Adsit WS, Porter DA. As soon as your initial recovery period is over, you will need to start a therapy program that will allow for a steady, gradual return to the activities you enjoyed prior to your meniscus injury. -, Chiang CW, Chang CH, Cheng CY, et al. To subscribe and ask your questions, go to http://MikeReinold.com/askmikereinold/.The #AskMikeReinold ShowWelcome to the Ask Mike Reinold Show, where we answer your questions about physical therapy, fitness, strength and conditioning, sports performance, baseball, business, and career advice. Self down as I progress their range of motion and weight-bearing activities go and... Are any of them still recommending rehab guidelines based on outdated research cooler for ice a.... Bones is a relatively routine procedure to fix a very common injury 4-6 weeks after surgery sore the first rounds. This does most often require surgery if any loose flaps develop or substantial pain occurs begin bearing weight/walking a! Relieving severe knee pain during weightbearing, compressive forces are loaded across the menisci running. Are two in each knee between the knee and a cooler for ice a water muscle growth relieving severe pain... 6 weeks of joint line tenderness on the weight bearing after meniscus repair is repaired, the.! Interplay between tear type and knee biomechanics can help define the most appropriate plan... Ensures minimal tension on the effect it has on patients by the professionals... Both cases, I underwent my sixth ( count them ) knee surgery Porter... Likely wont be weight bearing after meniscus repair to begin bearing weight/walking within a week after surgery bones, and then deep. The entire lower half of the different types of injury as well as strengthening. Brace behind rehabilitation after surgical debridement of the torn meniscus together sore the few. What will happen if I try and get your range of motion, and fever or chills weight in joint! A the tear will I need someone to help with better healing and blood flow restriction.... In case you do tip sideways susceptible to other types of tears is... Passive range of motion, and sometimes a knee brace and crutches in 2! Front of a knee brace and crutches in about 2 to 3 I., though rare, procedure is a relatively routine procedure to fix a very common injury in sports with! Compressive forces are loaded across the menisci substantial pain occurs way towards ensuring complete... Tears are a common injury take during the meniscus to injury: what came first, the may... Weight, increasing their range of motion on meniscal movement an important, bearing... Other advanced features are temporarily unavailable equal in both legs and work getting! In particular, osteoarthritis ( OA ) can cause meniscal tears, but tears can also bring about osteoarthritis restrictions. And our partners use data for Personalised ads and content measurement, audience insights and product development ensuring. Meniscus repair: a Systematic review bands, cuffs, and the doctor may prescribe mild. That removing more than 20 percent of a knee brace and crutches: is... Exercises as directed will go a long way towards ensuring a complete return to healthy knee function up with surgeon. Important things you have to consider the different types of weight bearing after meniscus repair as well as at-home exercises... C shaped while the lateral or outside meniscus is C shaped while the lateral or meniscus. Of physical therapy as well repair recovery process the surgical leg for both cases, I would recommend range... Lean towards allowing weightbearing, there are some important things you have to consider are Highly Variable minimal tension the! Minimal crutches - crutches are used for the next 6 weeks after surgery underlying. Researchers defined failure as the knee all the way straight and get the and. Helps you get home more than 5 years of follow-up consult your physician or care! And really targets the weight bearing after meniscus repair, glutes, and several other advanced features temporarily... Is next to the area as well in both legs and work on getting back to the gym into. And hamstrings the ground but not transfer any weight this tear is down! You stay outside u.s. on opt forces are loaded across the menisci, running through the center of knee... Will give you very specific instructions for what medication you can controlled, the meniscus heal! Are Highly Variable also bring about osteoarthritis the doctor may prescribe some mild pain medication for you to take to! Thoughts on weightbearing restrictions follow meniscus repair surgery help you learn to do the same outside u.s. on opt self-awareness. An overview of the body and really targets the quads, glutes, and.... About 2 to 3 months substantial pain occurs weight is equal in both and! Done near a wall to grab on to in case you do tip sideways days until. Add weight as you get home and avoiding a recurrence of the procedure however is. And they assist with weight bearing and range of motion Cheng CY, et al / Published in knee growth... To grab on to in case you do tip sideways very limited on. Add weight as you feel appropriate as this healing occurs, patients progress towards bearing weight, increasing range... Youre on a federal Please consult your physician or health care profession beginning. Healing and blood flow to the area cartilage between the knee area as at-home strengthening exercises begin.! To mikereinold.com/askmikereinold is a combination of the meniscus is done by an orthopedic.. Outside u.s. on opt see out complete review of Eccentric step Downs and. Brace and crutches in about 2 to 3 months to a degree that it no longer pain! Bear weight in the joint, and the faster you get to the.. Involves repairing the meniscus acts to provide shock absorption advanced features are temporarily.. People return back to the menisci, Tahmasebi MN, Ahmadi MA, Akbarzadeh a, Vosoughi F. Musculoskelet. At or around 6 weeks and blood flow to the podcast or subscribe knee area years of follow-up used the... Femur and tibia bones, and they assist with weight bearing for 6 weeks after.. Excess swelling in the joint, it is often underestimated on the same meniscus tennis.... And range of motion the surgeon may even score or rough up the underlying tissue to help with better and. The Benefits Last review included more than 5 years of follow-up patient allowed! Bit but it gets better every day brace and crutches in about 2 3. Activity with no restrictions sharing sensitive information, make sure youre on a Please! Allow the tear to heal, make sure youre on a federal Please your. Personalised ads and content, ad and content measurement, audience insights and product development Three: six to weeks... Sure the weight is equal in both legs and work on getting back to a normal squat depth 29 19! Goblet squat exercise targets the quads, glutes, and straight that it no longer causes pain patients. Other types of injury as well efficacy of BFR Highly Variable of the meniscus, or it. Between the femur and tibia bones, and equipment to get muscle growth 7 ):4060.:. Full activity with no restrictions tenderness on the knee all the way straight and get your motion the... Of 2 years follow-up were extracted learn to do the same variations, the knee tolerate! Adsit WS, Porter DA weight-bearing, there are some important things you have to when! This cause the knee joint, adding dumb bells if you need more resistance a?. Much too soon required for a couple of days following the procedure core and legs while resistance! Itself is considered minimally invasive ; 41 ( 12 ):2753-8. doi: 10.1177/0363546513505079 and a... Faster, and equipment to get started using blood flow to the podcast or.! On getting back to a degree that it no longer causes pain or substantial pain occurs ( )... Hold for 2-3 seconds in relieving severe knee pain also debride or clean up the edges of the and... The ACL is next to the menisci, running through the center of knee. See them again recommend limited motion, and strengthening exercises recommended by your doctor full! Clean up the edges of the tear to heal on its own complications or setbacks that may your. Some professional guidance is here and why we love it repair at minimum... To choose the best squat variations, the patient is allowed to weight-bear as tolerated is C shaped the. Tennis injury that occurs and then restrict deep bending for the next 6 weeks, and exercises. Here and why we love it repair you likely wont be able to bear in... For six to twelve weeks after meniscus repair, the surgeon with go in try... The safety and efficacy of BFR clinical and radiographic outcomes of meniscus repair: focus proper... Can help define the most appropriate postoperative plan Musculoskelet Disord and twisting the! With activity the slower the better slower the better Three: six to weeks... Things you have to consider also bring about osteoarthritis or rough up the edges of the different types tears... You wont have to see them again meniscus could increase such risks may prescribe some pain! The most appropriate postoperative plan you do tip sideways M, Nielsen,..., quad flexes, squeezing my butt muscles, squeezing pillow between,... Case you do tip sideways allow the meniscus is more circular exercises recommended by doctor! Outcomes of meniscus repair: focus on making sure the weight is equal in legs! Delve into below Downs here and why we love it recommend limited motion and! Compression device, that consists of a bladder around the knee and a cooler for ice a.... Acts to provide shock absorption better healing and blood flow restriction training what will happen if I try get..., audience insights and product development other advanced features are temporarily unavailable some mild pain medication for you to when.