Modern & measurable results

Physical Therapy for Meniscus Injury.

Physio Vital stands for modern physical therapy. In our physical therapy practice, the focus is on orthopedic rehabilitation. This means that we treat injuries to tendons, muscles, bones and/or joints. Sometimes nerves are indirectly involved. We make the treatment plan as transparent as possible so you understand where you stand. Our approach consists of a combination of the latest scientific insights combined with years of expertise in the field of injury treatment. Within these frameworks, we offer an exclusive service and there is always room for personal preference. Our treatment is designed to give people back their autonomy over their bodies. Fysio Fitaal Tilburg consists of a team of experts with a passion for physiotherapy and always goes for a sustainable result.

The knee has a medial (inner) meniscus and a lateral (outer) meniscus. The meniscus looks like two half-shaped moons sitting on the lower leg. When the knee has to make a quick and forceful rotational movement during sports, a meniscus injury can occur. Because inner meniscus is attached to the capsule of the knee, it gets damaged much faster. When the knee moves into a vulnerable position, the inner meniscus is much less flexible and, as a result, much greater forces are released on the inner meniscus. In addition to this acute form of meniscus injury, the injury can also develop gradually. Minor injuries can also cause long-term symptoms. Also, just like other structures in our body, the meniscus is subject to natural aging, which can potentially cause complaints over time

Trochantor major syndrome
Symptoms in a meniscus injury:
    • Pain is often on the side of the knee(inside or outside).
    • Squatting, climbing stairs and standing for long periods of time are often painful.
    • Often the knee gives swelling after loading.
    • Sometimes locking symptoms occur; the knee suddenly cannot be bent or stretched properly.
    • All of these symptoms can occur immediately after the injury moment or gradually increase.
How to diagnose a meniscus injury

If your knee is thick the next day after sports or after an injury moment, the meniscus may be affected. Often you can no longer bend and stretch properly. You may also experience an unstable feeling and the knee may sometimes lock up. The diagnosis becomes official only after an MRI or even keyhole surgery. If your knee is really locked and you can no longer get the knee out of this position, then you need surgery sooner to remove this restriction.

Physical testing of humanicus

Often the diagnosis is already fairly clear when the previously mentioned symptoms are present. To confirm this suspicion, several physical tests are performed where the recognizable symptoms are provoked.

McMurray 
From a maximally flexed position, the knee is rotated outward by means of the foot. The space between the joint gap becomes as small as possible, this causes symptoms of meniscus irritation between two bone parts. The test with the foot turned outward is described for the inner meniscus. This test is also performed with the foot turned inward for the outer meniscus.

Joint line tenderness
With the knee in a flexed position of 90 degrees, the joint gap is palpated both on the inside and outside by the examiner. The test is positive when recognizable symptoms are elicited. The result of this test should always be combined with the other test results. A recognizable pain with only this test cannot be conclusive about meniscus complaints.

Surgical intervention or conservative treatment

    Generally, a conservative management is initiated when there is no extensive lock symptoms. If no structural improvement occurs within 3-6 months, surgery may be considered. 

    Surgical intervention for a meniscus injury is done by keyhole surgery(arthroscopy) in almost all cases. Whenever possible, the meniscus will be sutured in order to preserve as much as possible of the original functions of the meniscus. In fact, suturing the meniscus leads to better long-term outcomes. The farther the tear is to the outer edge of the meniscus the more favorable the recovery. This is because the edges of the meniscus have the best blood flow. So also more likely to recover. The meniscus is schematically divided into different zones:

    • Red-red zone, good blood supply
    • Red-white zone, intermedia blood supply
    • White-white zone, little blood supply

    So despite the fact that suturing the meniscus does provide better retention of the meniscus, this procedure does have a greater chance of reoperation. 16.5% of people undergo reoperation within 4 years. This compares to 1.4% for a meniscectomy. In a meniscectomy, they remove the part of the tear in the meniscus. The choice of suturing or cutting depends on the type of tear but also the location of the tear the chance of recovery in this should be high enough. This again has to do mainly with the different areas in the meniscus.

    Knee osteoarthritis
    Kevin van Geel
    The different stages of meniscus treatment

    Successful rehabilitation consists of several stages and steps. Proper strength, stability and control of the knee is necessary to safely return to your sport. Both after a surgical procedure and with conservative management.

    Acute phase:
    In this phase, we focus primarily on symptom reduction. There is often swelling, pain and reduced mobility of the knee. In addition, it is important to regain good control of your quadriceps(upper leg muscle). After an injury to the meniscus or after surgery on that knee, we often see a decrease in strength and mass of the quadriceps. So it is important to quickly regain proper function of the knee. In addition, it is important to return to a normal walking pattern.

    Strength and stabilization phase:
    This phase involves more of a build-up in strength. Stabilizing exercises also come into play. How quickly this is built up depends on the knee's reaction to the given load. This is always personally tailored to the current status of the knee. 

    Sport-specific phase:
    The final phase focuses particularly on maximum strength, jumping power and explosiveness. This is all necessary to quickly change direction within your sport. Competitive fitness is also worked toward so that you can continue to perform under fatigue. The quality of movement must remain good under these conditions.

    Rehabilitation at Physio Fitaal

    During rehabilitation, there will always be small and sometimes large setbacks coming your way. Especially in certain phases, things will go slower than you thought beforehand. Patience is necessary. Our specialists will guide and motivate you as much as possible during this process. Fysio Fitaal works with specialists in the field of knee and sports rehabilitation. Through this combination of expertise, extensive facilities and passion for sports, you have come to the right place.

    Physio Vital

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