Meniscus Tear: The Evidence-Based Non-Operative Physical Therapy Treatment Guide

By dpope2020

December 6, 2024

all about meniscus surgery, dan pope, dr. david middaugh, el paso manual physical therapy, fitness pain free, fitnesspainfree, knee injury, knee meniscus surgery, knee pain, knee surgery, meniscus, meniscus exercises, meniscus injury, meniscus rehab exercises, meniscus repair, meniscus surgery, meniscus surgery decoded, meniscus tear, meniscus tear exercises, meniscus tear rehab, new meniscus surgery, orthopedics, physical therapy, torn meniscus, torn meniscus exercises

Meniscus Tear: Non-Operative Physical Therapy Treatment Guide [Evidence-Based]

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In today's video we go over: Meniscus Tear - The Evidence-Based Non-Operative Physical Therapy Treatment Guide: FPF Show Episode 153

  • 0:00 Introduction
  • 2:08 Is non-operative rehabilitation possible for all meniscus tears?
  • 8:10 Is non-operative rehabilitation possible or best for TRAUMATIC meniscus tears?
  • 12:38 Surgery vs. Physical Therapy [Chronic vs Acute Tears] and do mechanical symptoms play a role?
  • 19:46 What did patients perform as part of physical therapy in studies that show a benefit from non-operative treatment?
  • 25:41 How to perform patient education for meniscus tear patients
  • 35:10 Exercise prescription principles for your meniscus patients
  • 37:02 How different exercises stress the medial vs. lateral meniscus during exercise
  • 38:35 How forces across the joint increase based on the intensity of exercise chosen
  • 38:51 How stress changes in the knee during deep vs. shallow squats
  • 41:39 Acute phase rehabilitation principles (ROM, Gait, Muscle Inhibition, Swelling)
  • 48:56 Intermediate phase rehabilitation principles (Strengthening, Plyometrics, Running)
  • 54:25 Advanced phase rehabilitation principles (Strength testing, force plate data, sprint, change of direction)
  • 56:16 Keys for returning athletes back to sport after injury
  • 58:23 Should patients consider orthobiologics as part of their rehabilitation? (PRP)
  • 1:04:22 Case Study - Non-operative Physical Therapy Treatment of Meniscus Tear

Meniscus feels like a million bucks...

- Dan Pope DPT,OCS,CSCS

Show Notes / Relevant Articles:

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Dan Pope DPT, OCS, CSCS

References: 

  1. Logerstedt DS, Scalzitti DA, Bennell KL, et al. Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Revision 2018. J Orthop Sports Phys Ther. 2018;48(2):A1‐A50. doi:10.2519/jospt.2018.0301

  2. Wilk, K. E., Ivey, M., Thomas, Z. M., & Lupowitz, L. (2024). Neurocognitive and neuromuscular rehabilitation techniques after ACL injury, part 1: Optimizing recovery in the acute post-operative phase - A clinical commentary. Journal of Orthopaedic & Sports Physical Therapy, 19(11).

  3. Van Rossom S, Smith CR, Thelen DG, Vanwanseele B, Van Assche D, Jonkers I. Knee Joint Loading in Healthy Adults During Functional Exercises: Implications for Rehabilitation Guidelines. J Orthop Sports Phys Ther. 2018 Mar;48(3):162-173. doi: 10.2519/jospt.2018.7459. Epub 2018 Jan 6. PMID: 29308697.

  4. Damsted C, Skou ST, Hölmich P, Lind M, Varnum C, Jensen HP, Hansen MS, Thorlund JB. Early Surgery Versus Exercise Therapy and Patient Education for Traumatic and Nontraumatic Meniscal Tears in Young Adults-An Exploratory Analysis From the DREAM Trial. J Orthop Sports Phys Ther. 2024 May;54(5):340-349. doi: 10.2519/jospt.2024.12245. PMID: 38385220.  

  5. Skou ST, Thorlund JB. A 12-week supervised exercise therapy program for young adults with a meniscal tear: Program development and feasibility study. J Bodyw Mov Ther. 2018 Jul;22(3):786-791. doi: 10.1016/j.jbmt.2017.07.010. Epub 2017 Jul 27. PMID: 30100313.

  6. Brosseau L, Yonge KA, Robinson V, Marchand S, Judd M, Wells G, Tugwell P. Thermotherapy for treatment of osteoarthritis. Cochrane Database Syst Rev. 2003;2003(4):CD004522. doi: 10.1002/14651858.CD004522. PMID: 14584019; PMCID: PMC6669258.

  7. Rice D, McNair PJ, Dalbeth N. Effects of cryotherapy on arthrogenic muscle inhibition using an experimental model of knee swelling. Arthritis Rheum. 2009 Jan 15;61(1):78-83. doi: 10.1002/art.24168. PMID: 19116960.

  8. Stensrud S, Roos EM, Risberg MA. A 12-week exercise therapy program in middle-aged patients with degenerative meniscus tears: a case series with 1-year follow-up. J Orthop Sports Phys Ther. 2012 Nov;42(11):919-31. doi: 10.2519/jospt.2012.4165. Epub 2012 Sep 5. PMID: 22960783.

  9. Roos EM, Dahlberg L. Positive effects of moderate exercise on glycosaminoglycan content in knee cartilage: a four-month, randomized, controlled trial in patients at risk of osteoarthritis. Arthritis Rheum. 2005 Nov;52(11):3507-14. doi: 10.1002/art.21415. PMID: 16258919.

  10. Siemieniuk RAC, Harris IA, Agoritsas T, Poolman RW, Brignardello-Petersen R, Van de Velde S, Buchbinder R, Englund M, Lytvyn L, Quinlan C, Helsingen L, Knutsen G, Olsen NR, Macdonald H, Hailey L, Wilson HM, Lydiatt A, Kristiansen A. Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline. BMJ. 2017 May 10;357:j1982. doi: 10.1136/bmj.j1982. PMID: 28490431; PMCID: PMC5426368.

  11. Chirichella PS, Jow S, Iacono S, Wey HE, Malanga GA. Treatment of Knee Meniscus Pathology: Rehabilitation, Surgery, and Orthobiologics. PM R. 2019 Mar;11(3):292-308. doi: 10.1016/j.pmrj.2018.08.384. Epub 2019 Feb 27. PMID: 30195704.

  12. Skou, Søren T. et al. A 12-week supervised exercise therapy program for young adults with a meniscal tear: Program development and feasibility study. Journal of Bodywork and Movement Therapies, Volume 22, Issue 3, 786 - 791

  13. Gopinatth V, Batra AK, Chahla J, Smith MV, Matava MJ, Brophy RH, Knapik DM. Degenerative Meniscus Tears Treated Nonoperatively With Platelet-Rich Plasma Yield Variable Clinical and Imaging Outcomes: A Systematic Review. Arthrosc Sports Med Rehabil. 2024 Feb 23;6(2):100916. doi: 10.1016/j.asmr.2024.100916. PMID: 38525288; PMCID: PMC10960087.

  14. Katz JN, Brophy RH, Chaisson CE, de Chaves L, Cole BJ, Dahm DL, Donnell-Fink LA, Guermazi A, Haas AK, Jones MH, Levy BA, Mandl LA, Martin SD, Marx RG, Miniaci A, Matava MJ, Palmisano J, Reinke EK, Richardson BE, Rome BN, Safran-Norton CE, Skoniecki DJ, Solomon DH, Smith MV, Spindler KP, Stuart MJ, Wright J, Wright RW, Losina E. Surgery versus physical therapy for a meniscal tear and osteoarthritis. N Engl J Med. 2013 May 2;368(18):1675-84. doi: 10.1056/NEJMoa1301408. Epub 2013 Mar 18. Erratum in: N Engl J Med. 2013 Aug 15;369(7):683. PMID: 23506518; PMCID: PMC3690119.

Images:

  1. Medial Meniscus Source: https://commons.wikimedia.org/wiki/File:Medial_Meniscus_Injury.png Attribution: BruceBlaus / CC BY-SA (https://creativecommons.org/licenses/by-sa/4.0) Edited by fitness pain free LLC