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Best Torn Meniscus Treatment in Delhi

Torn Meniscus
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What is Torn Meniscus ?

A torn meniscus is one of the most common knee injuries. Each knee has two C-shaped pieces of cartilage, the menisci (plural of meniscus), that sit between the shinbone (tibia) and thighbone (femur). They act as shock absorbers, help distribute weight, and contribute to knee stability.

Causes of a Torn Meniscus:-
  • Traumatic Injury (Acute Tears): These are most common in younger, active individuals and often occur during sports. They typically result from a forceful twist or rotation of the knee while the foot is planted and the knee is bent. Examples include:-
    • Aggressive pivoting or sudden stops and turns.
    • Deep squatting or kneeling.
    • Lifting something heavy with a twisted knee.
    • Contact sports (football, basketball) or sports involving pivoting (tennis, soccer).
  • Degenerative Changes (Degenerative Tears): These are more common in older adults and can occur with little or no significant trauma. As we age, the meniscus can weaken and become more brittle, making it susceptible to tears from everyday activities like standing up from a chair or a minor twist. This is due to wear and tear over time.
Symptoms of a Torn Meniscus:-

The symptoms can vary depending on the size and location of the tear, but common signs include:-

  • Pain: Often localized to the inside or outside of the knee, depending on which meniscus is torn. The pain may worsen with twisting, squatting, or going up/down stairs.
  • Swelling: The knee may become swollen, sometimes gradually over a few hours or days.
  • Stiffness: Difficulty bending or straightening the knee fully.
  • Popping or Clicking Sensation: You might hear or feel a pop at the time of injury, or experience clicking, catching, or grinding sensations with knee movement.
  • Locking: A feeling that the knee is “locked” in place, making it impossible to fully extend or bend. This can occur if a piece of the torn meniscus gets caught in the joint.
  • Giving Way: A feeling of instability or the knee “giving out” when trying to put weight on it.
Treatment for a Torn Meniscus:-

Treatment depends on several factors, including:-

  • Type of Tear: Some tears (e.g., in the outer “red zone” with good blood supply) may heal on their own. Others (e.g., in the inner “white zone” with poor blood supply) may not.
  • Size and Location of the Tear: Larger tears or those in the “white zone” are less likely to heal without intervention.
  • Age and Activity Level: Younger, active individuals with a reparable tear are often candidates for surgical repair. Older, less active individuals with degenerative tears may respond well to conservative management.
  • Symptoms: Persistent pain, locking, or significant functional limitation often indicate a need for more aggressive treatment.
    • Rest: Avoid activities that aggravate your knee. Crutches may be used to take weight off the knee.
    • Ice: Apply ice packs to reduce pain and swelling (10 minutes, several times a day).
    • Compression: Use an elastic bandage or compression sleeve to help control swelling.
    • Elevation: Elevate your leg above your heart to reduce swelling.
  • Physiotherapy: Crucial for restoring strength, flexibility, and function.

Physiotherapy is a critical component of both non-surgical and surgical rehabilitation for a torn meniscus. The goals are to reduce pain and swelling, restore full range of motion, improve strength, enhance balance and proprioception, and facilitate a safe return to activity.

Initial Phase (Acute/Protective Phase):

  • Pain and Swelling Management: R.I.C.E., gentle massage, passive range of motion.
  • Gentle Range of Motion (ROM) Exercises:
    • Heel Slides: Lying on your back, slowly slide your heel towards your buttocks, bending your knee as far as comfortable.
    • Knee Extension (Passive): Lying on your back, let gravity gently straighten your knee.
  • Isometric Strengthening: Activating muscles without joint movement.
    • Quad Sets: Tighten your thigh muscle (quadriceps) by pressing the back of your knee into the bed/floor. Hold 5-10 seconds.
    • Glute Sets: Squeeze your buttocks together.

Intermediate Phase (Restoration of Function):

  • Progressive ROM: Gradually increase the range of knee flexion and extension.
  • Strengthening Exercises:
    • Straight Leg Raises (SLR): Lying on your back, lift your leg straight up, keeping the knee extended.
    • Hamstring Curls: Lying on your stomach, bend your knee to bring your heel towards your buttocks. (Can be done with a resistance band).
    • Calf Raises: Standing, lift up onto your toes.
    • Mini Squats/Wall Squats: Partial squats to build quadriceps and glute strength, ensuring knees do not go past toes.
    • Clamshells: Lying on your side, knees bent, open and close your knees like a clamshell, targeting hip abductors.
    • Bridges: Lying on your back, knees bent, lift your hips off the floor.
  • Balance and Proprioception Training:
    • Single-leg standing.
    • Balance board or wobble board exercises .
Advanced Phase (Return to Activity/Sport-Specific):
  • Higher-Level Strengthening: Lunges, step-ups, leg press, advanced squats.
  • Plyometric Exercises: Jumping, hopping, bounding (introduced cautiously after significant strength and stability are achieved).
  • Agility Drills: Cutting, pivoting, lateral movements (sport-specific).
  • Sport-Specific Training: Gradually reintroduce movements required for the individual’s sport or activity.

Manual Therapy Techniques for a Torn Meniscus

  • Soft Tissue Mobilization:-
    • Massage: To reduce muscle guarding and tightness in surrounding muscles (quadriceps, hamstrings, calf, IT band).
    • Myofascial Release: To address fascial restrictions around the knee and thigh.
  • Joint Mobilization:
    • Patellar Mobilization: Gently moving the kneecap to ensure it glides properly and reduce anterior knee pain.
    • Tibiofemoral Joint Mobilization: Gentle glides or oscillations to improve knee flexion and extension, particularly if there is stiffness. These are performed very carefully to avoid aggravating the meniscus.
    • Proximal Tibiofibular Joint Mobilization: To ensure proper movement of the small joint below the knee, which can influence overall knee mechanics.
  • Neural Mobilization (Nerve Gliding): If nerve irritation (e.g., from swelling) is contributing to symptoms, gentle nerve glides may be used.
  • Mobilization with Movement (MWM): A technique where the therapist applies a sustained glide to a joint while the patient actively moves through a painful range of motion, aiming to correct movement dysfunction and reduce pain.

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