Meniscus Injury in Happy Valley

Meniscus injuries are a somewhat common knee condition that are the result of degenerative changes or related to an acute tear. Both can be painful and lead to loss of motion, loss of strength, and increased stiffness. Degenerative meniscus conditions occur over extended periods of time from gradual wear and tear. These conditions are more prevalent in individuals who perform repetitive squatting, stooping, or crawling on hands and knee positions. Acute tears occur from a sudden overload typically experienced during a quick twist, change of direction, or falling. 

Common symptoms related to meniscus injuries:

  • Sharp quality pain during movement
  • Pain with touching the knee joint line
  • Experiencing a painful pop or tear sensation
  • A catching, clicking, or snagging sensation during knee movement
  • Trouble with straightening your knee
  • Experience swelling and stiffness in knee

Diagnosing a Meniscus Tear

Like any painful condition, the underlying cause is identified through a thorough physical examination in combination with a history of details surrounding symptom onset. If you present with a history and complaints consistent with meniscus injury, diagnostic movement tests will be used to confirm or rule out the hypothesis. If significant damage is suspected, a consultation with an orthopedic surgeon may be warranted and we’d be glad to provide recommendations if you are not familiar with any surgeons.

Does the Tear Heal Over Time?

The short answer is no. The majority of the menisci do not have an adequate blood supply to support healing. The positive news is, if the damage is mild to moderate, you can typically expect a full recovery through conservative management, such as with Physical Therapy. Research is now glowing about the long term outcomes being equivalent with such a strategy versus early surgical intervention. That being said, large or severe injuries are likely to require a surgical intervention for best outcome potential. Physical Therapy is a common strategy after a meniscus surgery for rehabilitation and maximizing outcomes.

How Physical Therapy Helps

The good news is, most meniscal injuries are able to be resolved through a physical therapy course of treatment. Most surgeons anymore will now request you complete a physical therapy plan of care if the injury is mild or even moderate. Your plan of care will be centered around: reducing pain, inflammation, & swelling, while restoring your strength, and correcting any movement deficiencies, such as squatting or going up and down stairs.

Initial goals are to control and manage the inflammatory phase while preventing deterioration of strength and motion. Clinic activities or even pieces of your home program may cause temporary increases in swelling, and that’s OK, but it’s always important to notify your therapist so that intensities can be adjusted accordingly. A small amount of soreness after a session is normal, just as after a good workout produces some soreness. The low-level soreness will help stimulate increases in bone density and muscle growth.

Once your strength and body mechanics have reached ideal levels, return to sport and recreational activities in a safe manner is initiated. Many times people will reach a symptom-free status with their day to day activities but aren’t quite healed all the way, then attempt to ‘pick up where I left off’ and get hurt again. Working with one of our doctors of physical therapy ensures you are progressed as quickly AND safely as possible!

Surgical Treatment of Meniscus Injury

If your symptoms are not manageable through conservative care, a surgical treatment would be a suggested next step. If the tear is identified as severe early on, a basic home program is typically established with your therapist to prepare you for surgery and the aftermath. A common approach is known as a meniscectomy, which is the debridement (or removal) of the damaged components of your meniscus. If left unchecked, the damaged portions may act as a prolonged source of inflammation, similar to having a hangnail inside your knee, yikes! With this straightforward treatment approach, you should expect a recovery in approximately 8 weeks with adherence to a physical therapy plan of care post-operatively.

There are situations where your surgeon will recommend a meniscal repair rather than meniscectomy. Your recovery after a repair will look much different than after a meniscectomy. Due to the poor blood supply to portions of the menisci, the repair must be protected for a time period to reduce risk of tearing. Typically, the long term outcomes of having a repair are better than the meniscectomy because of the preservation of the protective cartilage tissue.

With all surgical procedures, our therapists will work closely with your surgeon and adhere to any rehab preferences they request. We also will be their relative set of eyes and hands for risk mitigation from complications such as – infection, progress, etc.

Safe Return to Sport & Activity

You should expect to regain most, if not all, prior abilities you had before your surgery. Some activities take longer to resume without symptoms than others. Deep squatting, descending stairs, kneeling directly on your involved side, and ballistic loading (jumping) are commonly the final activities to return to normal. The nagging culprit that sometimes never fully resolves is direct kneeling on your affected side, particularly on a firm surface. We use objective tests and measures to identify when a safe return to sport threshold has been met and notify your surgeon for final clearance.

If knee pain has been interfering with your life, call us today to get started on a plan of care that works for you. Ascent Physical Therapy is conveniently located off Sunnyside Road in Happy Valley. We also love treating our neighboring communities of Damascus, Gresham, Clackamas, and Sandy at our top rated physical therapy clinic!