Knee injury - how to make better

[Lean L]

I think I tore my meniscus three months prior. It pained me at first but I walked through it without going to the hospital. Symptoms are almost non existant now but I still can't run or jump without feeling like it's tearing or something. What exercise can I do to make this better? I know the knee gets close to no circulation so that is part of the reason why it heals so slowly. Can I increase bloodflow somehow?

 

[BoomerD]

I think I tore my meniscus three months prior. It pained me at first but I walked through it without going to the hospital. Symptoms are almost non existant now but I still can't run or jump without feeling like it's tearing or something. What exercise can I do to make this better? I know the knee gets close to no circulation so that is part of the reason why it heals so slowly. Can I increase bloodflow somehow?

Nope...probably your only option will be to see an orthopedic surgeon and have it cleaned up.

 

[Lean L]

Nope...probably your only option will be to see an orthopedic surgeon and have it cleaned up.

cleaned up how? Are you speaking from experience? I never knew that knee injuries are so bad.

 

[BoomerD]

cleaned up how? Are you speaking from experience? I never knew that knee injuries are so bad.

http://www.arthroscopy.com/sp05005.htm

I had a pretty good amount of my medial meniscus removed when I had my ACL graft 8 years ago.

 

[SociallyChallenged]

I think I tore my meniscus three months prior. It pained me at first but I walked through it without going to the hospital. Symptoms are almost non existant now but I still can't run or jump without feeling like it's tearing or something. What exercise can I do to make this better? I know the knee gets close to no circulation so that is part of the reason why it heals so slowly. Can I increase bloodflow somehow?

You should go to an orthopedist to be evaluated. They'll take x-rays and give you their professional opinion. Almost always before surgery, they will opt for conservative care, which typically includes physical therapy. Physical therapy can improve the quality of the cartilage in your knee, improve your strength and stability, improve biomechanics during dynamic activities, etc. There is no one exercise that you can do to fix it, but you need to be thoroughly evaluated by a professional physical therapist that can address your specific limitations and weaknesses. I typically suggest that patients kindly request physical therapy. The ortho will almost always write a prescription for it, as it is beneficial to surgical outcomes and can typically enable a patient to avoid surgery.

 

[deadken]

I think he means that you need a doctor to clean up a torn meniscus. The tear itself won't heal by itself. A doctor can't 'repair' (stitch, etc...) a torn meniscus, but they can 'clean' it up (I think they remove any excess material), which makes it better then having it torn.

I think of it like this: You have a strap, it goes over a ball and slides back and forth. If the sides of the strap become worn / frayed / torn the edges can get under the strap and interfere with its smooth movement over the ball. If you trim off the excess pieces, there won't be any material to get caught up under the strap. Even though it is now 'thinner', it still works better then being wider and jamming.

It might not be a perfect analogy, but that is the way I think of a knee after it was explained to me.

FWIW: I think that knees typically suck. They are a weak spot in our bodies and really can't handle us walking upright. But living without them is not really an option.

EDIT: SC has responded. I'd follow his advice.

 

[BoomerD]

You should go to an orthopedist to be evaluated. They'll take x-rays and give you their professional opinion. Almost always before surgery, they will opt for conservative care, which typically includes physical therapy. Physical therapy can improve the quality of the cartilage in your knee, improve your strength and stability, improve biomechanics during dynamic activities, etc. There is no one exercise that you can do to fix it, but you need to be thoroughly evaluated by a professional physical therapist that can address your specific limitations and weaknesses. I typically suggest that patients kindly request physical therapy. The ortho will almost always write a prescription for it, as it is beneficial to surgical outcomes and can typically enable a patient to avoid surgery.

Depending on the severity of the meniscus tear, it might not show up on an x-ray, but will show with an MRI.
If the tear is very severe, physical therapy probably won't help much...if at all.
It MIGHT be possible to repair the meniscus...depending on a variety of factors including the severity of the tear and the person's age...and the general health of the knee and the rest of the meniscus.

http://www.arthroscopy.com/sp05026.htm

A meniscectomy is a fairly quick procedure, not terribly painful after the first day or two, and is the fastest "repair" possible. Physical therapy following the "repair" will almost always be ordered by the ortho and will help greatly in regaining mobility.

My knee was fucked up. Demolished ACL, several serious tears in the meniscus. One was so bad that when I walked, it'd "catch" inside the knee and lock it up. Sometimes I'd have to "work" the knee for several minutes to get it to unlock. Now, I'm almost "bone on bone" in a couple of spots, but it's still better than it was. Unfortunately, the gawd-damned thing hurts all the time, and due to the severity of the injury and my age, arthritis has set in...and that just adds to the overall pain level and level of disability.

 

[SociallyChallenged]

Depending on the severity of the meniscus tear, it might not show up on an x-ray, but will show with an MRI.
If the tear is very severe, physical therapy probably won't help much...if at all.
It MIGHT be possible to repair the meniscus...depending on a variety of factors including the severity of the tear and the person's age...and the general health of the knee and the rest of the meniscus.

http://www.arthroscopy.com/sp05026.htm

A meniscectomy is a fairly quick procedure, not terribly painful after the first day or two, and is the fastest "repair" possible. Physical therapy following the "repair" will almost always be ordered by the ortho and will help greatly in regaining mobility.

My knee was fucked up. Demolished ACL, several serious tears in the meniscus. One was so bad that when I walked, it'd "catch" inside the knee and lock it up. Sometimes I'd have to "work" the knee for several minutes to get it to unlock. Now, I'm almost "bone on bone" in a couple of spots, but it's still better than it was. Unfortunately, the gawd-damned thing hurts all the time, and due to the severity of the injury and my age, arthritis has set in...and that just adds to the overall pain level and level of disability.

Actually, meniscus damage typically doesn't show on x-ray (unless you have the paired cartilage degeneration), but orthos always go that route to check for osteoarthritis, autoimmune conditions, bone cancer, and bone damage. It is rare that physical therapy doesn't help to a certain degree with meniscus damage. If there is a space occupying lesion within the knee, then PT will definitely be limited. However, even severe meniscus tears can benefit from PT due to improving ROM (with joint mobilization, stretching, soft tissue work, PNF techniques), strength, coordination, biomechanics, modifying tension and reloading, etc.

I'm not saying that PT is going to be the answer necessarily, but it is very frequently the first step that orthos suggest considering it has proven efficacy in research, it's conservative, and it's what insurance companies want prior to surgery.

A true meniscectomy is rare nowadays and there's reasons for that. Removing the cartilage is detrimental to long term function. Typically, with the arthroscopic surgeries, the orthos will approach things in several ways. If it's in the red zone of the meniscus where there is some direct blood flow (the periphery of the menisci), they will debride the area to induce bleeding. This bleeding stimulates fibrocartilage formation, which although it isn't as good as the previous hyaline cartilage, it functions better than bone on bone.

Most of the time, they will clean things up, which also isn't considered a meniscectomy - just typically referred to as a knee arthroscopy. This includes removing any debris, shaving off frayed pieces, and smoothing out the surface. That's pretty effective.

However, as I said, PT can sometimes eliminate pain and restore normal function for the individual without surgery. We have joint mobilizations that have shown to promote cartilage regeneration (fibrocartilage), improve joint lubrication, and reduce or eliminate pain. If PT does not fix the issue, then orthos still prefer it before surgery because the patient has a quicker recovery time, due to better coordination, movement patterns, muscle mass, ROM, etc.

 

[Lean L]

Thx for the advice. Not to sound unappreciative but I am not really in a good situation to have surgery at the moment (I also just don't really want to). I have found an exercise: http://www.webmd.com/fitness-exercise/shallow-standing-knee-bends .

It makes a popping sound in my knee when I do it but there's no pain. Continue with this? It doesn't hurt most of the time. Just those rare moments when I am in the air from a jump or a run.

 

[the DRIZZLE]

I agree with SC. Go to an orthopedist and get it looked at. PT may or may not get you an acceptable level of function but it's worth a shot before you get surgery. If it's as bad as you indicate there's a good chance you will ultimately need surgery to fix it.

 

[SociallyChallenged]

Thx for the advice. Not to sound unappreciative but I am not really in a good situation to have surgery at the moment (I also just don't really want to). I have found an exercise: http://www.webmd.com/fitness-exercise/shallow-standing-knee-bends .

It makes a popping sound in my knee when I do it but there's no pain. Continue with this? It doesn't hurt most of the time. Just those rare moments when I am in the air from a jump or a run.

As I said before, there is not one general exercise that will get rid of your pain. Keeping your knee moving in a non-painful fashion is good, but you need to be evaluated and treated by a professional if you're this concerned. Popping isn't a good sign, but a PT needs to assess if that's coming from your knee or your knee cap.