Here are 4 key points for meniscal surgery rehab:
REHABILITATION FOLLOWING MENISCAL SURGERY
Meniscal injuries are common in today's exercise minded world. The medical meniscus is oval or C-shaped and is larger in diameter than the lateral meniscus. The entire border of the medical meniscus is attached to the tibia by thick coronary ligaments. The meniscal tissue is hydrated, soft, and fibrocartilaginous is slightly greater than that in articular cartilage.
The menisci function to:
1) Distribute weight-bearing loads
2) Increase joint congruency, thus aiding stability
3) Limit abnormal motions, and
4) Possibly improve articular nourishment.
MECHANISM OF INJURY
Noncontact stresses are the most frequent mechanism of injury to the menisci. These stresses result from a sudden acceleration or decelerations in combination with a change in direction (eg. when a soccer or lacrosse player “plants and cuts” to elude an opponent). In jumping sports such as volleyball or basketball, the additional element of vertical force with angular momentum upon landing can contribute to a Meniscal Tear.
Meniscal lesions may have clinical symptoms. Displaced tears, such as bucket handle tears, can produce locking and give way. Non displaced tear scan alter meniscus mobility and produce abnormal traction stresses to the capsule and synovium, accounting for the pain associated with such lesions.
The final component of implementing an individualized rehabilitation program is the formation of a treatment plan. The underlying message of the treatment plan should be a functional orientation to exercise.
It is important that the rehabilitation program follow a functional progression. In association with a functional progression, the therapist should follow the SAID principle(specific adaptation to imposed demands). The body adapts to specific activities based on the type of stress experienced, and the type of stress experienced, and the type of adaption that takes place will be specific to the type of training performed.
This concept is demonstrated throughout the rehabilitation process in various closed kinetic chain (body movement performed with one or both feet in a stationary position) exercises, which impose different forces at the knee in multiple planes.
Therefore, in following a functional approach to rehabilitation, emphasis should be placed on treatment in a closed kinetic state when appropriate. To initiate the treatment plan, it is imperative to follow certain rehabilitation rules. These have been described by Gray:
1) Create a safe environment for optimal healing
2) Don’t hurt the patient
3) Be as aggressive as you can without breaking the rule.
4) The treatment plan can be made effective by understanding the specific effects of the treatment, the cause of the patient’s symptoms, the functional biomechanics of the knee joint, stages of tissue healing, and the patient’s specific injury or surgery.