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5 Easy and Effective Knee Strengthening Exercises for Arthritis


Filed Under (Fitness, General, Knee Pain) by Rick Kaselj on 19-02-2017

Hey, happy Monday!

I forgot to take a photo of what we did last Friday. The videographer came over to my house and we filmed some more YouTube videos for you. So, watch out for those videos in the next two to three weeks.

Today, I will share a number of exercises that will help strengthen your knees if you suffer from knee pain and discomfort.



In today’s video, I wanted to go through some Easy and Effective Knee Strengthening Exercises for Arthritis.

Easy and Effective Knee Strengthening for Arthritis

CLICK HERE to watch the video.

I got Jenna to demonstrate the exercises.

#1 – Seated Leg Raises on the floor

Sit on the floor. Place hands on the side. Toes must be pointing straight up. Relax and contract the quad as you slowly lift one leg a few inches off the ground and then back down.

Seated Leg Raises on the floor

Seated Leg Raises on the floor

If you are not able to lift your leg off the ground, that’s perfectly fine. Just contract the quad and lift the leg a little bit or like half the weight or three quarters the weight of the leg.

Perform 1 set of 5 reps in smooth controlled movement with nice contraction; hold the top position for a few seconds. Intensity is light with the purpose of working on the activation, endurance and strengthening the muscles in the quadriceps and hips.

#2 – Seated Leg Raises using a chair

Sit on a chair. Contract the quad and straighten the leg out. Slowly lift the leg up. Ideally, the leg is parallel with the thigh. Slowly bring the leg down to the starting position.

Seated Leg Raises using a chair

Seated Leg Raises using a chair

Perform 1 set of 5 reps in smooth controlled movement with a good contraction at the top position. Intensity is light with the purpose of working on the activation, endurance and strength of the muscles in the quad and hips areas.

#3 – Half Squat

Begin with standing nice and upright. Separate the feet with your toes out to the side a little bit. Place your hands out front. Bring the hips back and knees forward and squat down. Slowly raise your body back up as you return to the starting position. Squat down to whatever level you can.

Half Squat

Half Squat

Perform 1 set of 5 reps in smooth controlled movement with a good stop at the bottom position. Intensity is light to moderate depends on how strong you are in your knees and in your hips. This exercise helps in strengthening the muscles around the hips and knees. Also, it trains good tracking of your legs for good movement of the knee over the foot and hip alignment.

#4 – Sits to Stand

Sit nice and upright on a chair, a box or something firm. Put your hands to the side. You move from a sitting position to a standing position and then back to a sitting position. You can use your hands to guide you when doing this exercise.

Sits to Stand

Sits to Stand

Perform 1 set of 5 reps in smooth controlled movement with a good stop at each of the positions. Intensity is light to moderate depends on how strong you are in the knees and in the hips. With this exercise you are working on strengthening the muscles around the knee and the hip.

Give these four exercises a go. These are easy and effective knee strengthening exercises especially if you have arthritis.

If you are looking for a program to help eliminate your knee discomfort, then check out the Fix My Knee Pain program here:

Take care!

Rick Kaselj, MS


IT Band Exercise Questions


Filed Under (Fitness, Knee Injury, Knee Pain) by Rick Kaselj on 06-10-2012

Good morning.

I am sitting here at the kitchen table answering a few questions from readers before I head off to enjoy a variety of Canadian Thanksgiving Festivities.

Before I get to the questions, make sure to vote on the injury you would like me to cover this month.  You can vote here.

Let’s get to the questions.

Can I Get Back to My Workouts While Doing Your Programs?

Hi, Rick.

I have purchased a few of your Injury Solution programs and have this question.

Can you use the exercise programs from more than one of your programs at the same time….such as IT Band Syndrome and Fixing Elbow Pain…or are they meant to be done individually?

Also can you continue with your regular workout routine while using your exercise programs?


Thank you so much Patty.

Yes, you can use multiple programs at the same time but my suggestion would be not use ones that target the same area. I would not do the Iliotibial Band Syndrome Solution and the Jumper’s Knee Solution at the same time.

I feel you can do the Iliotibal Band Syndrome Solution and Fixing Elbow Pain at the same time.

Now to the getting back to your regular workouts.

I do not advise jumping back to where you were the day before your injury, that will just lead to re-injury.

You are going to have to go back and build up to it.

I would suggest going back to your regular workout but to a level that is 50% of what you were at. Your focus should be making sure your technique is perfect because technique will be the number one reason you will get re-injuried. Perfect technique at 50%, then start increase the level.

I would also start with low stress exercises on that injured area. For example, you might do bilateral squats with a strong focus of a vertical shin compared to a pistol squat. You can work up to the pistol squat in time.

Yes, you can do your regular workouts while doing the injury programs, just follow my tips in the video presentation of each program.

I hope that helps, Patty.

I Think You Missed the Boat

Is there any research supporting the program that are not 10+ years old ?

Most research done in the last two years overwhelmingly state that stretching the IT band is like trying to stretch a car tire.

I think you missed the boat on this one. But still like your other products.


Hey Dave,

Yes, there is research that is less than 10 years old.

If you look in the reference section of the exercise manual in Ilitotibial Band Syndrome Solution, you will see it. You can also check out the abstracts and many of the full articles.

Plus I would also check out the work from Dr. Fredericson, he has done a lot of research on IT Band Syndrome. He is the guy in that area.

The Dangers of Stretching

Hi, I have bought many of your programs, and liked them.

Why is there so much info about not being able to stretch the ITBand because it is a tendon ?

Dr. C for example says ‘You cannot stretch a tendon, only strain it by attempting to stretch it’

Kind Regards;


Thanks for the question David.

Yes, if you take the IT band in a cadaver and out of its normal living environment, it does not have much elasticity or a change in length.

As you know the IT band is part of a living system so when you stretch, we don’t fully know if we are stretching the IT band or it is the structures that connect to it or round it that are being stretched and leading to an increase in range of motion.

Maybe in time we will get research that can distinguish this.

I hope that helps, David.

Just Flick the IT Band

You do not need to stretch the ITB, just flick it back into its correct relationship to the greater trochanter in a specific way. It is a neurological deficit not a physical problem.


Hey Trevor.

Looking at the results from the survey that people have filled out here, I am finding out a lot of doctors, surgeons, physical therapists, chiropractors, etc are reading my emails, articles and videos.

I am not one of those disciplines and my scope of practice does not cover many of the techniques they use.

My focus is exercise.

When it comes to any kind of manual therapy (touching a client in order to create a result), that is not my area of expertise and I do not recommend any fitness professional do that unless they have additional education, training and insurance that covers it.

Plus, I believe in empowering the client and giving them knowledge, skills and exercises that they can do to take control of their injury. Leading to less dependency on me.

Rick Kaselj, MS


Best Stretch for Iliotibial Band Syndrome


Filed Under (Fitness, Knee Injury, Knee Pain) by Rick Kaselj on 28-09-2012

The Iliotibial Band Syndrome Solution has already gotten great feedback.

Yes, it is part of the Injury of the Month (IOTM) but you do not need to be a member to get it. If you have iliotibial band syndrome (ITBS) or you have a client with it, you can get it without joining the IOTM.

With Iliotibial Band Syndrome Solution, I will give you:

  • 40 minute presentation on everything you need to know about ITBS, what to do and not do, plus exercise details
  • 40 plus page exercise manual
  • 3-stage exercise program to do for a ITBS
  • 24 exercise videos of each of the exercises

One thing during my research that interested me was an article that looked at 3 of the most common iliotibial band stretches and determined which was the most effective.

Best Stretch for Iliotibial Band Syndrome

CLICK HERE to watch the YouTube video.

One more thing, no more hate mail on you can’t stretch the iliotibal band. Gurus may have opinions but no research to back up their statements.

Oh ya, here is the research paper that I talked about in the video:

Fredericson M, White JJ, Macmahon JM, Andriacchi TP. (2002). Quantitative analysis of the relative effectiveness of 3 iliotibial band stretches. Arch Phys Med Rehabil. 2002 May;83(5):589-92.
If you want to overcome your Iliotibial Band Syndrome in a fast, simple, safe, and effective way, then check out the Iliotibial Band Syndrome Solution program here:

Rick Kaselj, MS



Best Way to Stretch the IT Band


Filed Under (Fitness, General, Knee Injury, Knee Pain) by Rick Kaselj on 25-09-2012

I am working on finishing up Iliotibial Band Syndrome Solution.

It will be out very very soon.

Here is a video on stretching the IT Band. In it I share with you how effective stretching is for the IT Band.

Not just my opinion on how effective IT Band stretching is, but what the research says.


Best Way to Stretch the IT Band

Later this week, the Iliotibial Band Syndrome Solution will be ready for you:

That is it.

Rick Kaselj, MS


Number One Way of Preventing ACL Tears


Filed Under (ACL Injury, Fitness, Knee Injury, Knee Pain) by Rick Kaselj on 21-09-2012

Today I have an interview for you on the number one way of preventing ACL injuries.

It is from strength coach, Jedd Johnson.

You know Jedd from the Fixing Elbow Pain program that he and I created a few months back.

Today, Jedd has a great video on preventing ACL injuries.

This is important if you do any kind of sports or dynamic activities.

Number One Way of Preventing ACL Tears

If you are looking for a program to help yourself, your clients, or athletes prevent ACL injuries, make sure to check out Jedd Johnson’s Deceleration Program:

Rick Kaselj, MS




Best Way to Foam Roll Your IT Band


Filed Under (Fitness, Knee Injury, Knee Pain) by Rick Kaselj on 17-09-2012

Today I wanted to go through the 3 important exercises for your IT band. It is one main one with a couple of tweaks to it, to make it 3 exercises that target your IT band — which is important for Iliotibial band syndrome.


How Big of a Problem is ITBS for Runners?

If we look at the percentage of runners that end up having IT Band syndrome, it’s pretty staggering; 12% of runners will get Iliotibial band syndrome.

Now the common thought out there is that if you stretch your IT Band, everything is going to be fine with your Iliotibial band syndrome or IT Band syndrome.

That’s not what I found on my own, and it’s not what I found with my clients.

Stretching is something that I do but it is a piece within the puzzle when it comes to Iliotibial band syndrome.

Something that I focus in on is improving tissue quality when it relates to the IT Band.

And one of the things that I use is the foam roller.

I foam roll the IT Band (and I will go through that in a minute).

Along with foam rolling the IT Band, I will move between the outer part of the thigh and the front of the thigh and work between those two areas.

Then I will go to other direction, so I will not go right on the back on the hamstrings, but I will go in between the hamstrings and the IT Band, kind of working on the upper hamstrings and the edge of the IT Band.

I target a number of spots throughout that area when it comes to the IT Band.

How I Target the IT Band

When it comes to foam rolling, I start right at the top of the pelvis — above the hip joint, right on top of the pelvis — going all the way down to just above the knee.

I will keep on going a few times, 5x up and down, 5x on the side and front, and 5x on the side and back.

There you go.

If you or your client ends up having IT Band or Iliotibial band syndrome, make sure to add tissue quality work like foam rolling. Work on that IT band but also a little bit in front of the IT Band, and a little behind that IT Band. Remember, if you are a runner about 12% of runners will end up having IT Band issues or Iliotibial band syndrome.

Take care and bye, bye.

Rick Kaselj, MS



Signs and Symptoms of a Meniscus Tear


Filed Under (ACL Injury, Fitness, Knee Injury, Knee Pain) by Rick Kaselj on 28-07-2012

Now let’s get into the signs and symptoms of a meniscus tear.

This is the third article on the topic of meniscus tears. If you missed the last two, you can check them out at the end of this article.

Signs and Symptoms of a Meniscus Tear

Similar to other knee injuries, a meniscus injury is manifested by acute or abrupt pain in the joint-line of the involved knee. All signs of inflammation, which include redness, warmth, pain, swelling, and function loss, may be observed and noted by the physician during physical examination.

A client with a meniscal tear may experience and report the following signs and symptoms:

  • Pain – After an acute injury, pain in the joint line of the affected knee is usually reported. Acute trauma is not a prerequisite to develop meniscal tears. Some patients may not even recall or describe the injury event. For non-traumatic cases, the pain may be intermittent and limited to the affected knee.
  • Tenderness on The Joint Line – This symptom is found in 77 to 86% of patients diagnosed with meniscal tears, classifying it as an accurate clinical sign of meniscal injuries (Baker, 2011).
  • Joint Swelling – Some patients may experience swelling in the involved joint line, occurring as a delayed symptom. Others may not display this symptom all.  Research revealed that 50% of patients with meniscus tears presented with knee joint swelling (Baker, 2011).

Tear of medial meniscus

Swelling that occurs minutes after an acute injury is highly indicative of a meniscus tear resulting from a tear associated with hemarthrosis, a condition where bleeding occurs in the joint space.

Immediate swelling with bleeding typically occurs in the outer one-third of the meniscus. In the 1993 study by Stanitski and colleagues, it was found that 47% of adult patients with hemarthrosis had a tear in the ACL (Bhagia, 2012). The same study also revealed that 47% of the affected patients had meniscal tears (Bhagia, 2012).


  • Locking of the Knee – Locking is a frequent symptom of meniscal tears. The knee of a client with a meniscus injury may freeze or get stuck in one position as it being bent or straightened, causing inability to straighten out the knee. Locking is more likely to occur with a displaced tear, where the torn fragment is trapped within the knee joint. Swelling may mimic the sign of locking. The physician may observe for clicks or snaps after unlocking the joint to distinguish locking from joint swelling.
  • Giving Away Sensation in the Knee – This symptom occurs when the detached fragment is temporarily lodged in the joint. A patient may report feeling wobbly without warning. Giving away sensation in the knee may occur immediately or 2 to 3 days after the inciting injury.
  • Abnormal Range of Motion of the Knee – Meniscal injuries may cause difficulty with straightening of the knee. When the knee is fully bent, as in squatting, pain may be reported. The pain may be so severe that the client is unable to perform or complete the movement. Deviations and compensatory patterns during walking are also observed.

Diagnosing Meniscal Injuries

A meniscal injury can be accurately diagnosed through a detailed subjective history, physical examination, performance of certain maneuvers, and diagnostic tests.

Taking the History of Your Meniscus Injury

Your physician will first obtain a detailed history, focusing on the mechanism of the injury, which includes timing of the injury. Trauma is not necessary to cause meniscal tears. There are cases where you may not recall or be able to describe the symptom leading event.

Physical Meniscus Injury Examination

A complete physical examination is conducted by your physician. During evaluation, the lower spine, hip and thigh of the affected leg, and the patellofemoral joint will be examined. Joint line tenderness, swelling, and range of motion of the affected knee will be checked.

A part of a complete physical examination is the performance of certain provocative maneuvers. These maneuvers elicit the signs and symptoms of a meniscus injury by causing impingement of the torn meniscus.

Your physician may perform the following provocative maneuvers:

  • McMurray Test – In the presence of a tear, this maneuver elicits knee pain or reproduces a click.
  • Steinmann Test – Pain is elicited when the shin bone is rotated with the patient sitting and the knee bent to 90-degrees. A medial meniscus is possibly torn if the client complains of pain as the shin bone as it is rotated going away from the center of the body. A torn lateral meniscus is suspected if pain is reported as the shin bone is being rotated toward the center of the body.
  • Apley Test – A client has a positive test when pain is elicited at the medial or lateral side of the knee joint as force is applied through the heel with the leg in internal or external rotation.

Diagnostic tests for a Meniscus Tear

If a meniscus injury is suspected, the physician may first order plain radiography to rule out arthritis and fractures.

To confirm the diagnosis, a magnetic resonance imaging (MRI) test is ordered. This diagnostic test is widely recognized as the standard imaging study for suspected meniscus pathologies (Baker, 2011). MRI is more reliable in capturing sharp and clear images of the soft tissues in the knee joint.

Arthroscopy may also be a reliable tool for meniscal tear diagnosis if it is performed by a skilled arthroscopist (Baker, 2011). Research showed that arthroscopy is nearly 100% specific and sensitive in diagnosing meniscal tears (Baker, 2011).

Types of Meniscus Tears

Meniscus tears are not all the same. Identifying the type of meniscal tear through MRI scanning is important during the diagnosis. Your treatment plan is also based on the type of tear you have sustained. Some tears may be treated conservatively. Other tears may be resolved through surgery.

There are Seven Types of Meniscus Tears:

  • Frayed Tear – A meniscus with frayed and jagged fronds on its sharp edges may be a sign of degeneration. If the inner meniscal rim is involved, the risk for further injuries and complications is not likely. If the whole meniscus demonstrates frayed fronds, the meniscus may collapse in ragged motion. A meniscus with severe degeneration is impaired to carry out its shock-absorber function. Arthritis of the knee is a likely consequence.
  • Radial Tear – In a radial tear, tearing occurs across the lateral rim of the meniscus. Tearing occurs from the edge of the meniscus, going inwards. In this type, the inner part of the meniscus may not completely heal due to inadequate supply of blood.
  • Parrot-Beak Tear – If an oblique radial tear is left untreated, it can lead to a parrot-beak tear. As an oblique radial heals, the tear may assume a rounded beak-shaped appearance.
  • Circumferential Tear – In this type, the tear may run along the length of the cartilage.
  • Bucket-Handle Tear – A tear running across the length of the meniscus may cause detachment of one of its sections from the shin bone, leading to the formation of a flap that resembles a bucket handle. A bucket-handle tear is more likely to cause complete straightening of the knee, locking, and pain. This type of tear is more susceptible to sustaining more damage.
  • Horizontal Cleavage Tear – Classified as a rare type of tear, a horizontal cleavage tear is manifested by a horizontal split found in the body of the meniscus. This tear is usually first sustained after a minor injury and then followed by degeneration.
  • Flap Tear – This type of tear is manifested by a horizontal split in the middle of the meniscus. The formed flap may flip over occasionally, leading to the symptoms associated with meniscal injuries.
There you go, the end of part 3.
If you would like to see the exercise program that I use for meniscus tears, you can check it out here:

Rick Kaselj, MS

If you liked the above, you might find these posts helpful:



What to Do About Meniscal Injuries?


Filed Under (Fitness, Knee Injury, Knee Pain) by Rick Kaselj on 23-07-2012

Here is an article on meniscal injuries.

Enjoy and let me know what you think.

What are Meniscal Injuries?

The knee joint, classified as a hinge joint, is one of the largest and most complex joints supporting the human body.

The importance of this specific joint to everyday activities is indisputable. For any adult with a healthy knee joint, walking, running, and squatting are tasks that require little effort. Since the knee is used so frequently, it is vulnerable to injuries, overuse and degeneration.

Meniscal injuries are the leading causes of disability directly related to the knee. A meniscal injury refers to tearing any of the two menisci of the knee. A meniscus is commonly described as a rubbery, crescent-shaped piece of cartilage that functions as the main shock-absorber in the knee joint. This structure chiefly cushions the two main bones making up the knee joint: the thigh bone and the shin bone.

When someone says they are suffering from a torn cartilage of the knee, they are referring to a meniscal injury.

Meniscal tears can occur in many ways. The most common for those that are active is a result of strong or forceful twisting motions. There are other ways that a meniscus injury can occur and I will go through those in a later article. A meniscal tear is classified based on its gross appearance and on its location along the meniscus. The different descriptions are thoroughly discussed in the succeeding articles.

A meniscal injury commonly occurs with other injuries of the knee, such as tearing of the anterior cruciate ligament. A meniscal injury is a knee injury that occurs in a wide variety of individuals. Although athletes engaged in contact sports are more widely recognized as at risk for meniscal injury, anyone can suffer from a meniscus tear at any age.

The meniscus weakens with age as well. For this reason, older adults may suffer from a meniscus injury even when they initially only had a minor knee injury. A meniscal injury is typically manifested by acute knee pain, swelling of the knee joint, and locking of the knee. These signs and symptoms may not be life threatening, but without the right interventions, meniscal injuries may significantly disrupt daily activities, reduce function, cause pain, and lead to reduced quality of life.

The understanding and appreciation of the menisci with regard to the biomechanics of the knee has drastically changed since Sutton described these structures as of no use in the 1960s. Given the limited understanding about its importance to knee biomechanics, the meniscus was commonly completely removed once its integrity was in doubt. Today, the menisci are regarded as vital structures of the knee. Along with this development, the diagnosis, treatment and rehabilitation of meniscal injury has radically changed through the years. These articles aim to introduce the basic concepts of a meniscal injury, focusing on its treatment and rehabilitation through exercise.

More and more research and client feedback supports the importance of an effective exercise program in the recovery of a meniscus injury in order to regain function, decrease pain, overcome knee catching, improve knee movement and increase knee strength. It must be noted a meniscus injury exercise program involves a lot more than just strengthening and stretching in order to make a full recovery. In the following articles we will go into the components in more detail.

Anatomy of the Knee and the Menisci

A meniscus is a rubbery wedge-shaped cartilage that cushions the thigh bone and the shin bone. Before thoroughly discussing this vital structure of the knee, it is essential to understand the anatomy of the knee joint. What structures make up one of the largest joints in the human body? How do these structures support the movements involving the lower extremities?

Overview of the Knee Joint

The knee joint is recognized as the largest joint in body. Similar to the elbow joint, the knee joint is classified as a hinge joint. A joint is the point where two or more bones meet to allow movement. A hinge joint is a type of joint where a bulging outward part of one bone fits into an inward curved-like surface of another bone. This specific type of joint only allows motion in one plane or a backward and forward motion. To be concise, hinge joints are so named as they resemble the hinges that allow the pivoting of a part, such as a door, on a motionless frame.

Let’s look at an overview of the knee joint. The knee joint consists of four bones and a broad network of ligaments, or structures that connect bones to other bones, and muscles.

Bones of the Knee Joint

The knee may appear like a non-complex joint, but it mainly consists of four bones:

  1. femur
  2. tibia
  3. fibula
  4. patella

The femur, or the thigh bone, is the largest bone in the lower extremity. It is attached by ligaments and a capsule to the tibia, which is commonly called the shin bone.

Running parallel to the tibia is the fibula. The patella, also known as the knee cap, is a flat triangular-shaped bone found at the front of the knee joint.

These bones are covered by a protective structure, called the articular cartilage. The cartilage is inherently designed to decrease the frictional forces every time the bones of the knee move. The major movements of the knee joint occur between the femur, the tibia, and the patella.

Ligaments of the Knee

The stability of the knee is largely attributed to the ligaments. There are four main ligaments found in the knee joint:

  1. anterior cruciate
  2. posterior cruciate
  3. medial collateral
  4. lateral collateral

The cruciate ligaments are found within the knee, whereas the collateral ligaments are found on the inner and outer areas of the knee.

Among these ligaments, the anterior cruciate ligament, or ACL, must be discussed further. Meniscal tears commonly occur in association with an ACL disruption, specifically on the lateral side of the knee (New England Musculoskeletal Institute, 2011). Injuries involving the menisci occur with ACL tears up to 70% of the time (Write State Physicians, 2012). The ACL forms a cross right in the middle of the knee. It runs from the front of the shin bone to the back of the femur. The ACL functions to inhibit the tibia from making excess forward motion. Twisting motions are the most common causes of ACL injuries.

Articular Cartilage

The articular cartilage is a smooth tissue that encloses the ends of bones making up the knee joint. In the knee, the articular cartilage facilitates gliding of the bones of the knee without causing damage or excessive friction to the surfaces.

The menisci protect the articular cartilage of the knee from sustaining excessive pressure on one surface area on the joint’s surface. In the absence of the menisci, the forces applied to the knee are not effectively transmitted. The pressure is applied more intensely on one region, a condition that will eventually lead to wearing and tearing of the articular cartilage, as seen in osteoarthritis.

Knee Joint Capsule

The joint capsule of the knee is described as a thick and tough structure that surrounds the entire knee joint.

A synovial membrane that lines the inside of the capsule produces the synovial fluid, which functions as a lubricant. The knee joint capsule is further reinforced by the surrounding ligaments.


Each knee joint is comprised of two menisci, the wedge- or crescent-shaped structures found between the two major bones of the knee: the thigh bone and the shin bone. The upper surfaces of the menisci are in contact with the round prominences of the thigh bone; the lower surfaces of the menisci make contact with the plateaus of the shin bone. In cross section, the menisci are triangular in shape.

The C-shaped medial meniscus lies in the inner edge of the superior surface of the tibial bone. It is found on the inside part of the knee.

The lateral meniscus found on the outer edge of the knee is almost circular in shape. Compared to the medial meniscus, the lateral meniscus covers a wider portion of the tibial plateau surface.

Reports showed that the medial meniscus does not demonstrate direct connection to any muscles in the lower extremity (Bhagia, 2012).

Function of Menisci

These fibrocartilages function as effective shock absorbers of the knee. The menisci efficiently spread out the forces that are transmitted across the knee joint, making them crucial structures in maintaining the correct distribution of weight between the tibia and femur. The back or the posterior parts of the menisci absorb most of the pressure every time the knee bends (Orthogate, 2011).

Mobility of the Menisci

Both the medial and lateral menisci are anchored to the other supporting structures of the knee. Despite the attachments, the menisci are mobile. The degrees of their mobility are not the same, however. It was found that the medial meniscus is only half as mobile as the lateral meniscus (Baker, 2011). The excursion or mobility of the lateral meniscus is thought to exceed more than 10 millimeters. The greater mobility displayed by the lateral meniscus is explained by its looser attachment to the capsule.

The posterior horn of the medial meniscus has the greatest risk for disruption (Baker, 2011). Its vulnerability to injury may be attributed to the fact that this part of the medial meniscus has the least degree of mobility.

Water and Collagen Component

Water is the major component of the meniscus, comprising 70% of the total wet weight of the fibrocartilage (Athanasiou & Sanchez-Adams, 2009). At dry weight, collagen, specifically type 1 collagen, makes up 75% of the total weight of the meniscus. Collagen is a group of insoluble fibroproteins that form the structures supporting and connecting the tissues. Type 1 collagen fibers are arranged in circumferential direction to endure the tensile strength of the meniscus during weight bearing and for shock absorption. It is approximated that there are nearly 30 types of collagen in the body.

Blood Supply

For any bodily tissue, an adequate blood supply is essential to repair and healing. The lesser the blood supply, the slower the healing time or the poorer the prognosis. The circulating blood distributes the nutrients and elements required for healing; thus, it is important to be familiar with the blood supply to the menisci to understand a meniscus injury’s potential response to treatment and rehabilitation.

The meniscal blood supply is limited to its outer edges or margins. The remaining areas lacking blood supply obtain the nutrients required for repair from the synovial fluid, a lubricating fluid found in the cavities of joints. Areas lacking blood supply rely on the process of passive diffusion and mechanical pumping to receive the said nutrients.

Arnoczky suggested a classification system that aims to categorize meniscus lesions with regard to the meniscal blood supply. As an overview, the red zone obtains sufficient supply of blood and the white zone does not.

  • Red-red tear – The red-red tear occurs in the red zone, recognized as a blood-rich area. This is found on meniscus’ outer border. In this type of tear, both sides obtain functional supply of blood, a condition that promotes good healing.
  • Red-white tear – The red-white tear includes the outer rim and the middle part of the meniscus. In this type, one end of the tear receives adequate blood supply and the other is in the area that lacked sufficient supply of blood.
  • White-white tear – The white-white tear is completely found in the middle part of the meniscus, an area where blood supply is lacking. As a consequence, repair and healing is not favorable.
Let’s wrap up the article right here. I will be back later the in week with another article on the meniscus.

Later this week, I will be releasing the Meniscus Tear Solution:

Rick Kaselj, MS

If the above article interested you, these article may as well: