What to do about a Meniscus Tear

I received a question from a personal trainer who has a number of clients with meniscal injuries; she was looking for some suggestions on program design and exercises.

There is a lot to consider when it comes to lower body injuries and exercises.  I go through all kinds of exercises for the lower body in the following courses:

Exercises Rehabilitation of the Knee

Balance Training for the Rehab Client

I will focus on a few key points to remember when strengthening the knee that has a meniscus injury.

What Does the Meniscus Do?

Taking a step back, the menisci act to spread the load of the body’s weight and reduce friction during knee movement.  When your client talks about “torn cartilage in the knee” they are often talking about meniscus.

5 Keys to Help Your Clients with a Meniscus Injury

Time Load on the Meniscus

Look at your client and see the amount of time they spend standing, walking, running and exercising during the day.  All of these activities puts load on the meniscus and if the meniscus is damaged, it will lead to inflammation.  It is important to load the meniscus, but the amount of time they load their meniscus needs to be monitored and your client needs to address any inflammation they have.

Plus a decrease in the load during the day on the meniscus will allow the meniscus to heal better and allow your client to do more during their exercise program when it comes to weight bearing and leg strengthening exercises.

Get on the Bike

Whatever your opinion is of the bike, the bike is great to strengthen the injured knee while putting low load on the internal structures of the knee, like the meniscus.

Get your client on the bike in order to strengthen the muscle around the knee.

Collapsing Feet

If your client has excessive pronation (flat feet) during gait, this will lead to increase medial load on the knee.  If their cartilage issue is the medial meniscus, this will put greater stress on their meniscus when doing day to day activities.  You need to assess you client to see if this is making the meniscus symptoms worse and slowing down their recovery.

Other Knee Strengthening Exercises

A lot of the common exercises given for the meniscus injury are hip flexion and hip extension exercises.  This is important, but does not address knee extension.  Few exercises that your client can do to strengthen the quadriceps:

Supine Tubing Leg Press

In a supine position straightening the legs out against resistive tubing.

Changing Stance Width

With the typical closed chain exercises like squats and lunges can be tough for a client with meniscus issues.  What you can do is play around with the hip width that your client performs the exercises.  Sometime varying the distance between their feet will decrease the load on the injured area of the meniscus and allow them to perform the exercise.

I have to thank Barb for the question about meniscus injuries and exercises.

Do let me know what you think of the post and if you have any tips for other fitness professionals on exercise and meniscus injuries.

Rick Kaselj, MS

Before I go, one last thing.

The picture above gives you an idea of how it looks in the knee.

1 = meniscus

2 = femur (thigh bone)

3 = tibia (shin bone)

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