Exercises to avoid surgery for a knee meniscus tear.mp4

A meniscus tear can be very problematic for the knee causing pain, popping or locking sensations and reduce mobility. So let's look at what you can do to avoid surgery. Hi everyone and welcome to Exercise for Health. I'm Richard and today I'm going to take you through eight exercises to manage a meniscus tear in the knee. If you're new to this channel we offer tips, advice and exercises each week to help you manage your health condition with physical activity. So go ahead and tap the subscribe button below and the bell icon if you want to be notified of when we upload a new video. The meniscus is a c-shaped tissue that sits on either side of the knee joint on top of the shin bone. It's what some people refer to as the cartilage in your knee but this fibrocartilage differs from the smooth articular cartilage that is on the end of the bones. Think of the meniscus being a bit more like an intervertebral disc of the spine that acts as a cushion and shock absorber for the knee. This meniscus can tear due to an injury or following degeneration of tissue over time. It's one of the common causes of knee pain most often located on the inside or back of the knee. It can make the knee feel unstable when walking and with severe tears it can cause a catching or locking sensation although some tears go unnoticed and are asymptomatic. There are different types of tears with the most serious being a root tear where the meniscus is pulled away from the bone because this type can accelerate the degeneration of the knee joint so a surgical repair is necessary. Depending on the type and severity of the meniscus tear and where it's not likely to heal on its own, surgery may be the only option if the condition is dramatically affecting one's quality of life. This can be a removal of part of the tissue known as a partial meniscectomy or repair of the meniscus where it's stitched back together. However for surgery that involves the removal of some of the meniscus this can unfortunately increase the risk of knee osteoarthritis in the long term. Therefore to offset the need for surgery and to help manage the symptoms there are exercises you can do as a form of physical therapy. I'm going to take you through a series of eight strength and mobility exercises that not only address the soft tissue around the knee but also muscles around the hip which can influence the mechanics of the knee joint. So let's take a look at them. The first three exercises are isometric meaning you'll be contracting the muscles statically and this is a good way to promote blood flow to the area around the knee as well as stimulate the muscles to provide stability for the joint. We'll start with lower leg rotations. With the knee of the affected leg bent to around 90 degrees without any pain and holding the thigh above the knee you will externally rotate the knee which is moving the toes of the foot to point outwards and continue to contract the muscles in this position for about five seconds before releasing off and internally rotating the knee which is moving the toes of the foot to point inwards and continue to contract for a further five seconds. Repeat this process three to five times each way and you may feel that one direction is more uncomfortable than the other depending on which meniscus is torn. But as with all the exercises in this video you shouldn't be moving into or through any pain. The next one is static quads to fire up the muscles on the front of the thigh. With your affected knee straight with the leg out in front of you think about trying to push the back of the knee down into the floor tensing the muscles on the front of the thigh. As with the last one hold the contraction for about five seconds and repeat between three and five times. The quadriceps play a key role in the stability of the knee joint so you could also do this with the other leg for comparison to see if there is an imbalance between the two. The last isometric one is the lying bridge. Start off led down on your back and bring both feet in towards your bottom bending the knees to about 90 degrees providing you don't experience any pain. So if needed don't bend them so much. Then think about pressing the feet into the floor pushing them down to begin to raise your hips up. Hold this position at the top for about five seconds to really engage the muscles of the hamstrings and the glutes before lowering back down. To add to this movement you can also perform some ankle pumps while in the bridge position. This is lifting the heels of the feet off the floor and then reverse back so that the toes and the forefoot is lifted off the floor a few times each way while you maintain your static bridge. This will help stimulate the muscles of the lower leg at the same time. The second group of exercises are dynamic meaning you'll be working the muscles with movement. The first of these is to target the muscles around the hip with straight leg raises and it's worth doing these on both legs rather than just the leg of your affected knee to help maintain a muscular balance. Start off seated on the floor with a back support if needed but in good posture and your legs straight out in front of you. Slowly raise it up and down without the foot touching the floor until you've completed the movement 10 times. This will stimulate the muscles of the front thigh. The second variation is lying on your side keeping your body in alignment from your shoulders through to the hip, knee and ankle. Raise the top leg slowly up and down ensuring that the toes of the foot point in the same direction as your body is facing. Repeat this movement for about 10 repetitions so you can feel the muscles on the side of the hip working. The third variation is slightly more restrictive but is lying on your front raising the leg up behind you to target the glutes around your bottom. Be careful not to lift the front of the pelvis up while performing this one so it purely targets the hip extension movement. As with the other two variations do this 10 times slowly before repeating on the other leg. The next dynamic one will target the hamstring muscles on the back of the thigh. For this exercise to work properly you will need a slippery surface to do this on so the heel of your foot can slide. If you only have a carpeted floor then sliders can be really useful. Start by lying down on your back with the non-working leg either out straight or bent in a comfortable position. Dig the heel of the foot of the leg that you're working into the floor and begin to slide the foot towards your bottom working through your pain-free range of movement. It may be that you only get a slight bend with this but that will be enough to stimulate the hamstring muscles. If this feels easy then you can progress this by lifting your hips up a few inches off the floor when pressing the heel of your foot into the floor and maintaining a hovering of the hips throughout the movement making the muscles work harder. Only choose this progression though if 10 repetitions on the basic version doesn't feel like it's stimulating the muscles enough. The last exercise in this group is a partial squat where we only bend the knee to about 60 degrees. This is to allow the quadricep muscles to activate without placing too much pressure into the meniscus. You can use the back of a chair or item of furniture if you feel you need it to hold on to but start with your feet a hip's width wide and begin to bend at the knee and the hip to drop down into a quarter squat position. Make sure your knees don't collapse inwards or splay outwards while they're bending so you maintain a good alignment of the joint throughout the 10 repetitions. As with the heel slides you can progress this into a split squat to place more emphasis on the front leg by placing the other foot behind you and keeping more of your body weight on the front foot but still ensure the stability and alignment of the knee throughout the movement. The final two exercises are stretches to help deal with tight muscles potentially from reduced movement as a consequence of the injury or pain. The first one is getting the knee to bend. Lie on one side with the knee you want to bend on top, grab hold of the ankle and slowly bend the knee bringing the heel of the foot close to the bottom. Once you have bent it as much as is possible without any knee pain, begin to take the knee backwards to open up the hip further increasing the stretch of the quadriceps on the front of the thigh. Hold this stretch feeling for at least 20 seconds and you can always increase this time or move further into a deeper stretch if necessary to develop the flexibility of the muscle tissue. The last one is stretching the hamstring and calf muscles on the back of the leg. Ideally use a towel for this one as it helps you engage a stretch. Place the middle of a rolled up towel underneath the ball of your foot. Lie back down lifting the leg up off the floor while pulling on the ends of the towel. Make sure to keep the knee as straight as possible and if it bends then allow the leg to drop back down slightly. Push your tailbone of your spine or your bottom into the floor while pulling on the towel bringing the toes back towards you. The combination of all these factors will greatly stretch the muscles down the back of the leg behind the knee. As with the other stretch, hold it for at least 20 seconds and move further into the stretch if necessary. I hope you can take something away from this video today. If so, please give it a like by clicking the thumbs up button below to help this channel grow so more people can benefit from it. Thank you so much for watching and remember to stay active, keep moving and I'll see you next week. Thank you for watching. If you enjoyed this video today, please give it a thumbs up. You can also click here to subscribe to this channel or click here to watch a recent video. See you soon!