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Knee Meniscus Tear Tests and Exercises for Full Recovery

yo what’s up it’s Eric Wong here from
Precision Movement and today we’re gonna talk about the meniscus and how to
recover from a knee meniscus tear so I’m actually dealing with a Nima’s
meniscus tear right now myself I got mine at the time of shooting this video
about two and a half months ago and I would say I’m about 90 to 95% to being
100% okay and we’re gonna talk about exactly how to diagnose it with three
different tests as well as four exercises to help you get to full
recovery now these aren’t all the exercises that you’re you’re gonna need
and it depends on what sport you do but these exercises will help to restore the
core functions of the knee and to ensure that you have the movement and mobility
that’s required to keep a meniscus healthy for the long term okay so I got
my meniscus injury and I’ve injured the medial meniscus because I was doing some
exercises experimenting with some exercises and I got a little too
aggressive and after there’s some rotational stuff of the knee some deep
squat crawling so then he was in full flexion and I had to be rotational on
got my meniscus tear and right away the first few days it was very very stiff
okay now one way to differentiate between a joint or a connective tissue
injury and a muscular strain is simply just do isometrics and activate the
different muscles activate quads hamstrings calves adductors whatever
muscles that you suspect might be involved do a strong isometric
contraction and if there’s no extra pain or if there’s just a little bit more
pain then it’s likely that you’ve got a connective tissue injury and not a
muscular strength okay because if you’ve got a muscular strain and you do a
strong isometric contraction of that muscle you’re gonna feel it okay so
that’s one quick way to differentiate between muscular strain
and connective tissue like meniscus injury yep
so let’s go through go through three tests for the meniscus specifically so
the first test is just palpation there’s gonna touch the joint line so find your
knee and touch right in the medial aspect here and just kind of add some
pressure and if you’ve got some tenderness going on somewhere in this
area you might have a meniscus injury same with the lateral line you can just
kind of palpate and rub right along the knee joint there and if you’ve got some
tenderness suspected meniscus so that’s the first test you can do just kind of
get a general idea next up we’re gonna go and do some open chain tibial
rotation so the tibia can rotate externally so when the knee is flexed
only not when it’s extended when the knee is flexed you can rotate the tibial
tibia externally and internally okay so here to test your meniscus first you
want to go to lift the leg up and then actively bring your knee to flexion into
flexion so if you’ve got an injury you’re gonna be limited and you’re gonna
maybe hit an area like oh right there is where I have pain so at that area you
want to go into external rotation and internal rotation and one of those
directions is likely going to increase your level of pain if it’s external
rotation that increases your level of pain that’s your medial meniscus if it’s
internal rotation that’s your lateral meniscus okay so here now we’ve got a
little more information on what tissue exactly is painful so again active knee
flexion to the point of pain once you’re there go to external rotation external
tibial rotation that’s gonna be medial meniscus and then internal rotation
that’s going to test your lateral meniscus and you can add a little more
flexion just to increase the pain there okay so that’s going to tell you okay
lateral medial meniscus figure out what shit is then we’ll know what we’ve got a
target well we don’t even have to target anything we still want to restore full
function of the joint regardless of if you have lateral or medial yeah just
something to look out for final test will go through is simple one knee
extension full knee extension so straighten your
knee and if you cannot achieve full knee extension what that’s indicative of is
you might have what’s called no one has a bucket handle tear of the meniscus and
that’s when basically the meniscus there’s a rip right in the middle and
it’s like you could like the handle of a bucket yep what’s showing here is that
the flap might have folded over and now it’s lit basically like say the meniscus
is normally like this flat folds over itself you cannot go to a full extension
pulling the extension anymore because the compression is gonna happen and you
won’t be able to straighten through otherwise you’d be really squeezing that
tissue hard and that would cause just too much pain so if you cannot achieve
full in the extension you might have a flap that’s kind of folded over and
something that happens with that issue is a lot of times it might just go away
on its own the flap might just restore itself one way to facilitate that is
with a little bit of traction okay so with this we just loop a band around
your ankle lie down and have to bend pulling that way that’s just gonna
decompress the joints a little bit and it might allow that meniscus flap to go
back and lay flat okay so it’s not folded over alright so there you have a
few different tests to figure out a is it my meniscus and B what kind of
meniscus tear do I have whether it’s medial lateral bucket handle just gives
you a little bit more inferring information but regardless the treatment
is gonna be pretty much the same now there’s a study out in 2013 in the New
England Journal of Medicine that tested physiotherapy versus surgery okay they
had two groups and there was like 350 patients two groups and split them in half
sent them into either physio or surgery and what they found is that six months
the pain outcomes and functional outcomes
we’re pretty much the same between both groups now that’s very important to note
however what they found is at the six-month point thirty percent of the
people who started in the physical therapy group moved over to the surgery
group okay so basically what this means is it’s probably a good idea just to
start with exercise and if you’re going for six months and you find either the
pain is maintaining staying the same or it’s getting worse then surgery might be
a good idea yeah I’m not against surgery at all I just think that a lot of times
that’s prescribed too early where we could try these more conservative op op
treatment options and find the same level of success so my suggestion is
start with exercise give it a good go at least three months but up to six months
and then make your decision if you want to go into surgery at that point okay
so if you don’t want to go into surgery and you want to do some exercises let’s
do that right now so the first technique should stay down
call it open chain of tibial rotation isometrics so what you’re going to do is
yeah you’ve got a sore meniscus you’re gonna find the end active range okay so
let’s say this is my end active range and any more than that I get pain okay
so end active range you want to back off just a little bit from there and all
we’re gonna do is internal a nice external isometric so from here you’re
gonna go to external rotation and you’re gonna keep externally rotating for five
seconds hold it and then you’re gonna go into the internal rotation and hold it
for five seconds and you can do three repetitions of either of those okay what
this is doing is we’re firing up the muscles that obviously create external
and internal rotation so this is going to help to facilitate blood flow in the
area which is going to facilitate healing because if you’re not moving and
you’re not creating the forces that need to go through the knee for it to be
healthy you’re not going to bring in the forces that are needed
strengthen that tissue so the meniscus is just like ligaments it’s just like
tendons just like muscles your response to force and when you load it through in
this case external and internal rotation you’re creating those forces and that’s
going to stimulate recovery yeah it’s user to lose it if you’re never loading
it your body’s not going to adapt and make that tissue stronger all right so
that’s the first one I just want to do three repetitions hold your five seconds
in either direction think of it as kind of a warm-up and a
restoration and activation of this movement pattern and of these muscles
okay next up simple squats two painless end range doing 10 10 repetitions
however you normally squat like if you’re if you do back squats or front
squats in the gym whatever your stance is do the same stance this is kind of as
a guide to where you’re at okay because your range of motion is going to tell
you if you’re progressing or not so if you can normally just get down to there
before you feel pain then after a week or two weeks you should be able to get a
little bit lower each time okay so ten repetitions just squat the end range and
like I said I’m about two and a half months in and I can start to feel it
right about there okay so pretty good all right so that is the second exercise
third exercise hip bridges with ankle plants here in
dorsiflexion so there’s a couple key points here I’m gonna lie down in the
supine position okay and I want first thing to set up that’s actively go into
knee flexion and then once you feel the pain back off of that range a little bit
okay so just get out of the painful end range so all these exercises we
shouldn’t be going into pain repeatedly and trying to force our way through it
but we just work just before pain is elicited and we’re still gonna build
strength beyond that range and this will help again to facilitate recovery blood
flow build strength and progressively build strength throughout the full range
okay so here you’re gonna hip bridge first activation is just squeeze the
glutes fire them up bridge up and then from here maintain the position of the
pelvis and the spine and you’re just gonna go into plantar flexion so lift
the heels off the ground by activating the calves and then slowly into
dorsiflexion ya plantar flexion breathe hold just a couple second old and dorsiflexion okay so this you’re gonna
do anywhere from four to six cycles of the planter in dorsiflexion and then do
three repetitions of that okay what this is doing is a lot of the exercises that
we do are gonna build the knees from above so quads hamstrings those muscles
this exercise helps to build the knee stability from below okay the calves
tibia to Vialis anterior okay so this way we’re hitting all of the muscle
groups needed to keep the knee healthy okay so that’s the hip bridge with ankle
planter and dorsiflexion three repetitions with four to six cycles
between ankle planter and dorsiflexion now the last exercise that we’re gonna
do you’ve got to be really conservative with I call this one leg tibial rotation
squat okay so this one you want to go really slow and controlled do not go
into this with momentum or with speed otherwise you’re gonna injure yourself
but if you do this properly you’re gonna strengthen exactly what you
need to strengthen to keep the knee healthy okay so you’re gonna load up one
leg so working on my left knee here and all I’m gonna do is I’m gonna squat down
keeping the weight on my heel and the ball my foot especially underneath the
big toe okay the weight is evenly distributed there
and I’m just gonna squat down and drive the knee outside of my foot to the left
but make sure you plant the ball of the foot the foots gonna want to lift up
like that I want to plant the foot pressure on the foot on the ball and the
heel and then I’m pushing myself up through this leg okay from there I’m
gonna go tibial external rotation so the knee goes the inside you can see how
it’s as if the tibia externally rotated that way same thing
squat this time keep the feet flat but a little more pressure on the outside ball
of the foot so the pinky toe okay and heel foot stays flat just go slow
painless and range and then drive yourself back up using these muscles
okay this is just here for balance my right leg
so again drive the knee to the outside of the foot think of pushing the ball of
the foot down keeping the heel flat on the ground and then push up through the
painless end range and then on the inside of the foot think of pushing
through the pinky toe metatarsal and keep the weight on the heel here okay
and you want to do about six repetitions of either going slow and under control
think of with that map I call it the movement and/or activation pattern that
I described and that’s gonna build up the stability of the whole lower limb
from the foot up to the hip yeah so it’s gonna integrate that all and what you’ll
find is as you do these exercises I recommend you do them on a daily basis
it’s not a lot it’s gonna once you get them down it’s gonna take you about five
minutes to do but this is going to simultaneously speed healing build
strength and stability and it’s gonna ensure that you’re increasing the
mobility the range that is needed okay because if you don’t have good rotation
of the tibia then any time you get into that whether it’s a sport or training
whenever you’re forced there you’re going to hit and range very quickly and
that’s where you can damage the tissue okay so those are four exercises to get
you on the path to the full recovery if you’re just doing
extensions and hamstring curls you’re gonna heal the minister is just gonna
heal over time but you’re not building that all-important rotational mobility
of the knee that is critical for meniscus injuries yeah you’ve got to
restore that so there you have it tests and exercises for full medial or
full meniscus recovery and whether it’s medial or lateral it doesn’t matter okay
if it’s medial in my case you’re just gonna hurt a little bit more whenever
you do tibial external rotation techniques so turning the foot out or
when you’re squatting the knee going inside the foot yeah
and vice-versa for lateral the pain is gonna increase a little bit sooner but
you’re always working the painless end range anyway so it doesn’t matter and
these techniques apply to both conditions alright so this is these are
just four exercises now I’ve got a complete course called lower limb
control that works everything restores full function and takes you from basic
techniques some of which we showed here to more advanced techniques where you’re
actually getting into some ballistics and some jumping some plyometric type
techniques okay and that’s important to train as well because if we’re jumping
we’re running in real life and we got to rehabilitate ourselves using those
techniques so we don’t continue to reenter ourselves and continue to stress
those tissues so check that out you go to precision movement coach
forward slash and lower – Liam – control put a link down there – expect you to
remember that in the description and at the end of the video if you want to
ensure that your whole lower limb is functioning properly to prevent injury
and heal any problems that you’re having right now ok so thanks again for
checking this video out I’ll see you next time peace you

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