Inside
Physio Professionals Newsletter October 2012
this issue P ro f e ssi o n a l D e ve l o p me n t
THE MENISCUS
Physio Professionals prides
P.1&2
itself in its continuing staff education initiatives.
THE MENISCUS Staff
Michelle Crew (nee: Peauril) Masters of Physiotherapy Level 3 Sports Physio AIS MAPA
Andy Magill B.Sc. Physiotherapy (Hons) Level 1 Sports Physio MAPA
The knee consists of a medial and lateral meniscus, positioned between the tibial plateau and femoral condyle. In addition to providing stability, the menisci act as shock absorbers by effectively distributing forces during weight bearing activities. Thanks to these two important roles, of stability and shock absorption, meniscal injury of the knee is a common complaint in the general and sporting population. Injury may be Insidious, related to repetitive traits that put cumulative stress through the knee. Heavy manual occupations, road running
Andrew Crew Remedial/Sports Massage Performance Bike Fit Accredited Track and Field / Cycling Coach
and obesity are examples of significant contributing factors. Traumatic injury will be caused by sudden weight bearing and twisting, such as falling from a ladder or landing awkwardly on the netball court. Meniscal injuries aren’t as severe in presentation as acute ligamentous injuries, in comparison there is generally less pain and swelling develops at a slower rate, normally over 12 hours. Individual’s may initially experience some difficulties weight bearing however depending upon the severity of injury, may regain a degree of pain free movement. Commonly, the knee may be painful for two to three days following sport, however by one week the individual may feel ready to play sport again. “Weekend Warriors” and social team sportsmen are typical of this presentation. Aside from MRI, there is no one true gold standard clinical test to diagnose a meniscal injury, rather a battery of tests to detect the likelihood of injury.
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The majority of smaller meniscal tears and early meniscal damage can also be treated conservatively with Physiotherapy and lifestyle modification. In the short term, strengthening lower limb musculature and providing orthotic or mobility aids can allow an individual to regain pain free movement. Non-weight bearing exercise such as cycling and swimming, in addition to weight loss are effective long term strategies to control symptoms and improve function.
Important parts of the subjective examination are “locking” and the 12 hour pattern of swelling, with ongoing difficulties with pivoting, such as getting in and out of the car. Symptoms will be aggravated with weight bearing, and eased with rest. Objectively, effusion, loss of extension, joint line tenderness and positive McMurray’s and Appley’s testing have all been suggested as sensitive measures.
Management is determined by the site, type and extent of injury. The outer third of the meniscus is vascularised and has good potential to repair, therefore with a peripheral tear, surgical management will have a positive outcome with a reduced chance of future difficulties. In contrast, the inner third is avascular and surgical management will involve partial menisectomy, consequently altering the biomechanics of the knee and placing increased stress through the tibial plateau, leaving the individual at greater risk of early degenerative changes.
Physio Professionals offers weekly hydrotherapy classes which is highly beneficial for the rehabilitation of meniscal knee injuries.
Shop 27 “CENTREPOINT PLAZA” Cnr Minchinton St & Leeding Tce Caloundra Qld 4551 Your Personalised Physiotherapy Centre
PHONE: (07) 5438 9111 Email: admin@physioprofessionals.com.au
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