Knee Pain 1 Year After Meniscus Surgery
Sudden motion where your knee twists while your foot is planted on the ground can result knee ligament injuries including a meniscus tear. These tears are common in people who frequently play sports, have muscular weakness, or have worn-down cartilage due to age or arthritis.
Although a meniscus surgery aims to relieve knee pain, life after meniscus surgery may still be filled with knee pain. This article discusses the causes of knee pain after meniscus surgery and how physical therapy in Merrick, NY, can help with rehabilitation.
What is Meniscus Surgery, and Why is it Necessary?
The meniscus is a piece of cartilage in the knee. It is a C-shaped cushion that serves as the knee joint's shock absorber. However, the meniscus has poor healing capabilities so the type and size of tear determines the type of treatment. Very large tears that cause locking and buckling of the knee often require surgery, but maller tears can often calm down and become non-painful with Physical Therapy. A meniscus surgery aims to remove the torn portion of the damaged meniscus.
Risk factors for meniscus surgery include age and activity. For example, people who play sports are likely to develop a meniscal tear. And without prompt treatment, the knee can become unstable and cause pain and swelling.
How is a Meniscus Tear Diagnosed?
If you feel like your knee may give out beneath you or cannot fully bend or straighten your leg, you may have a meniscal tear. Other meniscus tear symptoms include knee pain, stiffness, or a swollen knee.
Your Physical Therapist can identify the likelihood of a meniscal tear through a physical examination. You may have to walk, squat, and move your leg in different positions. Your doctor can also use a physical examination to diagnose, but Imaging tests like X-rays and MRIs are also used to confirm the damage.
Torn Meniscus Treatment
After diagnosing a torn meniscus, your doctor will prescribe treatment based on the severity of the injury and your symptoms. Before recommending surgery, you may undergo the following treatment:
Your doctor may prescribe medications like nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs relieve pain and reduce swelling.
The RICE protocol can help with a meniscus tear. RICE is an acronym for rest, ice, compression, and elevation. It helps to reduce swelling and provide comfort.
- Rest – keep your weight off your injured knee
- Ice – place an ice pack on the injured knee for 20 minutes each time. You can do this several times a day. Compression – wrapping your knee in a compression bandage can help to reduce swelling.
- Elevation – rest and elevate your leg higher than your heart to reduce swelling
Braces can keep your joint stable to help it heal. Crutches or cane can also help you move around without putting as much weight on your joint.
Physical therapy in Merrick can help to decrease the swelling and pain of a meniscus tear, improve your range of motion and strengthen your knee. Some physical therapy techniques for meniscus tears include electrical stimulation for pain, manual therapy for swelling and flexibility, and strengthening exercises.
Manual therapy includes joint mobilization and stretches to reduce stiffness and restore muscle function. Electrical stimulation uses electric current to stimulate the knee muscles gently, improving strength.
Strengthening exercises also restore your full range of motion and help you return to your regular activities as soon as possible.
Your doctor will recommend meniscus surgery if you still experience pain after undergoing conservative treatments without any improvement. With larger tears having locking and buckling, this decision is made in weeks to months. In smaller tears and symptoms we wait longer due to the potential for success through conservative treatment.
What Happens During Meniscus Surgery?
Surgery is often the last resort after a meniscal tear. A meniscus surgery is usually done arthroscopically. The surgery begins with small incisions, after which your surgeon will insert an arthroscope into your knee. The arthroscope is a narrow tube attached to a video camera.
Your surgeon can then shave away damaged tissue and repair the tear. The meniscus surgery is minimally invasive, and you will receive anesthesia to numb you during the procedure.
Why Does Knee Pain Persist after Meniscus Surgery?
Although a meniscus surgery is supposed to reduce pain and improve mobility, you may still experience pain one year after. Reasons knee pain may persist after meniscus surgery include;
After meniscus surgery, your knee is vulnerable. Although exercises are excellent for improving mobility, exercising in specific ways or limping can damage the joint. After meniscus surgery, following your physical therapist's instruction is essential, ensuring you recover properly.
Arthritis results from the deterioration of the cartilage lining the joint bones. Although meniscus surgery removes damage, it can increase the risk of developing arthritis. Arthritis after a meniscus surgery results in persisting pain, and you may eventually need knee replacement surgery.
Your surgeon will shave off damaged tissue during a meniscus surgery. This results in a smaller meniscus. Unfortunately, because the meniscus is a shock absorber, it cannot absorb the same amount of shock as it usually would. This can result in a retear of the meniscus, especially in situations where strength and stability has not been restored through Physical Therapy.
Infection is a complication of arthroscopic knee surgery. And without prompt treatment, it can damage the cartilage protecting the bones in the joint. In addition, persisting infections become harder to cure. Symptoms of infection after your meniscus surgery include warmth in the joint, persistent swelling, redness around the surgical site, and fever.
If you notice the symptoms of an infection, visit your doctor for prompt treatment. Usually, antibiotics can help you recover. However, the longer the infection persists, you may need additional surgery.
Physical Therapy after Meniscus Surgery
Surgery is often the last resort after a meniscus tear. Physical therapy is a conservative treatment that can help with a non-surgical meniscal tear, but it is essential following surgery.
Physical therapy after a meniscus surgery prevents the development of scar tissue, aids in faster healing, and prevents persistent pain. Fortunately, physical therapy in Merrick, NY, does not worsen your pain. Instead, an effective treatment plan occurs in stages. Each stage is suited to your level of injury and your symptoms.
Phases of Physical Therapy Post Meniscus Surgery
Week 0-3 - Protective Phase
This is the first phase of rehabilitation, focusing on reducing swelling, minimizing pain, and restoring your mobility. After your surgery, you will go home with crutches and a knee brace. During this rehabilitation stage, you should only bear the weight you can tolerate. As long as you don't feel knee pain, you can put your weight on the limb.
Furthermore, keep your brace locked when walking. When going up the stairs, lead with the non-surgical side; when going down the stairs, lead with the crutches and the surgical side.
In this phase your physical therapist will work with you to reduce swelling using cold therapy, electrical stimulation, and retrograde massage. PT will also initiate very low grade flexibility and strength exercises to prevent scar tissue formation.
The second rehabilitation stage after a meniscus surgery is to restore your complete range of motion. This stage aims to reduce pain, maintain full extension, and protect your knee. Your physical therapist will also recommend exercises for strengthening your muscles.
During this phase, you should still use crutches and bear weight as tolerated on your operated leg. When walking, lock the brace with your knee fully straight, and you can unlock the brace when sitting.
This phase seeks to normalize strength, normalize gait, and promote proper movement patterns. You may discontinue using the brace and crutches during this stage after normalizing your gait. Instead, your physical therapist will recommend exercises that improve your range of motion, balance, and strength. You may also undergo cardio exercises like stationary bicycle.
This phase aims to maintain your full range of motion, promote proper movement patterns, and improve strength. You should also be able to undergo exercises without experiencing pain or swelling post-exercise, and begin training patterns for return to recreational activity.
You may undergo cardio exercises like stair climbers during this stage. Strengthening exercises for your knee may also include lateral lunges, squats to chair, and single-leg squats.
You can undergo a sport-specific program, improve your movement patterns, and progress your strengthening. Your physical therapist will also work with you to return to an interval running program. This stage also includes an agility and plyometric program to help you return seamlessly to life after meniscus surgery.
Month 6 and onwards
The rehabilitation goals for this phase include helping you return safely to full sport and improving your symmetrical performance with sport-specific drills. You may also continue with strengthening and proprioceptive exercises.
Meniscus tear is a common knee injury, especially in athletes and older people. Although a meniscus surgery can help with a meniscal tear, it is often the last resort. This is because removing the damaged tissue from your meniscus reduces the size of the meniscus while it is still prone to the same amount of shock. Consequently, there is a higher chance of getting another tear and feeling pain even one-year post-surgery.
In addition, poor rehabilitation, infection, and arthritis increase the risk of feeling knee pain after your meniscus surgery. Fortunately, Summit Physical Therapy can help with knee pain pre and post-surgery. Although it may take months to recover fully, proper rehabilitation is essential in preventing knee pain one year after your meniscus surgery.