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Health, Knee pain

Torn Meniscus: Self-Treatment Exercises

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Often, surgery is not the best option – So what should home-rehab exercises look like for a torn meniscus?

In this second post in the series we look at your home rehab programme, covering exercises to reduce muscle spasm, improve balance and strength a well as an effective self-mobilization technique that will help you make big gains.

As we covered in the first post, a torn meniscus is a very common injury and there’s some important points when it comes to anatomy and surgery vs. conservative rehab, so make sure you have a read of that also.

Knee rehab exercises

NOTE: You can now get our comprehensive KNEE Injury rehab guide – a full rehab guide that you can download with the click of a button!

So, here is your self-treatment:

Rehab for a torn meniscus needs to cover four things:

  1. Muscle spasm
  2. Balance and muscle activation
  3. Graduated strengthening
  4. Joint mobility and meniscus healing

This is the order we need to start them in as well as the first step of your rehab is to settle the secondary symptoms, which is mainly muscle spasm and muscle switching off. This initially reduces pain, improves the range of motion and starts you being able to use it more – which speeds up recovery by helping you optimally load the knee.(1)

RICE injury treatment, heal strong and fastStep 1: Ease pain and improve range

First 72 hours:
As with most acute injuries, you need to first look after it, to allow initial healing – basically where the “scab” forms and to allow it to settle down.

Step 2: Switch the muscles back on, decrease spasm and improve balance

After the first 72 hours, it is important to prevent loss of muscle mass and get your muscles switching on again using some simple proprioceptive and stretching exercises:

  • Bosu ball, wobble board ankle and calf re-training rehab quickSingle-leg balance: The knee loses proprioception very quickly when injured (you can think of this as the “feeling” or the balance). So to get it back, you need to challenge your balance.
    • Level 1: Stand on one leg on the floor, when comfortable for 1 minute, progress…
    • Level 2: Fold up a towel and stand on this, when easy for 1 minute, fold it up thicker or
    • Level 3: Either roll a towel up tight or use a Balance Board or BOSU ball
  • calf stretch , soleus, gastroc - self treatment for shin splintsCalf stretch: Hang one heel off a step for 30 seconds at a time. Once per side.
  • Inner range quads torn meniscusInner range quads / Extensions: With knee injuries we lose activation of the distal thigh muscles, just above the kneecap very quickly. This is a nice and easy one (but still very important!). Sitting in a chair, or in bed with a towel under the knee, extend the knee by lifting the foot up to full extension or pain. Repeat this 20 times, every 2 hours.
    • Note: Do not force it, and take it nice and slow

Step 3: Start strengthening the knee

This is where it finally starts getting less boring! Start step three when it is comfortable to do the above exercises and remember not to push into pain.

  • correct squat form, strong and safeSquats. Yes these are great for getting your leg stronger again but it is important to start at the right level for you and progress from there through the following:
    • Level 1, Wall squats: Lean against a wall, with your feet shoulder width apart and out from the wall. Slide down the wall 1/2 range and no more. Hold this for 5-10 seconds and repeat 10 times. Tip: make this a bit easier on your knee by having a large round ball or Foam Roller between you and the wall.
    • Level 2, Double Leg Squats: Again, fee shoulder width apart. squat up and down within the comfortable range. repeat 10 times for 3 sets.
    • Level 3, Single Leg Squats: Now, standing on one leg, perform squats, within a comfortable range, 10 reps, 3 sets. Note: with this one you won’t be able to squat very low, and that is perfectly fine!
    • Technique: To take pressure off your knees, don’t let your knee/s go forward past your toes and it helps to stick your bum out further!
  • Cardio: Keep your fitness up and boost healing by utilizing:
    • Biking on a Exercycle ideally is great once you have over 90 degrees range in your knee
    • Swimming is a good one for un-weighted exercise, just stay away from breaststroke
    • Walking, as able. When you are able to walk pain-free for 1/2 hour, you can try a short jog and build from there.

Step 4: Gain full knee range

MTSS shin splints self treatmentThere are three things that will limit range mainly at this point: Joint stiffness, muscle tightness and the knee still healing.

The knee should continue healing, as long as it isn’t overloaded, so let your body get on with that.

Muscle tightness can be addressed by stretching out muscles such as your calf, hamstring and quads and also by foam rolling.

Last but not least, joint stiffness can be helped by self-mobilization to improve it’s bending and get the joint oiled-up. See the below video for a short and easy demo:

YouTube player


Health, Mobility

Can’t get up off the floor or a chair? Here’s how to improve

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cant get up from chair? exercises to fix thisMovements that many of us take for granted at some can become harder with age,weight-gain or injury and it isn’t until we can’t do them that we really appreciate how important they are. Regular strengthening exercises and using the right technique can make the world of difference and give you the freedom you deserve.

A follower of PhysioPrescription emailed me last week asking me what he can do to help him get up off the floor and out of a chair better. Well let me tell you, you are not alone, not by a long shot and there are some easy exercises that you can do to get better at it. It limits our lives so much when we can’t do the simple things like getting put of a chair without a lot of pain and effort, let alone getting off the ground – a lot of people actually just don’t get onto the ground for fear of getting stuck there!

Fortunately, there are some great techniques and easy exercises that you can use to improve these.

We are going to run through

  1. The best techniques for getting up off the ground and out of a chair
  2. Exercises to strengthen the muscle that should be powering you out of a chair or off the floor.

Technique – Lets get the basics right

First of all, you need to be doing it the right way (which is the easiest and most efficient way). If you aren’t, you will  just be battling away and wasting energy – potentially leading to injury.

sit-to-stand correct technique and exercise1. Sit – To – Stand

Getting up out of a chair is something that is very, very often done wrong and there are some great tips to improve how you do it.

  • Lean forward at the hips

  • Look up

  • Nose over toes

  • Drive up!

Tip: This technique utilizes your body weight going froward – hence why you need to lean forward so that you nose goes over past your toes. This will start you falling forward, and then all you need to do is push up with your legs to stand up-right.

Note: remember if you are looking down, you might go down, so keep you chest up-right and focus on the top of the wall.

2. How to get up off the floor

The main thing here is to:

  1. Roll onto your side and plant your hands on the floor
  2. push your upper body up, so that your arms and straight
  3. Pivot onto your knees so that your hip comes off the ground – This will get you into four-point kneeling
  4. From there you need to bring one foot forward and plant it – from there you can drive up with that leg.

Watch the video here for a good demo of how to get both down safely and up again:

YouTube player

Exercises to strengthen

Strengthening exercises, when done regularly can make so many daily activities a lot easier. And I don’t mean going to the gym and throwing iron around – There are some great exercises that you can do from home!

1. Sit-to-stand

wpid-wp-1411171453740.jpegGreat functional exercise. If you are finding it difficult to stand up out of a seat, then one of the best ways to improve is practice – build up the muscle memory using the correct technique.

sitting down into a chair and standing up again is almost like doing a good squat and you can use the same technique to do it right.

Now, I know that not everyone can start doing this straight away, so I have included two levels:

Level 1: Modified sit-to-stand

Here, we make it easier by adding a pillow or cushion to the chair – This raises up the platform and means less distance for you to go up, making it easier on your legs.

Now, I want you to use the correct sit-to-stand technique I taught you above, to do this exercise. Stand up from the chair, not using your arms (your legs are only going to get stronger by working at it) and then slowly sit back down again using the same technique as when you came up (except in reverse!)

This is a great one for strengthening your posterior chain and is very functional. Remember to make it easier just place cushions, or solid books etc on the chair seat to raise the platform.

Do 3 lots of 10 – that means do ten sit-to-stands, have 1 minute break and repeat 2 more times.

Level 2: full sit-to-stand

This the same as above but without the cushion or pillow to raise it up – you are doing it right onto the chair seat.

tip: to make it harder hold, a small weight in your hands in front of you , start with 1-3kg.

Bridge - increase leg strength, glute activationa dn decrease back pain. physiotherapy exercises for everyone

Bridge – increase leg strength, glute activationa dn decrease back pain.

2. Bridges

Your extensors (Glutes, back muscles, hamstrings etc) are what really drive you upwards and straighten you up at the hip and torso. This is a great exercise to do to get them working for YOU and the good thing is that it can be done on a firm bed or bench, as well as the ground.

Action:

  • Lying on your back, on the ground, firm bed or bench, bend your knees up and place your feet on the ground.
  • Pushing through your heels and keeping your back straight, lift your bottom off the ground
  • Lower down again, in control the entire time
  • Repeat 10 times for 3 sets.

Tip: If you get back pain doing this or hamstring spasm, try moving your feet in closer to your bottom – this will likely make it easier.

3. Lunges

lunge to strengthen glutes exerciseThis exercise builds great control and strength through your hips.

Action:

  • From a standing start, take a step forward, planting your front foot
  • As shown in the picture, bend the back knee towards the ground, keeping your toes on the ground.
  • Control this all the way with your front leg – this will be doing a lot of the work
  • Only go down as far as you can comfortably and safely
  • Push off with your front leg so that you come back to standing
  • Repeat 5 times on each side for 3 sets.

wall squat exercise4. Wall squats

These exercises are easier than the name lends to thinking and is great for targeting your quads (thighs), these, along with your extensors help drive you upwards, straightening out your knees.

Again, there is two levels here, so that you aren’t thrown straight in the deep end and can start where you feel comfortable:

Level one: Squat and hold

Action:

  • Lean against a wall with your feet at least a foot out from the wall
  • Slide your back down the wall, controlling this with your legs until you are about halfway down
  • Only go down as far as you are comfortable with!
  • Hold this for 5 seconds and then slide back up again
  • Repeat 10 times

Wall ball squat exerciseLevel two: Swiss ball wall squats

You will need a swiss ball (also called gym balls among other things) for this good little exercise

Action:

  • Place the ball against the wall and lean against it at the height of your low-back – make sure your feet are out from the wall
  • Slowly squat down, keeping the pressure against the ball
  • Only go down as far as is comfortable.
  • Return back up and repeat 10 times for 3 sets

Bosu ball, wobble board ankle and calf re-training rehab quick5. Single leg standing – For balance and hip control

Level 1:

Action:

  • Stand on one leg on the floor
  • Don’t let your legs touch each other
  • Goal: hold for 1 minute

Tip: if you cannot hold this very well, you can start with one finger on a wall or bench close to you

Level 2:

Action:

  • Stand on a wobble board, dura disc or bosu ball on one leg
  • Aim to hold this for 1 minute or build up to it
  • If you cannot afford one of these you can also fold up a towel and stand on that – rolling it up firm to make it harder

As I mentioned above, these exercises are effective if they are done regularly, so make it routine and stick to it.

Aim to do these exercises at least 4 times per week and you will really notice the difference.

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Note: it is always best to consult with your GP first if you have any medical conditions and have someone standing by when trying these exercises.


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