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Knee pain post meniscal tear

Jan 12th, 2014

Alastair asked The Guru for the following Physiotherapy Advice:

Hi,

I suffered a meniscal tear about 2 years ago and having had an operation to repair it, one of the anchors moved and required another operation to remove it… This then lead to inflammation in the surrounding area and a cyst. I’ve since has my third operation and the surgeon is happy that my meniscus is repairing and tried to remove the otherwise inflamed areas surrounding the knee. My last operation was 3 months ago.

I have seen physios as part of my rehabilitation and they’ve given me stretches to do.

I generally do these stretches for 45minutes before then running, cycling or rowing for 45 mins 2-3 times a week.

However after any exercise the surrounding muscles and tendons of my knee still feel very painful and makes even walking difficult.

Do you think there would be any benefit in seeing a specialised sports rehabilitation physio or should I just continue my stretches and hope for the best?

Many thanks,

Alastair

The Guru Responded:

Hi Alastair

Cor – you’ve been through it.

I think as a word of caution I think I’d go easy on the stretching. It may well make the knee feel better, but when you’ve a torn and repaired and re-repaired knee the underlying issue was that you an over stretched knee that caused the cartilage tear in the first instance. So without gaining more control around the knee, just blasting on and stretching (despite feeling better!) may have inherent longer term risks….

Stability, control and strength are key – not just of your knee but of your entire leg from the pelvis down and the foot up. You try to make all the other bits around your knee work more efficiently to allow your knee to heal correctly. Do you have a pretty wobbly single knee squat on your painful side compared to the good leg?

The amount of pain you describe post running, would probably make me stop you running – it just can’t be doing you any good. Where the pain comes from needs to be sussed. Is it from the knee itself (obviously!) or as you say the muscles/tendons or is it (and very commonly in chronic knee pain) an irritated “bit” of nervous tissue (have a look at the infrapatella branch of the saphenous nerve).

So – stop the stretches, go and see someone [sport physiotherapy] who’s very decent and talk to them about stability, control and strength (in that order!) and maybe even get them to have a look at your running stylee. If you’re nodding approvingly start treatment. I think you’ve hoped for the best, but haven’t quite got there….

The Guru

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