♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Howdy, folks.
I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together we are the most famous
physical therapists on the internet.
- In our opinion, of course.
- Just trying to mix it up, Brad.
Today we're gonna talk about
top three exercises to perform
after a meniscus tear.
This is the assumption
that you're not having surgery
and that you just want to go ahead and try
to do some exercise
after you've tore your meniscus
or your cartilage in your knee.
- Right. Yeah.
We're already making the assumption
you're probably are very familiar
with the meniscus and your knee joint.
It can tear,
it can get all kinds of little problems.
It could cause knee pain and locking of the knee.
It locks right up sometimes.
So let's go through the first exercise.
- Right.
Brad, before you do the exercise,
you're probably, you know,
you're gonna do a couple days
of rest, ice, compression, elevation,
the RICE acronym.
- Right.
- Okay. All right.
The first exercise that you're gonna do
is just what we call "straight leg raises".
So we're gonna pretend this is the one
that has the knee meniscus tear.
And the first one you're gonna do,
you go ahead and bring this one up
and put it flat on the bed
or the floor.
- Propping your knee up.
- And you're gonna go up about this high.
You're doing isometric strengthening.
Count to what?
How long, Brad?
- Well, I like to count to 7, 8,
somewhere in there. It depends on how fast you count.
- That's right.
If you count really fast,
better count to 10.
- Right.
- And believe me,
it'll start to shake after a little bit
after you're doing these.
- So working the quad,
as matter of fact,
I can feel Bob's massive quad right here.
- It's already starting to shake, isn't it?
- Yeah. Now you're gonna try and keep
the knee straight with this,
but you can do as tolerated.
If you're getting some sharp pain in there,
you're gonna have to not do this one.
- Right. Good. And how many are we gonna do, Brad?
- I'd like to do 8 to 10.
- Okay. 8 to 10.
I'm keeping the toe straight up on this one.
- Yep. - Or do you wanna turn out?
- Well, we're not gonna do that
'cause we're gonna do the abductor-
- That's right. Okay. Why don't we do that one next?
- Yep.
- So then you just flip over onto your side.
I hope you can hear me with my mic.
And what you're gonna do is
you're gonna bring it up this way now.
And this one works the abductors,
the inside of the thigh,
and it also gets that VMO a little bit.
- Right.
The one that's important
for the patella to move properly.
- Right.
- That foot is almost kicking me, Bob.
- Can you see okay?
I'm pointing straight forward. Are you in the way, Brad?
- Yes. I'm in the way.
His foot is like this.
Okay.
- So again, 8 to 10.
- Yep.
- And hold for a good 8 seconds or so.
- Yeah,
these aren't gonna necessarily heal your meniscus
but they're gonna keep your leg in shape.
- That's what we're trying to do.
Keep your leg strong.
Now I gotta flip over onto my side
and now I'm gonna bring it up straight like that.
- Right.
Knee is straight, if you can do it.
Point your knee up, Bob.
That is what you do not want to do.
You want to keep it pointed like this.
Do it incorrectly,
bring your hip way over here like that.
This is exaggerated but you wanna make sure your hip
is way up like that.
So you're doing a true hip abduction.
- [Bob] 1, 2, 3, 4, 5, 6, 7, 8, 9, 10.
Okay.
And then the last one
in this position you're gonna do
is you're actually gonna go ahead
and bend your knee a little bit
and you're gonna dig your heel into the bed.
- So if I have my hand-
Can you relax, Bob?
And I put my hand there.
Right now he's squishing my hand
and it's a little painful.
You're strong Bob.
- You're gonna feel it in the hamstring
and that's what we're trying to do
is isometric strengthening to the hamstring.
- Pushing down in that direction.
- Yep.
Count to 10, same thing.
8 to 10 and a 10 second hold.
- Sure.
And again, should be pain free or just,
if anything, a mild pain,
but then you gotta be careful.
- Now then when you're in this position
then what you're gonna go ahead-
You wanna put that down, Brad?
- Sure.
- You can do this with your heel.
You can do it with a sock on your foot
instead of using a shoe.
But you're gonna go ahead
and slide the heel this way
and bend it as far as you can,
as pain allows.
- Right.
- You wanna make sure
you're getting full range in that knee,
full range of motion.
- And you can take your hands
and help it a little bit-
- Exactly.
You can go ahead and grab
and pull it a little bit.
- Right.
We're just getting that range of motion
so things stay loose
and the range of motion maintained-
- Stays full.
- And you know,
hopefully the meniscus is not tore that bad
that eventually it's going to heal on its own.
You know, you don't know if it's-
- Or if there's a piece broken off,
maybe it'll get reabsorbed.
- Sure.
- Or it's just not gonna give you any trouble.
- Right.
If it's real painful
or starts locking up with these exercises,
it's not the thing to do.
- Right.
And in fact, this-
Brad, can I use your chair?
- Oh, sure.
- The other one is
you're gonna want to go ahead
and stretch it straight.
You're gonna go ahead and put it up on a chair
and go ahead and push it down a little bit. Now, if it locks
or it won't let you go completely straight,
that might mean
you're gonna be a candidate for surgery.
Especially if it stays that way.
- Let's do a profile on that
so they can see that better, Bob.
- So we're like this
and you're gonna go ahead
and try to stretch it straight.
Kind of a hamstring stretch is what you're doing.
Good posture.
- Yep.
- But if it doesn't go down,
you can give it little pushes,
but just don't cause pain.
- Right.
- You want to stay in that pain-free zone,
you know, bump up against the pain,
but don't cause the pain.
- Right.
Don't get the attitude,
no pain, no gain.
It's not going to be effective.
- Right.
So number one
was doing all the straight leg-raises.
Number two was doing the range of motion.
And number three is more of an advanced
strengthening exercise.
- So if it's feeling better when you're walking,
stairs might be a little difficult yet
so you're gonna avoid those,
but then you're gonna go to here,
have something to hang onto
and simply do a partial squat.
- Half squat or partial squat.
What you're trying to do is not really
have the knees bend more than 60 degrees.
- Right.
- 90 is a right angle.
- Too far.
- Yeah.
- But we can go down about to here
and you're gonna feel those quadriceps working.
Good posture, of course.
Now this, this is a common mistake.
It's up tall, shoulders back,
and down to about that 60.
And you're gonna do 'em slow
and you're gonna do about 10 again.
You can hold them here
to get that isometric strengthening in the quads
and working it.
All these are pretty-
- Yeah. Pretty mild.
What they found is that
if you bend the knee only that far,
less than 60 degrees,
you're not really putting much stress
on the meniscus.
So you're not gonna make things worse.
You're not gonna tear it worse.
- Right.
- So these are all things you can do.
And hopefully that, you know,
when the swelling goes down,
you'll find out the tear,
maybe it's a tear,
but that you can live with it.
- Right.
- It's not really giving you any pain
so why have anything done with it?
- Right.
So, I don't know, Bob,
we were getting pretty good at this.
- I would say so too.
I don't know why you think that now
but I thought we always were pretty good.
- 742 videos now?
- Yeah, that's right.
We've been around for a while.
- Got a lot of practice.
- Thanks a lot for watching.