Hi folks
I'm Bob Schrupp physical therapist, Brad Heineck physical therapist. Together we are the most famous physical therapists on the internet in our opinion of course Bob
Top seven exercises after a meniscus tear and how to get yourself some pain control, that's the topic today Brad exactly
Are you suprised to hear that? No bob
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If you like us we'll like you, that's right all right Brad what's the first exercise we're gonna do?
Okay, so meniscus tear this could be after a meniscus surgery too, similar protocol
But you're going to have to move Bob
Oh, I will do that, out of the way out of the way first of all these exercises the first
This I put under one
but it's really three separate little exercises and the one is working on the hip the quads and
And basically the hip and the quads
So we're working above the joint to stabilize that joint, a lot of the muscles run down across the joint from the hip
So the first one we're going to do is pretty simple. If this is the involved leg right there
We're gonna keep that knee straight. This one's gonna go up like this and oh Bob you're gonna give me a pillow?
Yeah, you didn't look comfortable
Thanks, now I know you care. What's nice about this is you're strengthening the knee without putting stress on it, right
It's basically an isometric strengthening technique
Pretty standard here to do these and this is one of those that looks pretty easy
It's not real difficult
But you got to remember you've got an injured knee and these muscles have not been working
Like they should be, you may actually have a lag when you start off with, right so you might be coming up like this
You may have trouble keeping it straight, right and the goal is to keep it perfectly straight while you do the whole lift
Then you get a little hamstring stretch, and that's the higher you go
Then we're gonna go sideways again with this leg, and we're gonna lift like that
I apologize we do what we can here, now this works the adductors
These muscles are typically not as strong as the quads and you'll feel it when you're working
Yeah, this'll be harder for you
We're gonna do about ten to fifteen of all these and then finally, so he's going around the world here, yeah he's catching the front
inside outside
number two
All right, this is one where we're gonna work the hamstrings
We want to make sure hamstrings are strong and we're gonna do it in an isometric fashion
So it's going to not work with the joint because remember the meniscus is injured and it's healing at the same time
We don't want to let the hamstrings get weak so to protect the meniscus we're gonna do an isometric
Bob can you show which direction I'm digging my heal in? He is pushing down
Into the bed like this, right so there we go and my hamstrings are going
I'm gonna count up to ten 1,001 1,002 all the way up to ten and then relax, and then I'm gonna hold it again
I'm gonna do three sets of ten on these, you know assuming it doesn't hurt the knee
Do you think it would be too much to do bridging on that Brad? Or not
That's something that you could do, cuz if they did it with both
And if you lift up you're doing very little movement on the knee. Sure that's a good point
That's a good option, but I'm just wondering if it would be one to try, as a matter of fact
We could get the ball in here on this
I don't know if we want to do that right now, sure and pushing into the wall
Get the red one, we're spontaneous here,
If you have a ball, if you don't have a ball you can do what you're doing
And now you can see I'm just gonna push straight down
You can see the direction of the force by the ball on my foot and this is a really nice way to get that isometric force
May the force be with you Brad, there you go Bob
And then you could even do a little bridging on this too, I could go up like this
And again you can see he's not moving the knee really, he's just moving his butt and his hips
So that he's strengthening the knee again without putting stress on it, a lot of hamstring there
Yeah, it's gonna be a tough one though probably after surgery, if you haven't had surgery
This is one you should be able to do and with the ball
And then you could do some range of motion here to see how far you can bend it
okay, and
Straighten it out
Okay, if you don't have the ball
I'll let you take that Bob
You can use a device like this we call it the Knee Glide because that's what it is and
This works out really well you can put this in the bed
It's not so bulky and just do some sliding with that all the way up as far as you can now these
All these products if you're interested we have them in our list down below
you can click on it, and the nice thing about this is that you're not going to get better with
putting something down on the bed or the floor
We can elevate it. It's a little thing, but it helps get that
emphasized hamstring stretch
The other thing is when you're on the bed you can't slide
Yeah, you got to put some plastic down. It doesn't work near as nice as this
Okay, alright. Now. Don't put that away Bob. All right. I won't
I'm one that likes to clean up all the time. Yeah, yeah
It couldn't be farther from the truth, okay, all right the next one sitting on the floor
Not sitting on the floor, foot on the floor, put it on the floor seated in a chair
It's basically what we're doing there except for in a seated position so it does change
And we're just you can take a towel and put it on the floor, but why don't you grab that knee glide Bob. Oh sure
Because this is
Nicer to use and again, so we're starting to get some knee motions
Right and here you actually get a little more weight through it and as you lean forward
you can push down and introduce a little weight in through that joint as
You're working the motion so it's that whole idea of
Movement with the stress on the joint so that it's gonna help it heal and again as an alternative you can put a towel on the floor
And slide back and forth
With a towel you can't do this though and this in the seated position makes you really feel the difference on the hamstring
work with this particular device so
And we do want to get full range of motion
And you know you may test it out like this. You know and stretch it all the way
here
Even after a meniscus injury you can try to stretch it too, as long as it's not painful, right pain has always gotta be your guide
Now what do you have in mind Brad? Well we got to straighten the knee, we talked bending it, range of motion, moving our weight
But we have not addressed full extension or getting that knee as straight as it needs to go
Which is right to there, and if you're here
And it's back and you put the other leg up and you can see that it's lower
We need to get that fully straight, right so you can do it using a stool like this works well
It does work well, if you have an office chair or something, real dynamic stretching
Then you're gonna work it, you can use your other hand here and not on top your kneecap, but around your kneecap
So it's not painful irritating the kneecap and you do the old pressure on pressure off pressure on
I think it's good to do both a little bit. You know pressure on pressure off then some sustained stretches
Yeah
Where you hold it for
a minute, because we want to make sure we give you everything, should we even show them the Pro and Hang Bob? Sure
Can I do it? Yeah, go ahead
So he's gonna lay prone on his stomach and
I got my knees still on the bed, but
The rest of the leg is off the bed, now this all depends on if your kneecap is uncomfortable here you may have to go
Move your body off a little bit, or you could put a pillow there
I guess, this is a lot more comfortable
What will happen here is if you put both legs there
As a therapist what I do is I look at it and just compare right to left, that's what's nice
about working with legs, you can always compare with the good leg to the bad leg
and you know if this was his bad knee you can see it needs to go straighter, so
With time now usually this is not real comfortable you feel the stretch and if you have sharp pain with it
You probably should back off and maybe go with the other more controlled or the seated position
But if it just feels like a stretch you can hang and you know I've had people like this up to five minutes
You can put an ankle weight on there. Yeah, you can also do a little bit of this
Yeah, so he's gonna assist with his leg, but I don't have someone else help, right
There's way too much leverage on there. This way they're in control, they know how much they can tolerate and again
They're gonna allow pain to be their guide, and people are much more relaxed when they're in control,
Versus someone else having the potential to create pain
Exactly yeah
All right, we're up to number six Brad. We probably added a few more
Well, those are bonus Bob. We don't like to give bonuses. That's right. Why Bob? I'll tell you why, because
We like to, okay get something to hold on to
And we're just gonna do some squats with both legs
Now I'm gonna put more weight on my strong leg and this kind of tests how the
We still want to try to not have the knee go past the foot, right right good point you wanna grab it, it's over there Bob
Once again Bob is keeping me in line yeah
So a vertical plumb line right from the toe, you don't want to be doing this
We want to keep it behind there like that, and then we're not gonna go past sixty degrees
Which ninety would be down here
We don't have the goniometer, but we're going to show you it's about right to there
There's very little stress on the meniscus at that level, at sixty
Yeah, it's when you start getting deeper that that's where you start putting a lot of stress, a lot of times
These are a lot easier to do with the ball again
We're gonna go back to the ball on the what? The ball on the wall. There's one more point
I want to bring up Bob because it's the same with if you look at
The line straight ahead make sure that your knee does not go in
Most people's knees have a tendency to go inwards, we want to keep it right in line
Okay, so we keep the joint where it needs to be, very good point
These are a lot easier to do to me because it's so easy now to keep my knee behind the foot
Yeah, I mean you're just really in control and some of the body weight is on the balls. Yeah
It's a really good progression into that
Getting knee through the joint, getting the muscles stronger, getting functional. That's what we're all about Bob is getting function
That's right. We're just not puppets on the wall, all right one step up on the stool. Where is the stool?
This one's really getting more advanced for strengthening
I'm gonna use this chair here and right behind you Bob is a cane
This is nice to do in a stairwell which we don't have here
but now with this one you want to make sure the knee stays over the toe it doesn't go in like this and
This way the knee so it stays behind the toes as we mentioned already
And if you have a stair rail you can hang on there
Yeah, it worked our really well with that, and this works out fine too I'm gonna just go up like this and down
Why don't you grab that PVC pipe
It won't move Bob, okay, and show in front
Aand look at this
I'm not pushing off from here, but I got my toe pulled up right here
And I'm gonna touch my heel
Making sure those quadriceps will do as much work as they can and I'm not gonna go in like this
We're gonna go straight in line and up
Really important, that's not a minor point
So to start out with I'm gonna use both hands to help push up and down because this gets difficult
Then I'll take one hand off and when you get really good you can try to do it with no hands
And that really works the quads well, then when you get really good go up there again
I can start whacking ya, yeah a little perturbations. That's right. Yeah in the therapy world, but that would be kinda true in school
Oh, yeah, we love pain and torture so all right, thanks everybody for watching
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