When will you need physiotherapy for a meniscal tear and why?
Small tears may heal by themselves in time, usually over about six weeks. You may be advised to see a physiotherapist or sports therapist to advise you on how to strengthen the supporting structures of your knee, such as the quadriceps and hamstring muscles. Some tears don't heal but, even so, they may not cause long-term symptoms once the initial pain and swelling has settled, or cause only intermittent or mild symptoms. In these cases, no further treatment will be needed.
If you are having symptoms which interfere with your ability to work or which have been going on for more than 6-8 weeks, despite rehabilitation with a physiotherapist, a referral to an orthopaedic surgeon is advised. However, it is important to realise that if you have been diagnosed with a meniscal tear, even if it has shown up on an MRI scan, this doesn't mean you will have to have surgery.
If you do need surgery to your knee, you will be advised to have physiotherapy afterwards. This is so as to keep the knee joint active (which encourages healing) and to strengthen the surrounding muscles to give support and strength to the knee.
When will you need physiotherapy for an articular cartilage injury and why?
Advice from a physiotherapist can be particularly useful if you have been diagnosed with an articular cartilage injury. Moving the knee passively (which means moving it without using the surrounding muscles) may help the articular cartilage to heal. Moving the knee passively also helps to reduce the formation of scar tissue.
Further reading and references
Englund M, Guermazi A, Gale D, et al; Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med. 2008 Sep 11359(11):1108-15.
McDermott ID, Amis AA; The consequences of meniscectomy. J Bone Joint Surg Br. 2006 Dec88(12):1549-56.
Sihvonen R, Paavola M, Malmivaara A, et al; Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med. 2013 Dec 26369(26):2515-24. doi: 10.1056/NEJMoa1305189.
Knee pain - assessment; NICE CKS, March 2011 (UK access only)
Bark S, Piontek T, Behrens P, et al; Enhanced microfracture techniques in cartilage knee surgery: Fact or fiction? World J Orthop. 2014 Sep 185(4):444-9. doi: 10.5312/wjo.v5.i4.444. eCollection 2014 Sep 18.
van den Bekerom MP, Struijs PA, Blankevoort L, et al; What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults? J Athl Train. 2012 Jul-Aug47(4):435-43. doi: 10.4085/1062-6050-47.4.14.
Holzer LA, Leithner A, Holzer G; Surgery versus physical therapy for meniscal tear and osteoarthritis. N Engl J Med. 2013 Aug 15369(7):677. doi: 10.1056/NEJMc1307177#SA1.
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