What is the Medial Meniscus?

The Medial meniscus is a soft tissue structure in the knee that acts like a shock absorber for your leg, knee and hip. The medial meniscus is a C-shaped pad located on the inner (medial) of the knee. Medial and lateral meniscus tissue is made of a pad of fibrocartilage. This pad sits on top of the tibia bone (shaped like a plateau) and forms a concave surface for the rounded ends of the femur bone (femoral condyles) to rest on. This pad of tissue acts like a suction cup to hold the tibia and femur bones together in the joint.

*The medial meniscus is an important piece of fibrocartilage tissue. The medial meniscus is known to absorb approximately 50% of the shock of the medial compartment. Because of this, if you suffer a medial meniscus tear it becomes very important to try and heal/repair the tear quickly. If a medial meniscal tear persists, there will be increase of load on the medial compartment which will basically overload the articular cartilage (the smooth cartilage on the end of the bones that meet at the knee) and this is known to ultimately lead to osteoarthritis.
(*reference: "Medial Meniscus Tear | Knee Specialist | Vail, Colorado". 2015. Robert Laprade, MD | Minnesota Knee Specialist | Twin Cities, Minneapolis-St.Paul, Edina, Eagan. Accessed July 16 2019. from website)

The medial meniscus covers more surface of the tibia bone compared to the lateral meniscus. The medial meniscus is thicker on the outside and thinner on the inside, appearing triangular in cross section (from the front or back). Both menisci fill the space between the leg bones and cushion the femur so it doesn't slide off or rub against the tibia.

The menisci are attached in the middle of the joint by ligaments. They're also surrounded by ligaments on the outside and inside of the joint (the anterior cruciate ligament - ACL, posterior cruciate ligament - PCL, medial collateral ligament - MCL, lateral collateral ligament - LCL). The entire knee is then surrounded by leg muscles and tendons to hold the whole structure in place.

The medial meniscus is held in place at three points. One point (at the anterior horn location) attaches at the front to the tibia via the anterior cruciate ligament (ACL) on the intercondylar area. The second point (at the posterior horn location) attaches to the intercondylar area of the tibial plateau. The third and final attachment point is where the medial meniscus meets the medial collateral ligament (MCL). The MCL anchors the medial meniscus so it doesn't move as freely in the knee joint space as the lateral meniscus. The knee is obviously a very complicated joint with a lot of different tissue structures in place, this is why more than one injury can happen at a time along with your medial meniscus pain.

You are more likely to suffer from a medial meniscus tear than a lateral meniscus tear. One reason for this is that the medial meniscus is more firmly attached in the joint capsule whereas the lateral meniscus can move more freely. Another reason is because the medial meniscus absorbs a large portion of the shock of the medial compartment. Both of these factors give the medial meniscus a higher susceptibility to injury than its lateral meniscus counterpart.

Both medial and lateral meniscus tears are known to receive very little natural blood supply. This is especially true if your tear is located in the Red-White or White zone of the medial meniscus (closer to the center of your knee). It's the lack of blood flow around your tear that makes medial meniscus injuries so hard to heal. Healing is tough no matter what course of treatment your doctor's suggesting - ice, heat, physical therapy or surgery. It's no secret that no matter what is done to treat a medial meniscus tear, you really need blood flow in the meniscus to get your body on the path to healing it.

What Causes a Medial Meniscus Tear?

Anyone can injure their medial meniscus badly, though the medial meniscus is most often injured from sudden and traumatic accidents. This can happen from sudden stopping or sudden changes in direction with the leg - like when your foot is fixed / planted on the ground and a twisting force is applied to your knee. It can also get injured with a combination of excessive straightening or bending of the knee which is what happens in a forceful jump or landing.

This includes athletes who participate in sports like volleyball, football, soccer, basketball, hockey and racquet sports such as squash and tennis. An incorrect slide into a base during a baseball game could may cause this as well.

Young athletes are more likely to suffer a medial meniscus tear combined with a medial collateral ligament (MCL) injury. When the medial meniscus tissue is stressed and pulled, a 'bucket-handle' tear might happen. The most common location for injury is to the posterior horn of the medial meniscus, and longitudinal tears are the most common type of tear that happens.

Everyone can be affected by degeneration of their medial meniscus over time. As we age, our tissue ages too; over time, meniscus tissue starts to deteriorate, becoming thin and more likely to break down. Repetitive or frequent movements can place stress on the medial meniscus over the years, increasing the risk of an eventual tear. The knee joint itself suffers degenerative changes such as arthritis, osteoarthritis and/or cartilage thinning on the ends of the bones. This gradual wear and tear on the knees comes from overuse, repetitive knee movements, twisting or prolonged weight bearing activities. Degenerative changes to the knee happen slowly, so you may suffer a torn medial meniscus from a simple daily activity. You need to be aware that this injury can happen to anyone and is not just isolated to athletes!

Types of Medial Meniscus Tears

Medial meniscal tears are classified and treated based on their location within the knee, tear pattern, complexity of the tear, and quality of the tissue. There are a number of classifications for tears to the meniscus.

The most common type of medial meniscus tear is the bucket handle tear. This is because the meniscus is anchored in 3 places (anterior horn, posterior horn and lateral by the MCL). When the knee is twisted and force is placed on the meniscal tissue, the meniscus splits in the middle. This creates a longitudinal tear that looks like a bucket-handle anywhere on the meniscus surface.

Bucket-handle tears are displaced vertical longitudinal tears and usually involve the medial meniscus. The separated inner tissue resembles the handle of a bucket. The remaining larger outside portion of the meniscus resembles the bucket. These tears account for about 10% of all meniscal tears. (reference: 1)

Click here for more information about the different kinds of meniscus tears.

 

In most cases, mild to moderate tears in the Red or Red-White zones of the medial meniscus can be treated through conservative treatments. In cases where the medial meniscus has torn into the White zone or there is a displaced flap of meniscus that catches / locks your knee, surgery will be needed to repair or remove the torn piece of medial meniscus.

Symptoms of a Medial Meniscus Tear

If you've suffered a traumatic sudden injury to your knee while playing sports, swelling on the inner (medial) side of your knee will happen within a few hours after the injury or in the following days. You may also experience more intense pain when bending, walking, or twisting your knee. You'll continue to feel some tenderness on the inner part of your knee.

If your medial meniscus tear is severe enough you might feel a 'giving-way' sensation (instability) in your knee. This feeling may be combined with locking, catching or clicking in your knee. There is usually pain with weight bearing activity such as climbing stairs and twisting movements of the knee when kneeling or squatting.

Degenerative medial meniscus tears are subtle with pain that increases over time. You may also notice swelling after exercise or daily activities. If you do have pain, you'll experience pain on the inner side of your knee and possibly feel weakness / instability in your knee with locking, catching or clicking. Pain may increase with certain activities, like climbing a set of stairs, kneeling to do the simplest thing as putting away your groceries or squatting to pick up something you may have dropped.

If you're suffering for a chronic medial meniscus injury you may have developed a limp due to severe pain or you're unable to stand for long periods of time. A chronic injury could also result in 'buckling' of your knee when weight is placed on it and loss of range of motion.

You might be suffering from a medial meniscus tear if:

• You have sharp pain on the inner side of your knee.
• You have swelling and stiffness, increasing gradually over 2 to 3 days.
• You feel weakness, locking or catching in your knee. Your knee may also show a tendency to "get stuck".
• You might hear/feel a clicking when moving your knee.
• Your knee joint feels unstable.
• You are experiencing a loss of full range of motion - you may be unable to bend or fully straighten the knee.
• You're suffering from pain on the inner part of your knee with activities like deep knee bending, walking, and twisting.

If you are experiencing one or more of those symptoms or you're suffering from on-going pain on the inner part of your knee then you might have a medial meniscus tear injury or possibly a lateral meniscus tear as is can often be difficult to distinguish based on symptoms. Location, shape and size of your tear can greatly influence your success in healing your medial meniscal tear.

Know that ACL tears are also common causes of knee joint instability. You will also find that there are some diseases and chronic conditions (arthritis, lyme disease) that are symptomatically similar to meniscus tears. As always, we definitely advise getting yourself to a physician for a proper diagnosis to determine the true cause of your symptoms as you really need to know what the underlying problem is before you can treat it.

How Is A Medial Meniscus Tear Diagnosed?

The best way to diagnose this condition is with a quick visit to the your doctor for a physical examination of your knee. There are many conditions other than meniscus injuries that can cause knee pain such as an ACL tear, patellar or quadriceps tendinitis, a fracture, arthritis or knee bursitis. Getting a proper diagnosis is important so you can treat your condition correctly.

Your doctor will gather a medical history about you, and likely consider previous knee injuries or joint stiffness that you may have had in the past. This will help the doctor to determine if you have a more complex injury in your knee and rule out any other knee injuries that may be present.

A set of range of motion tests will be undertaken by the doctor that may or may not include the McMurray's Test, Joint Line Tenderness Test, Ege's test, Apley Grind test and Thessaly test. Your knee might hurt from the doctor poking and prodding at it, but by doing this the doctor will know for sure the source of your pain, the level of tenderness in and around your knee and how well your knee can move with this condition.

Your doctor may suggest diagnostic imaging to obtain more detailed information, and assess the amount and/or type of damage done to your knee and meniscus. There are a variety of different tests available to help them analyze the situation; and the recommendation will be dependent on your injury. X-rays will provide an image of the overall bone structure of your knee. It's helpful in identifying abnormal bone shapes, fractures, arthritis, or loose bones and bone abnormalities that may mimic a torn meniscus.

Other tests like a bone scan, MRI (magnetic resonance imaging) or blood tests may be done if an x-ray looks normal or the doctor is unsure whether you have a fracture. These tests will also rule out any infections of the bone or tissue and help to determine if you are suffering from other injuries like arthritis or osteoarthritis (degenerative damage).

If you are experiencing a build up of fluid in the knee, your doctor may aspirate (use a needle) to remove fluid from the joint to check for bacterial infection. Your doctor will be able to determine whether there is an infection or not by drawing a small sample of the synovial fluid with a needle. If it is determined that there is an infection, you will be prescribed antibiotics to get rid of the infection and the physician may pursue deeper inspections into determining the source o infection.

If you suspect you may have a medial meniscus tear injury..

• The first thing to do is speak with your doctor. Only your doctor can give you a proper diagnosis and from this, determine a course of proper treatment. Unless you need surgery to fix your torn medial meniscus, your doctor will almost always recommend conservative treatment options - conservative treatment options for a medial meniscus tear typically means rest, ice the injury, elevate the injury and take anti-inflammatory medication.
• Second, if your doctor has decided that your injury can be treated with conservative treatment options, then you'll find that many of our customers have had great success treating themselves with our powerful home conservative treatment device - the Knee TShellz Wrap^®.
• If surgical intervention is required, talk with your doctor about using the TShellz Wrap^® for post-surgery recovery as you will find it highly effective for enhancing range of motion, stimulating an increase in blood flow in soft tissue and minimizing scar tissue growth.

Sudden force to the outside or inside of the leg - or sudden twisting of the leg (most common in sports such as football or skiing) can cause a number of types of inner knee injuries.

MCL Tear

MCL = Medial Collateral Ligament

The MCL is the ligament holding the medial meniscus and the tibia and femur bones together. The MCL is typically torn due to a direct blow to the outside aspect of the knee. It is common to suffer both MCL tear and a meniscus tear at the same time.

Medial Cartilage Tear

Both the tibia and femur bones have cartilage attached at the ends where they meet. The medial meniscus is a "C" shaped pad that lies between them. A traumatic event with impact to the knee or twisting can tear the protective cartilage on any one of the knee bones; as you may expect, the medial meniscus can be damaged in such an incident as well.

Goosefoot (Pes Anserine) Bursitis

Pes anserine bursitis is a painful, inflammatory condition affecting the tendons between your shinbone and the hamstring tendons at the inside of your knee. The pes anserinus is the area where the tendons of 3 muscles (sartorius, gracilis, and semitendinosus) come together. The three tendons merge together in the skin of the bone on the inside surface of the shinbone. These three muscles are the dominant knee flexors; they influence the rotation of the tibia and protect the knee against rotary stress.
Read more about pes anserine bursitis here. (aidmybursa.com)

Pes Anserine Tendonitis

Inflammation of the pes anserine bursae or tendons usually develops due to overuse, trauma, or degradation. The most common cause of pes anserine bursitis is hamstring tightness due to a lack of warming up and stretching properly before activity, particularly long distance running or excessive climbing. You may notice swelling in front and/or underneath the kneecap as well as often warmth and tenderness when touched. Onset of this condition is typically gradual rather than stemming from a specific traumatic event.
Read more about pes anserine bursitis here. (aidyourtendon.com)

Arthritis / Osteoarthritis

Degeneration to the cartilage on the ends bones in your knees can become torn or wear down and is typical in cases of knee osteoarthritis. This can cause knee pain, locking, swelling, weakness in the knee and range of motion difficulties.

Calcified Meniscus

This condition has been directly linked to end-stages of Osteoarthritis and the degeneration of the meniscus. As the disease progresses calcium crystals are deposited into the meniscus tissue and into the fluid of the knee joint. Increasing inflammation levels, swelling, tenderness, stiffness and loss of range of motion in the knee and leg. (source: Arthritis Research )

Osteochondritis Dissecans

This is one of the less common causes of knee pain. A reduced blood supply to parts of the bone cause loose fragments of cartilage and bone to break off. This disease can occur in any joint, it is the knee that is the most commonly affected. This can cause pain, locking and clunking sensations in the knee, limited movement and swelling.

'Over Compensation Pain' Is A Big Problem With Meniscus Injuries

Since you are reading this, you probably know that serious knee injuries do not just disappear. Over time, it will wreak havoc on your knees, hips, ankles and lower back due to lack of movement, over-compensation and a change in gait. It will also wreak havoc on your opposite knee, due to the fact that you will be overusing it to compensate for not using the bad knee. Recovery takes a longer time for such chronic (long term) injuries, but proper healing is essential to regain strength and get you back to the activities you enjoy.

Everything in the human body is connected. Any meniscus injury can lead to other injuries over time if not treated properly. You WILL subconsciously start shifting more of your weight onto your opposite leg when performing normal daily activities, like climbing the stairs or when standing for long periods of time. You may also try to limp using your opposite (healthy / stronger) leg to get back to work, activities or your sports sooner to avoid waiting for your medial meniscus injury to heal completely.

Many of our clients have experienced pain in their opposite foot, ankle, knee and hip because they shift their standing weight to the opposite side of their body. For example, you might normally climb stairs by leading with your injured knee, but instead will lead with your opposite leg and hop or shuffle more than walk the stairs. Even though changing something like this seems like a really small thing, changing the way you would normally climb a set of stairs when your body isn't used to that can result in pain and injuries in your healthy knee and leg.

Over time you'll notice that you automatically start to put more weight on your non-injured side to cope with everyday activities. When you experience pain in other areas of the body due to minimizing the pain from an older injury, this is something called "over compensation" pain. Usually degenerative medial meniscus pain will happen to your dominant knee (if you are right handed, this would be your right knee). When this happens there is a higher risk that you'll over-strain your weaker knee that's compensating for your injury, because it's just not as strong as your dominant side.

Circulation Boost (Circulatory Boost) is the best treatment available to deal with over compensation issues and injury prevention by maintaining healthy blood flow in around your injured meniscus AND in your healthy knee as well. If you are also experiencing overcompensation pain in the hips, we recommend the use of a BACK/HIP TShellz Wrap^®

Even if you try to avoid over compensation pain in your healthy knee, you're still at risk for re-injuring your damaged meniscus. Ignoring over compensation pain and the pain felt from your meniscus injury while returning to regular activities or your job can and usually will lead to even more problems with healing.

To Stop A Worsening Meniscus Tear & Reduce the Risk of a More Serious Overcompensation Injury, You Need to Heal Quickly & Completely!

Time is no friend to an immobilized joint - you lose strength in your knee but worse than that, you lose the range of motion from atrophy (your flexible tendons, muscles and ligaments slowly shrink / waste away, decreasing joint elasticity). The more time that goes by with your knee immobilized, the more likely you'll wind up with a worsening meniscus tear or perhaps a secondary chronic (long term) problem stemming from reduced range of motion and/or immobility. Basically it means that your knee won't perform as well as it once did and becomes more prone to injury again later on.

If you have a torn meniscus in your knee, it's very important to heal it quickly and completely. Minimizing the healing time of your medial meniscus should be an obvious goal, as meniscus tears will no doubt limit your ability to go about your daily routine; but also keep in mind that untreated meniscus tears will typically get worse over time. As stated here (pennmedicine.org), "If not treated, part of the meniscus may come loose and slip into the joint. You may need surgery to restore full knee function. Untreated meniscus tears can increase in size and lead to complications, such as arthritis."

Dealing with a continuously worsening meniscus tear, chronic inflammation / swelling, loss of range of motion and an increasing risk of overcompensation injuries mean you'll have a greater chance of winding up with a chronic knee condition or a serious case that needs to be resolved with surgery. This is why it's so important to continuously use conservative treatment tools to treat and heal recurring soft tissue damage before it builds into something bigger. For anyone that is suffering from a torn meniscus, having the right tools makes all the difference.

Scar Tissue

During the healing process your body fills in soft tissue tears with brittle tissue called "scar tissue". Scar tissue also grows once you've had surgery to repair your meniscus. The human body uses scar tissue as a temporary binding solution and will try to build the scar tissue as fast as possible around damaged soft tissue. The scar tissue that forms in the knee will be unorganized and won't line up properly with the healthy tissue surrounding your meniscus. This scar tissue will also attach to everything around your meniscus (including the ACL, PCL, MCL and LCL ligaments). This can result in a long-term fusing together of your tissue that stiffens up your entire knee, reducing your mobility and making your meniscus injury even more painful!

• Scar tissue is hard, inflexible, and tough to get rid of.
• Scar tissue will restrict your ability to control the movement of your knee.
• Scar tissue will make your knee more susceptible to soft tissue injuries (strains, tendonitis).
• The more scar tissue that develops, the more you lose the range of motion(ROM) in your entire knee joint.

Scar tissue can become extremely problematic over time, as you have to understand that scar tissue growth can persist and accumulate quite easily. There is a condition known as "arthrofibrosis" - also known as "stiff knee syndrome". Arthrofibrosis occurs when scar tissue has built up inside the knee, causing the knee joint to shrink and tighten. As scar tissue limits joint range of motion, it is not uncommon that the patient eventually exceeds the ROM limits, causing strains/pulls and encouraging the growth of even more scar tissue. This is one of the major reasons why physical therapy is such a crucial component in the rehabilitation process - through many various methods, a physical therapist is fighting to reduce, break up and get rid of your scar tissue. It is often a painful yet necessary process.

Continuous re-injury and build-up of scar tissue while staying active means you'll have a greater chance of winding up with on-going pain, and more tearing or weakening (atrophy) of soft tissue in the knee (ligaments, tendons, muscle).

If you have pain and inflammation in your knee, it's very important to heal your injury quickly and completely. You must avoid the build up of scar tissue. If you don't, your meniscus tear may start you on the path of a downward spiral that could result in something much worse such as permanent loss of range of motion or osteoarthritis. This is why it's so important to continuously use conservative treatment tools to deal with your meniscal damage before it can build into something big. For any medial meniscus tear sufferer, having the right tools means all the difference.

Scar tissue is something that needs to be dealt with fast. If you try to get back into your regular daily activities after surgery with a mound of scar tissue in your joint you'll have a higher risk of re-injury. Scar tissue is just not built to withstand the pressures of regular activity.

If you have scar tissue in the knee and re-injure your knee, even more scar tissue will grow to fill in those tears. If you keep falling into the dangerous cycle of re-injuring your knee without proper treatment you could end up with massive amounts of scar tissue in your joint. Your ability to move your affected joint in a normal way will be impaired as the amount of scar tissue increases.

The truly get on the path toward repairing your meniscus injury through conservative treatment methods

• minimize inflammation
• minimize scar tissue growth by avoiding re-injury while your body is healing
• increase blood flow to the injured meniscus and surrounding soft tissue in the knee to accelerate the body's own healing process
• use passive stretching - carefully - to keep your knee joint flexible and minimize loss of range of motion

Anti-Inflammatory Medications for Meniscus Tears

NSAIDs, non-steroidal anti-inflammatory drugs, can be used if required to help manage your pain. However, these aren't recommended for long term use, as they can cause gastrointestinal difficulties and increase the risk of cardiovascular disease. The TShellz Wrap^®, when used in conjunction with NSAIDs can greatly improve the effect of the medication; this can not only help you heal quickly but also reduce the amount of NSAIDs that you ultimately may require.

Meniscus Surgery

Depending on a variety of factors, your surgeon may recommend surgery on your meniscus tear. Usually this is done via arthroscopy, which is a surgical procedure where tiny incisions are made and a pencil-sized camera is inserted into the knee. The surgeon will then look for damage to the meniscus and make repairs if possible. This is also done to remove fragments, bone spurs, meniscus flaps or portions of the meniscus or the complete meniscus.

Recovery time for the surgery will depend on a number of different factors including your healing ability, diet, rest and how many procedures were done in your surgery.

Post-op recovery time can be reduced with the use of Cold Compress or Ice Pack and a TShellz Wrap^® following surgery. Cold compression is recommended by doctors after surgery to treat your pain in a natural, non-addictive way and to reduce swelling. Once the incision has healed, speak with your doctor about the use of a TShellz Wrap^®. The TShellz Wrap^® encourages more oxygen and nutrients to flow to the area to speed healing and improve the strength of the soft tissue in your knee. Using the TShellz Wrap^® following your surgery (after inflammation is down and the surgical wound has healed) will help prevent and minimize the scar tissue that forms as you heal. Treating scar tissue is the most important step following surgery, especially in a joint, to help improve the range of motion in the knee. Leaving the scar tissue untreated can lead to stiffness, chronic knee pain, osteoarthritis or other chronic conditions.

Read more about Meniscus Surgery here.

Before we go further, it's important to understand that your body is capable of healing itself - though it requires the flow of blood to do so. When it comes to meniscus injuries, the inner third of the meniscus (known as "the white zone") really gets little to no blood flow and if you have a meniscus tear in this area, your physician will probably recommend surgery to fix it. This is one of many reasons why you need to see a doctor - only they will know if the tear is "surgically necessary" (SN). A physician will always try to opt for the conservative treatment first - usually, it works although it takes time to heal. If your meniscus tear is outside the white zone, then, with good blood flow in the area, the damaged fibrocartilage will receive oxygen and much needed nutrients while flushing away toxins and waste - otherwise known as healing. Inflammation and reduced movement (lack of activity or on-going immobility) reduces the flow of blood to an area that's already receiving very little blood flow which is why it is important to keep it down. If you are still active with a meniscus tear, you run a risk of increasing the severity of the injury; if there has been some healing, you could re-injure your meniscus all over again and/or easily make it worse.

Blood Flow - the natural healing process in your body - needs assistance for medial meniscus injuries because blood flow is greatly reduced when you're injured. When treating a medial meniscus injury or really any type of meniscus or knee injury (ie. lateral meniscus tear, bucket-handle tear, posterior horn tear, or anterior horn tear), you need to increase blood flow to your injury while your knee is healing. This increase in blood flow will accelerate your body's own ability to heal itself. We believe the Knee TShellz Wrap^® is to be a highly effective blood flow stimulation device for the knee that is registered with the FDA and available for home use.

If you have a medial meniscus injury, it's very important to heal it quickly and completely. Minimizing the healing time should be an obvious goal, as a chronic medial meniscus tear will limit your ability to go about your daily routine for a long period of time.

A seemingly small, nagging injury in your meniscus that's not properly treated can lead to a chronic painful degenerative medial meniscus tear that can persist for years if not properly treated.

Meniscus surgery is the most commonly performed orthopedic surgery in the United States¹. One major reason for this is that the meniscus is very important; knowing the heavy correlation between meniscus deficiency and osteoarthritis, doctors are doing everything they can to try and repair a meniscus instead of removing it. Doctors and surgeons know that meniscus surgery will introduce more scar tissue into the knee - this is why they only recommend surgery as a last resort. This added scar tissue will be problematic, requiring physical therapy and conservative treatment options post-surgery. If you receive good news from your doctor, he or she will predict that your meniscus can be successfully healed through the use of conservative treatment therapies - without resorting to knee surgery. If you have been given news that you're going to need surgery, once surgery is complete your doctor will once again start you on home conservative therapies. Talk to your doctor about when you can incorporating the Knee TShellz Wrap^® into your home treatment plan during your post surgery recovery.

Some conservative treatment methods recommended include:

• Rest - This is important for initial healing because without proper rest you're at risk for increased pain, inflammation and possibly furthering the damage to your meniscus.
• Avoid Activities that Caused Your Meniscal Damage - While resting your knee it's also important to avoid all activities that may have caused the damage to start with, including any work related tasks that require kneeling or pressure on the knees. Continuing on with regular activities can increase the severity of damage, turning a mild to moderate tear into something much more serious, requiring more drastic measures to fix.
• Apply a Cold Compress or Ice Pack for Inflammation - Immediate cold therapy at the onset of your injury (or during flareups) will help you combat pain and inflammation. Immediate pain relief and reduced inflammation can also relieve some of the pressure that's being placed on soft tissue in the knee and keep the injury from worsening.
• Use a Knee TShellz Wrap^® Once Swelling is Down - After inflammation and/or swelling has been reduced, use your own blood flow to maximize your rehabilitation, decrease recovery time, and boost your bodys overall long-term recovery process. The Knee TShellz Wrap^® is a heat application, and as such, is especially useful in helping combat stiffness or atrophy in the knee joint.
• PT and rehabilitative exercise under supervision of a PT or doctor. The intent of this is to provide you with increased range of motion, pain relief and strengthening of the soft tissue surrounding the knee. Caution: aggressive PT can be harmful, such as aggressive stretching or massage. When dealing with a knee that has very low range of motion, there is high risk of greater injury to weak, damaged muscles and tendons of the joint.

Step 1 - Reduce Pain and Swelling with Cold Compression

The first step for conservative treatment of a meniscus tear is to reduce the swelling in the knee to "open up" the area for more blood flow. Anyone in the health-care business knows that your blood supplies the oxygen and much needed nutrients required to heal soft tissue tears. This is why for years, doctors, trainers, and other medical professionals have recommended RICE (Rest, Ice, Compression, Elevation) to treat the pain and swelling of fresh injuries, chronic pain, re-injuries and overcompensation strains.

This is important because once blood vessels are blocked or damaged, they can no longer carry oxygenated blood to your damaged tissue so this tissue begins to break-down. Without the application of a Cold Compress or Ice Pack, cellular break-down and tissue damage continue because cells can't get the oxygen they need to survive. By limiting the amount of damage done to the meniscus (and other soft tissue in the knee), you also limit the amount of healing that needs to occur. Arresting the damage (preventing the injury from worsening), is an extremely important step to get quickly on the path to heal both acute or chronic knee injuries faster and with less pain.

Use a Cold Compress or Ice Pack:

• 24 to 72 hours after your initial injury or when you first notice pain and swelling in your knee to stop tissue damage, relieve pain, and decrease swelling.
• After exercise, workouts or activity of any kind to prevent re-injury of your knee.
• Before and after surgery during rehabilitation to control pre and post-surgery pain and swelling.
• Anytime you feel your knee is painful or you're having a flare-up of an old injury.
• Anytime you have swelling, sharp throbbing pain or inflammation in your knee.
• Any other situation where you need to draw the pain and inflammation out of your knee.

Step 2 - Introduce Heat to Improve Circulation, Soften Scar Tissue & Prevent Re-Injury with a TShellz Wrap^®

After the inflammation in your knee has been reduced, providing extra blood flow and strengthening soft tissue around your knee is recommended.

TShellz Wraps^® contain a unique Carbon Fiber Energy Pad which is flexible and will shape to conform to your body. This Energy Pad emits uniform waves of energy over the entire treatment area. The body responds to heat energy by increasing blood flow in the treatment area to dissipate this heat.

• When treating any soft tissue injury, an effective treatment will increase blood flow to the injury while the joint is immobile.
• This increase in blood flow will maximize the body's own ability to heal itself.
• In our opinion, the TShellz Wrap^® is the most comfortable and effective blood flow boost device on the market that is FDA registered and available for home use.

What Else Makes the TShellz Wrap^® So Special?

To get more blood flowing in the knee, you need to either use the knee or introduce another way to boost the flow of blood to the knee without the need to move it. Since using a damaged meniscus is out of the question, if you want to accelerate blood flow to the area, we recommend the Knee TShellz Wrap^®

We can promise that you will receive a product that is designed to be safe and does what it is supposed to do...quickly relieve pain and increase the flow of blood to the application area.

The unit plugs into a standard wall outlet to get its power. The nice thing about the power supply is that the same unit can be used in North America and overseas as well. It has the capability to operate between 110v and 230v. It has a special signal controller that can be set for 3 different power levels of application (3=High, 2=Medium, 1=Low). The cord is long so you can sit or lie comfortably and watch TV, read or surf the net while you're using it.

We recommend 5 to 10 minute treatments to start; the safety shutoff controller is set to max 30 minutes in duration. The device can be worn over clothing and allows you to use the device at work, at home, or really anywhere you have access to an electrical outlet.

A Recap of the Benefits of the Knee TShellz Wrap^®..

• Our Knee TShellz Wraps^® can fit ANYWHERE on the knee - side, back and front.
• It can be used before activity or exercise to warm up tissue in the knee to reduce the risk of further injury

• FDA Registered medical device for use in home or clinics - very high quality
• Temporarily increases flexibility and length of soft tissue (reducing the re-injury factor)
• It soothes pain and whisks away toxins.
• Carbon fiber Energy Pad is strong, lightweight, and flexible - contours very easily.
• A boost in blood flow helps maximize the body's ability to recover from soft tissue damage. This can be beneficial in saving time and money when associated with doctor or physical therapist visits.
• For degenerative conditions, such as arthritis, the heat effect combined with the boost in blood flow from a TShellz Wrap^® will help combat atrophy (shortening and wasting away of connective tissue), while reducing inflammation due to lack of active use of the knee. The intent of such treatments is to help keep your knee as healthy and flexible as possible despite the degeneration.
• A boost in blood flow will help maximize the body's ability to recover from tissue damage quickly. This can be beneficial in post-surgery rehabilitation, getting you back to work faster. Do not use until at least 6 weeks after surgery, and only after approval from your doctor.

When Should I Use My TShellz Wrap^® During the Day?

The most common question we receive from individuals prior to purchasing is - how many times a day should I be using my wrap and when should I be using them? While treatment plans will differ for each individual and their specific injury, there are general guidelines that should be adhered to.

• Use a Cold Compress or Ice Pack when you are experiencing inflammation (usually after exertion or movement of the injury area).

The TShellz Wrap^® would then be used:

• Right after rising from bed in the morning (as this is when your knee is often stiff)
• Prior to going to bed at night (to relax the area and allow for better sleep)
• Before you know you will be using your injured joint (going to work, driving, typing, etc).

Use a Circulatory Boost Knee TShellz Wrap^®:

• After swelling and inflammation have been reduced with cold compression.
• Before exercise or workouts to warm up your knee to reduce your risk of re-injury.
• Before and after surgery during rehabilitation to warm up soft tissue in your knee before physical therapy, exercising or stretching.
• Anytime you feel the tissue in your knee has stiffened up, is tight and your mobility is reduced causing you more pain.
• Any other situation where you need to increase blood flow to your knee to relax your soft tissue, relieve pain, prevent re-injury and enhance flexibility of your tissue.

With regular use of the Knee TShellz Wrap^®:

• Your pain will be reduced.
• The applied heat will increase blood flow. This increased blood flow will stimulate your body's healing response, helping your chances to recover from a treatable meniscus injury more quickly, at a reduced risk of re-injury.
• Your corresponding knee will have a larger range of motion and increased extensibility of collagen tissue. (Chapter 9 of "Therapeutic Heat and Cold", 4th edition. (amazon.com link - Ed. Justus F. Lehmann, M.D., Williams, and Wilkin)

Step 3 - In Between Treatments With TShellz Wrap^®, Apply Our New Fast Acting Pain Relief Cream Called ARNICA INFUSION

Dealing with aches and pains affecting the leg, knee, hamstring or hip? If so, then applying the Arnica Infusion to any of these targeted areas will bring about fast relief from the pain and sore tissues. Simply apply a small amount of cream to the body and moments later, you will experience a soothing and comforting sensation over the area.

Arnica Infusion is specially designed to relieve pain due to sore muscles and joints associated with arthritis, knee pain, sprains, strains, and bruises. No matter if you are dealing with an acute injury, chronic pain, or a general "flare-up" - you will experience fast relief from pain and inflammation.

This is a product that many of our current MendMeShop customers asked us to develop. So we focused our time and resources over the past few years and came up, with we believe, will be one of more effective, fast acting, topical pain relief creams on the market.

You are likely familiar with some of the standard topical agents on the market as most of our customers use them. The are mass marketed and even found in most department stores now.

Well, we are here to say that Arnica Infusion goes many steps beyond what they offer.

Made in the USA at an FDA registered manufacturing facility, you can be assured that Arnica Infusion is both safe and effective. We only source top grade ingredients while implementing strict quality control checks during every step of the production process. Expect the same high quality that MendMeShop customers have been accustomed to since we started the company in 2005.

The "Cool Blue" formula is the perfect balance between the smooth application of a cream and the effective absorbing factor of a gel. It is not too thick and not too thin - just the right texture. Best of all, it feels very nice on the skin!

Each application of Arnica Infusion feels so comforting and soothing, we are certain it will become an item you will not want to live without.

Arnica Infusion Ingredients

The Arnica Infusion formula is based on a combination of scientific research and the use of high quality ingredients. The properties within the formula were chosen for their pain relief, anti-inflammatory, and soothing qualities.

The acting ingredients within the formula include ones many of us are familiar with; along with ones that have not received a lot of publicity (only in research circles). Extensive testing resulted in a blending of ingredients that provides the most synergistic of benefits.

The notable ingredients in the Arnica Infusion formula include:

• Arnica - powerful anti-inflammatory, speeds recovery, enhances circulation
• Menthol - provides deep penetrating pain relief with a nice cooling sensation
• Vitamin B6 - promotes normal nerve function
• MSM - supports healthy connective tissues, anti-inflammatory
• Ilex Leaf Extract - increases circulation, skin conditioner
• Vitamin E - anti-inflammatory, enhances circulation, hydrates the skin
• Aloe - anti-inflammatory properties, soothes the skin
• Tea Tree - enhances penetration of ingredients

Extensive quality control procedures during the manufacturing process ensure the ingredients and final product are both safe and effective. We would not stake our reputation on anything but the best.

When Do I Apply the Arnica Infusion?

While At Work

Apply Arnica Infusion at work to help reduce acute discomfort associated with overuse of muscles and joints. No matter if you are in a physical demanding job or work within an office environment, you will be placing stress on different parts of the body and aches and pains will result.

Before Or After Work, Sports, & Activity

If you suffer from a sprained ligament, pulled muscle, strained tendon, or even bruising - apply Arnica Infusion for quick relief of the pain.

Chronic Pain Suffering

Application of Arnica Infusion can be done up to a maximum of 4 times per day on a consistent basis to help bring about relief from various pains and aches.

In-between Treatments With the TShellz Wraps^®

Follow up your TShellz Wrap^® treatments and Cold treatments with an application of Arnica Infusion. Combine the pain relieving benefits of Arnica Infusion along with the healing benefits of the wraps to make your recovery go much more smoothly.

Do not apply Arnica Infusion within a 2 hour time span before a TShellz Wrap^® treatment.

Whether you decide to use the Arnica Infusion in conjunction with the T-Shell and other treatments - or if you decide to use the cream as a stand-alone product - you will not be disappointed with the results. We guarantee it.

Step 4: Passive Knee Stretching...
an Essential Tool for Complete Knee Injury Recovery

Before making the transition to crutches, PT's prescribe gentle stretching of an injured knee. They don't prescribe this to annoy you - it is in fact the most important part of knee injury recovery. You probably know of someone that chose not to do these stretches as it is common - and they paid a high price for it. By not listening to the therapist (ie. not stretching), there is a huge chance of re-injuring your knee or even sustaining an injury greater than the original injury ever was.

Incorporating passive knee stretches into your treatment routine (when your physician says you are ready to do so) not only helps minimize the growth of scar tissue, but it also increases the elasticity and strength of the joint. After utilizing passive knee stretches over time, your knee joint will be better prepared to handle higher and higher loads. Eventually you will reach a stage where your knee joint can handle crutches or standing for longer and longer period of time. This is the final stage of recovery and depending on age, the nature of the injury, your weight and many other factors, it can take the longest time to complete. But remember, for knee injuries, it pays to be patient! Rushing your knee injury recovery almost never pays.

We Guarantee That If You Use Our Products on Your Meniscus for 60 days as Directed, Your Pain Will be Greatly Reduced or Eliminated and Your Joint Flexibility will Increase. If This Does Not Happen, We Will Refund Your Money.

We are an FDA Registered Company, and our TShellz Wrap, also known as a Circulatory Boost Wrap, is an FDA Registered Medical Device suitable for use in hospitals and clinics. Since it is deemed safe for patients to use themselves, the TShellz Wrap can be used for home treatment.

A Note On OverCompensation

Since you are reading this, you probably know that serious meniscus injuries do not just disappear. Over time, they usually wreak havoc on other joints in the body due to lack of movement and over-compensation. Recovery takes a longer time for such chronic (long term) injuries, but proper healing is essential to regain strength and get you back to the activities you enjoy.

The longer your injury endures, the greater the risk of running into serious overcompensation injuries.

To Stop Re-Injury & Reduce the Risk of a More Serious Overcompensation Injury, You Need to Heal Quickly & Completely!

Anyone in need of rapid recovery and complete healing must consider a comprehensive treatment plan that includes an effective means to minimize swelling and inflammation yet also stimulate healing and tissue elasticity. We have found no better set of tools that can be used at home than this:

Conservative treatment tools just like these have been used successfully by thousands of meniscus tear sufferers - just like you.

We believe the use of TShellz Wraps^® for effective treatment of soft tissue injuries is one of the most under-utilized home treatment options available on the market today. We have thousands of customers that have tried many options out there and have been amazed at how effective and fast TShellz treatments can relieve pain and increase blood flow in the treatment area.

References:

^1."W.E. Garrett Jr., M.F. Swiontkowski, J.N. Weinstein, J. Callaghan, R.N. Rosier, D.J. Berry, J. Harrast, G.P. Derosa, American board of orthopaedic surgery practice of the orthopaedic surgeon: Part-II, certification examination case mix J Bone Joint Surg Am", 88 (3) (2006 Mar), pp. 660-667

I want to learn more about Post-Surgery Recovery

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During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!