Passive Knee Stretching:
The Final Step in Meniscus Rehabilitative Therapy

'The house is only as strong as the foundation' this statement rings true with your knee(s). Each step we take we rely on our foundation to be strong, straight and true. Your knee is a weight-bearing joint and the most important thing about when it comes to your knee is stability. Yes, we need our knee(s) for move around in our daily life, but if we have weakness in the muscles and the foundation is going to collapse there will be no mobility.

The stronger your muscles are around your knee, the less energy is passed onto your meniscus. When you have any type of injury to your knee, the first thing your doctor tells you to do is 'rest' in order to heal and use cold compression for swelling. Here is where the trouble begins, our muscles start to lose strength after just a few day of rest. It becomes critical to start passive stretching and not loose muscle strength and may be one of the most valuable things you can do to recover from your meniscus injury! A balance of exercise, range of motion, strengthening and endurance can relieve symptoms, protect your knee joint and prevent knee degeneration of the meniscus and cartilage. (source: American Academy of Orthopedic Surgeons)

Muscles begin to atrophy (waste away) only after a few days of dis-use. As time passes the muscle fibers shrink and the muscle loses strength and microscopic bits of tissue begin to die inside the muscle. (source: American Academy of Orthopedic Surgeons)

Your muscles supporting your knee are in weakened state you may have even already felt is if your knee may 'give-out' on you; walking up a set of stairs or getting up from your chair. It may have been even difficult to take that first step in the morning. All signs that the tissue around your knee is weakening and you are losing range of motion with your leg. While in fact, this pain and lack of movement in your leg and knee is holding you back in the healing process. Your body needs blood flow to heal correctly. The old adage 'use it or lose it' holds true here: in not moving your knee, you are losing out on critical extra blood flow to promote healing.

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Bring Back Full Movement

Pain can restrict your leg and knees range of motion, you hurt so you don't move. Pain free range of motion exercises are your best friend and can get you on the road to recovery from your meniscus injury. Any injury to tissue is in a weakened and fragile state as healing starts and your body will quickly fill in the tears or strains with scar tissue. So using your knee if even only a bit, any pain-free movement is good for your knee!

The golden rule for the best chance of successful recovery from meniscus damage is to increase flexibility, tissue strength and range of motion.

Passive knee stretching assists in complete and full recovery for:

Before making the transition to crutches, physical therapists prescribe gentle stretching of an injured knee or hip, and if no device is available, they usually prescribe heel slides. 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.

Passive knee stretching not only helps minimize the growth of scar tissue, but it also increases the elasticity and strength of the joint. After using streches 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.

Stretch At Home To Maintain Range of Motion & Minimize Scar Tissue Build-Up

The final step in meniscus rehabilitation is stretching - this is a critical step for complete recovery from your medial meniscus tear!

When your meniscus is injured, stretching plays a huge role in treating your injury with or without surgery... This is especially true if you're immobilizing your knee after surgery with a cast, brace or by using crutches. Long-term immobilization of your knee can lead to massive amounts of scar tissue that stiffens all of the tissue in your knee causing your surrounding muscles to atrophy (waste away).

For many people stretching seems like a basic thing but you'd be surprised by how many people there are that don't understand the importance of stretching a medial meniscus injury, especially after surgery.

Each of your legs support an intense amount of weight everyday. When you suffer from a meniscus injury in your knee you're unable to support your own weight in the same way you used to. This can make simple tasks like walking or even standing extremely difficult for you. A full recovery from your meniscus injury (especially after surgery) depends on your commitment to stretching and strengthening exercises.

Physical therapists prescribe gentle stretching of your knee before making the transition to crutches after surgery and as you recover from having to use immobilization tools like a knee brace. They don't prescribe this to annoy you - it's in fact the most important part of your recovery. You probably know someone that chose not to do any stretching - and they paid a high price for it. By not listening to their therapist (i.e. not stretching), there is a huge chance of re-injuring your meniscus or even getting a more serious injury than your original meniscus tear.

Ask any physical therapist and they'll tell you the key to a successful recovery is commitment to exercise at home.

Passive Knee Stretching is Intended to Help in the following areas:

• Meniscus post-surgery rehabilitation efforts.
• Recovery from serious medial, lateral, bucket-handle, posterior horn and/or anterior horn meniscal injuries.
• Increasing flexibility in the tendons, ligaments (ACL, MCL, PCL, LCL) and muscles in and around your knee.
• Stretching out scar tissue that forms in your knee while your meniscus heals with or without surgery.
• Decreasing the stiffness in your knee.
• Preventing atrophy in surrounding soft tissue from your knee being immobilization.

When You Use Passive Knee Stretching, your goal is to:

• Build muscle strength around your knee for added support to your recovering meniscus.
• Increase hip, knee, ankle, heel and foot joint mobility and range of motion (ROM).
• Speed overall healing of your meniscus injury.
• Prevent soft tissue (tendon, ligament, muscle) loss (atrophy) around your knee.
• Improve soft tissue / muscular function and capability.
• Encourage overall knee joint flexibility.
• Facilitate a proper warm up for regular exercise.
• Promote healthy circulation in all of the joints in your leg (hip, knee, ankle, foot).

HEAT (warmth) is used after you've reduced your swelling / inflammation and the sharp pain is less intense (you have more of a dull / nagging ache and soft tissue tightness in your knee). Warming up soft tissue results in increased blood flow circulation as the body sends more blood to attempt to remove this same heat. It's the blood in your body that will bring oxygen, nutrients and water (basically energy) to deep soft tissue - blood flow is what the body uses to repair tissue.

When heat is applied to the knee, veins will start to get bigger (expand) to allow more blood flow through the area. This in turn relaxes your knee, making the tissue more flexible and elastic. This is why heat is used on older (chronic) injuries, to loosen tissue and bring in the blood flow needed for healing. Your body will begin to heal itself after it is injured - increasing your blood flow will speed up this natural process - often surprisingly well.

Doctors usually call this process 'Vasodilation'.

A TShellz Wrap^® temperature treatment works best to increase blood flow circulation and stimulate the bodys healing response for older (chronic) injuries, re-injury (after swelling has been reduced) and during long-term post surgery recovery. Warmer temperatures should not be used until at least 3 to 5 days after you first have the injury. Heat should not be started for a least 2 weeks after surgery because inflammation levels will be very high as the healing process starts over again. Any use of heat should also be combined with gradual movement to stretch out your knee and increase range of motion.

If you have a chronic knee injury that keeps getting re-injured you should use heat before activity to loosen up your tissue (making it more flexible). When used at this time the warm temperatures naturally extend the elasticity (elastic-nature) of the joint, making it more movable / pliable for activity.

Sometimes we feel pain while doing a certain activity - should you still use heat? Using heat in the morning before you start your day or before activity can help to boost the healing process and reduce your risk of re-injury. Too much heat (especially when you suffer a set-back with swelling / inflammation) can make your inflammation worse. Cold treatments with a Cold Compress or Ice Pack should be used part-way through your day when you suffer from on-going pain and inflammation as a natural pain-reliever.

Rehabilitation Exercise for the Knee

Physical therapy is a beneficial way to restore atrophied muscles and improve strength and mobility during knee rehabiltation. The type of physical therapy and the duration will be dependent on the tissue damage and your symptoms. When you are treating or recovering from a meniscus injury, it is important to ensure you do not perform any exercises that will further irritate the meniscus or possible cause reinjury.

Once your pain starts to diminish, a physiotherapist will set up an individualized strengthening and stretching exercise program for you to perform at home or in the gym. This will be based on your needs and abilities, and will help you return to performing your normal routines.

Individuals will often lift weights on their own, to try and build up their strength. However, in doing so, they can do more damage to their joint. It is extremely important to strengthen your muscles properly, as they may have weakened during the period of non-use. A trained therapist will help to ensure your rehabilitation process is appropriate and effective. For best, long term results use TShellz Wraps^® at home, in conjunction with physical therapy and an exercise program.

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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!