Experiencing Knee Pain?  You may have a meniscus tear or Knee OA.

Knee pain is one of the most common body and joint aches experienced by people of all ages, and in most cases it’s generally not due to a serious injury or a cause for serious concern. However, pain in the knee that persists over time can be an indication of something more serious, with meniscus tear or Knee Osteoarthritis (Knee OA) being among the most common. Because knee pain is such a common issue, representing roughly 25 percent of patients we see at here at Trio Rehab, we invite you to get the facts about common knee injuries, as well as helpful advice from Eileen Vogt, our resident physical therapist specializing in meniscus tears and Knee OA treatment plans.

Meet Eileen Vogt

“While meniscus tear and Knee OA are the most common and the official diagnosis for those experiencing severe knee pain, our patients come to us with their unique and personal concerns and list of pain points, which is why no matter the injury, we take a very personalized approach with both our symptom evaluation process and treatment plans,” Eileen explains.
“After all, knee injuries generally occur as result of one or multiple personal lifestyle activities, which is very specific to the individual being treated.”

– Eileen Vogt, Physical Therapist,
Trio Rehabilitation & Wellness Solutions

Assess Knee & Symptom

At Trio Rehab, the first step we take during the assessment phase is to ask lots of questions, starting with the most obvious, “what symptoms are you experiencing,” which generally result in pain scenarios and more specific descriptions such as catching or locking feelings in the knee. We believe that allowing patients’ the opportunity to explain their symptoms in their own words is helpful because answers to very specific technical questions may not reveal un-scientific feelings. For example, explanations  such as stiff or painful knees that lock up at the joints might be an indication of an acute injury, resulting from trauma; whereas painful knee joints that do not present feelings of locking up may be Knee OA with a chronic meniscus tear.

Other questions we ask include:

• Have there been any past injuries in the impacted knee?
• Is there a change in pain levels at different times of the day, such as when waking in the morning?
• Have there been any swelling?

The answers to these questions help to determine the special test needed to help further assess the muscles and overall knee impairments, which may include:

• Hip Scour Test (Also known as Hip Quadrant test)
• McMurray Test
• Apley’s Compression Test
• Thessaly Test

Establish Treatment Plan

At Trio Rehab, a very high percentage of the patients we see in this treatment area are older patients who have both Knee OA and meniscus tears (up to 90%). Since Knee OA is a condition that develops overtime, generally impacting people over the age of 60, we are likely not only educating the patient, which is the first step for all our treatment plans, but we also provide education to their caregiver.

In addition to education, some form of physical therapy is also a very important component no matter the treatment plan. In most cases, our approach, with regard to physical therapy, is to initiate a home exercise program (HEP), which is an individualized set of therapeutic exercises that a patient is given  to complete on their own at home. Additionally, a customize a manual therapy plan to help improve range of motion (ROM) in the knee is also initiated to help improve stability around the knee, which strengthens the surrounding muscles, the quads, hamstrings, calves, and gluts, which all help to improve motor control. Better motor control helps to restore knee function and takes the pressure off the meniscus and knee joint.

Treating Meniscus Tears

Surgery may be required for a diagnosed meniscus tear, discovered through an MRI or X-Ray, but it often depends on the location of the tear. If the tear is on the outer one-third of the meniscus, it may heal on its own. However, with consideration to the type of pain, results of initial therapy, and further collaboration with referring physician, we may determine that knee surgery is the most appropriate form of treatment.

Treating Knee OA

When treating Knee OA, we often start with a lot of discussion around what is osteoarthritis, which is degenerative joint disease that involves the degradation of joints, articular cartilage, and subchondral bone as a result of mechanical stress on the area. The “itis” in osteoarthritis refers to inflammation, an important area to address during the initial phase of therapy.  Inflammation is often treated with pain meds and/or ice.

Other Knee OA treatment recommendations include:

• Reduce the pressure off the joint by using an assistive device, such as a knee brace or cane,
• Engage in specific cardio, stretching and strengthening exercises based on objective findings
• Make activity modification to limit pressure on the joint and reduce pain. If you over do it, it will hurt. There is no magic bullet.

“The most important thing to consider when treating both meniscus tear and Knee OA is that physical therapy exercises and activities is the most powerful contributor to long-term rehabilitation success,” offered Eileen. “Surgery alone may fix the tear, but it will not eliminate the pain, which can cause new concerns if not managed properly.”

We can help!

If you’re experiencing knee pain, don’t ignore it. Give us a call and schedule an evaluation with Eileen, and let her help you access your symptoms and navigate the best treatment plan going forward.

MEET EILEEN VOGT

Eileen Vogt

Physical Therapist
Trio Rehabilitation & Wellness Solutions
Boerne, Texas