Hello, Caruso community! This is Ricky reporting in today. Physical therapists are people just like anyone else, and as such we can be victims of the very injuries our patients come to see us for. Many of my current patients already know this, but over the past month and a half I have been walking with a little bit of a limp and have been managing my own minor meniscus injury. I say “minor,” but despite this it has had a pretty significant impact on my day to day life and my ability to work and exercise. As I have been working on this, I wanted to give the Caruso community a little look into my case and see how a therapist manages these injuries, be it on themselves or on their patients.
What happened? How did it happen?
The short answer is, “I’m not sure.” The slightly longer answer is that my knee began having a strange popping and painful sensation near the end of a long work day and all the problems escalated from there. Next couple of days it felt unsteady to put weight on and gave me little twinges of pain when I turned a certain way or when I fully straightened the knee. You can ask any of my patients or coworkers and they’d tell you how bad I was limping at the time. Whenever I tried to put weight through the leg it was like the muscles didn’t know how to turn on and if I tried to engage them, my knee would tremble like I was one week out of a knee replacement. It was certainly a discouraging sight to see for someone who is at the gym five times per week.
Whenever something goes wrong, our first prerogative is usually to identify the reason why, and it’s always disappointing when you can’t quite pinpoint it. Many cases of meniscus injury present like mine, where there is no specific moment that one can point to, but others are a bit easier to identify. These more obvious injuries usually involve a challenging movement (like a quick cut or pivot during athletics) or an accidental movement (like a trip and fall). The exact nature and degree of a meniscus tear can vary greatly and these are important factors in understanding one’s prognosis and rehab recommendations.
How have I been treating it?
Rehabilitating a suspected meniscus tear is nothing new to me, but seeing the injury from the patient side is a whole new experience. The first step should always be consultation with a professional (yes, even for myself). A quick trip to the doctor helped support my theory and gave me the go-ahead to continue working on my rehab. This first step is important and can be done with a trip to your primary doctor, an orthopedic doctor, or even your physical therapist (yes, you can come to us first). Do not hesitate to get yourself looked at. If your knee is feeling out of sorts, it’s trying to tell you something. Listen to your body!
My treatment has gone down in several mini-phases:
- Rest and activity modification: When the knee was most painful, the most important thing was to allow it to rest and to move carefully to avoid accidentally tweaking it. I used a simple knee brace to help keep it supported, which was another helpful component.
- Gentle, controlled exercise: As inflammation started to die down, I began to work on a slow re-introduction of my range of motion and initiated targeted exercise of the weakened muscles. If you’re a patient, your physical therapist will help guide you through the appropriate times to begin these treatments.
- Introducing more complex movements: As the knee healed, I began to work on more functional movements that my knee was not able to do before due to pain and apprehension (hinges, squats, etc). Again, as a patient, your physical therapist will help determine when these are appropriate for you.
How is it doing now?
One would think that being my own therapist would make the recovery process easier, and in many ways it has, but I’m a human just like any other person. I had my concerns and worries about my own injury, sometimes second guessing and overanalyzing my actions along the way. Thankfully, things have taken a positive turn, as after about ten weeks of self treatment, my knee has been doing very well, but is still not fully 100% just yet. I can walk without limping and am back to my favorite workout classes at my gym, but am still cautious when it comes to deeper squats or any plyometric (jumping) exercises. Every now and then it swells or gives me some painless popping (totally normal for this phase), but this typically only happens after long days on my feet and dies down the next morning. All in all, the healing has come a long way in the past several weeks and has gotten this way without any injections or invasive treatment.
Meniscus injuries are relatively common, but the upside to this is that management of these types of injuries is well practiced in the field of orthopedics and physical therapy. The meniscus is slow to heal and depending on the severity of the injury, it may not heal fully on its own. Non-operative recovery is achievable for mild or moderate injuries and should be sought out where appropriate, but a conversation with your healthcare team will be necessary to find out where you lie on the spectrum. If you find yourself in a position where a surgical revision is your best option, you will want to know this sooner rather than later.
I wanted to share my (ongoing) story today because my injury has given me a lot of first hand insight as to what my patients go through when they come in to see me, both in terms of the physical and psychological impact it has. Whether you have a similar injury you’re working through, wanted to learn about meniscus tears in general, or if you’re one of my current patients just wondering how I’m doing, thank you for taking the time to read my story today. Cheers!
Dr. Richard C. Irace PT, DPT
