Medial meniscus tear: consider a multimodal treatment

Chiropractic patients who experience a medial meniscus tear are often young. They generally sustained damage as a result of a sports injury. However, meniscus tears can also occur in older active patients, although in these cases, the injury is more likely due to changes in muscles, tendons, and bones over time, particularly with degenerative changes to the knee joint.

Common reasons for a meniscus tear due to degeneration are: sudden change in direction while walking or running; forceful full flexion, such as squatting down or coming back up from a squat; or minor stress to the knee joint. In such cases, a multimodal treatment plan is recommended.

History and diagnosis

A thorough medical history can speed up the process to a correct diagnosis of a medial meniscal tear. Indicators include: a traumatic event, with the knee hit from the side; a non-traumatic event, with weight-bearing and then twisting of the knee; a popping sound or sensation at the time of injury; delayed swelling; a giving-way sensation; and/or if the knee painfully locks in one position.

Multimodal treatment approach

Therapy examples for a multimodal treatment include: adjusting (manipulation) and mobilization; soft tissue and stretching techniques; rehabilitation and corrective exercises; taping; physiologic therapies; nutrition; and training advice/programs during rehabilitation.

Mechanical adjusting

In 2010, two chiropractors published an article about the multimodal treatment of an elderly woman who suffered a medial meniscus tear. They recommended using a handheld, mechanical thrusting device with the patient supine, and the affected knee supported in 5 to 10 degrees of flexion, three repetitions of mechanically assisted adjusting were done to the tibiofemoral and patellofemoral articulations. This was done in a medial to lateral direction. Sports tape was then applied to the quadriceps. The patient was subsequently given isometric exercises to perform.

Over a nine week period, the patient received 12 treatments; two treatments a week for three weeks, then one treatment a week for six weeks. She later reported being able to once again walk, swim and ride a bicycle. Her pain intensity score had reduced by 40 percent and there was no reported pain upon palpitation.

Conclusion

There is excellent therapeutic value in multimodal chiropractic treatment provided it is in conjunction with an orthopedic treatment plan.