Written by Dance Meets Fitness Physical Therapy Expert, Matthew Laporte, DPT
In this article I want to discuss an injury of the knee joint especially common with the physical demands of dancing. This injury involves a structure called the meniscus.
Now the menisci play a crucial role in the knee joint but did you know that it was once thought to be remains of leg muscles and useless in the knee joint?
Well after years and years of surgeries where this structure was removed, surgeons began to realize that these menisci were crucial to optimum joint function. The sports medicine community learned from their mistakes and began to protect this structure as much as possible.
When this structure was torn, surgeons would simply remove the entire meniscus rather than saving as much as they could. Today, this surgery involves the removal of the damaged portion with the intention of saving as much of the meniscus as possible.
So, now that we know that the menisci are important, let’s talk about what they do for the knee joint.
The end of the thigh bone (femur) and the end of the shin bone (tibia) form the knee joint. In order to make this union more flush and congruent, the menisci which are made of cartilage enhance this joint congruency and stability. This cushion allows the rolling and gliding of the knee joint to occur more smoothly.
Another function of the menisci are with the compressive forces of the body. The knee joint is responsible for incredible forces during normal activities such as walking and rising from a chair. The menisci act as shock absorbers cushioning the joint for the forces imposed on it during normal activities.
To show you the tremendous forces our knee joints must endure, a study in 2002 discussed the fact that during stair climbing our knees receive forces that are 4.25 times our bodyweight. So, I weigh around 165 lbs. That means that when I climb stairs, the force on my knee is 701.25 lbs!! Further studies have looked at rising up from a chair and determined that the force on your knee can be as much as 7x your bodyweight !
Yikes, that’s a lot of force. Now can you see why surgeons do everything they can to salvage these menisci? It also goes to show you how important weight loss is to take some stress off of our knees. Check out Patty’s awesome Dance Strong workouts for a great weight loss solution. Your knees will thank you. Simply click here to check them out.
Damage to the menisci most often occur traumatically from a fall or twist of the knee. Many times people will simply plant their foot and twist or change direction quickly which tears this structure. You can see how this would be a common injury with dancers. Making a leap or jump in dance, landing and quickly moving with the foot planted would causing a shearing force at the knee joint risking a tear of the menisci.
Unfortunately the menisci have a poor blood supply. Our bodies are incredible machines and heal many injuries. Now, our body needs blood supply which carries nutrients in order to heal itself. The menisci is commonly divided into three zones based on it’s blood supply. The outer 1/3 is called the red zone since it receives the most blood and has the most potential for healing. The middle 1/3 is called the red-white zone since the blood supply is decreased in this area. The central 1/3 is called the white zone since hardly any blood supplies this area and it has very little potential for healing.
The common symptoms of meniscal tears are knee joint pain, swelling, catching sensation when walking and a constant clicking sound in the knee with squatting, walking or climbing stairs. This clicking sound or catching sensation is from the torn piece of cartilage. Picture that torn piece flapping around. As the knee joint moves this loose piece flaps back and forth over the bone producing a clicking sound and can also get caught in the joint producing a catching sensation.
Your Physical Therapist can perform special orthopedic examination tests to determine the presence of a meniscal tear and can also instruct you in proper stretching and strengthening exercise to address this issue. Since some exercise can actually make the condition worse, it is important that you speak with your physical therapist regarding the best course of action.
Your orthopedic surgeon can diagnose a meniscal tear with the use of an MRI which will show the soft tissues of the knee joint.
Some tears will heal, some will require surgery and others will never become problematic.
The best prevention you can take is by being proactive instead of waiting until it is too late. By stretching and exercising properly you can reduce your risk of this common knee injury.
Be Well,
Matthew Laporte, DPT
Doctor of Physical Therapy and founder of YourGuideToWellness.com
Matt@YourGuideToWellness.com
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