Diagnosis Explanation:

A meniscus tear is an injury to the cartilage in the knee that cushions and stabilizes the joint. It often occurs from twisting, pivoting, or sudden stops, common in sports or activities requiring knee rotation. Symptoms include pain, swelling, stiffness, clicking or locking of the knee, and difficulty fully straightening the leg. Severity is classified as:

• Minor (Small Tear): Mild pain, swelling, improves with rest.
• Moderate (Partial Tear): Pain with activity, occasional knee locking.
• Severe (Large or Flap Tear): Persistent pain, catching or locking sensation, possible need for surgery.

Specific Work Modifications:

• If your job requires standing or walking: Use a knee brace for support and take seated breaks.
• If your job involves lifting: Avoid deep knee bending and twisting motions.
• If your job is desk-based: Keep your knee elevated when sitting, and perform gentle mobility exercises throughout the day.
• Avoid: Deep squatting, kneeling, excessive stair climbing, and activities that put rotational stress on the knee.

Specific Activity Modifications:

• If you run or play sports: Reduce high-impact activities and switch to low-impact options like swimming or cycling.
• If you hike: Use trekking poles, avoid steep inclines, and stick to flat terrain.
• If you do weightlifting: Avoid deep squats, lunges, and leg presses until pain-free. Focus on controlled, low-impact movements.
• Avoid: Jumping, pivoting, sharp turns, and repetitive deep bending until fully healed.

Recommended Supplements:

• Collagen Peptides – 10g daily for cartilage repair.
• Glucosamine & Chondroitin – 1500mg/1200mg daily for joint support.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Turmeric (Curcumin) – 500-1000mg daily for pain relief.
• Vitamin C – 500mg daily to enhance collagen synthesis.

Recommended Nutrition and Hydration:

• Increase Omega-3 Intake (salmon, walnuts, flaxseeds) to reduce joint inflammation.
• Consume Collagen-Rich Foods (bone broth, citrus, tomatoes) to support cartilage healing.
• Eat Anti-Inflammatory Foods (leafy greens, berries, nuts, turmeric) to reduce swelling.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to maintain joint lubrication.

Home Exercise Prescription:

Early Phase (0-2 Weeks, Reducing Pain & Swelling):

• RICE Protocol – Rest, Ice (15-20 min, 3x/day), Compression (brace as prescribed), Elevation.
• Quadriceps Sets – Tighten thigh muscle, hold for 5 seconds, repeat 10 reps, 3x/day.
• Ankle Pumps – Move ankle up and down to improve circulation, 10 reps, 3x/day.
• Heel Slides – Gently slide heel toward buttocks to improve mobility, 10 reps, 2x/day.

Strengthening Phase (2-6 Weeks, Once Pain Decreases):

• Straight Leg Raises – Keep knee straight, lift leg, hold for 5 seconds, repeat 10 reps, 2x/day.
• Seated Knee Extensions – Extend knee while seated, hold for 5 seconds, repeat 10 reps, 2x/day.
• Glute Bridges – Lie on your back, lift hips while keeping hamstrings relaxed, 10 reps, 2x/day.

Advanced Phase (6+ Weeks, Stability & Return to Activity):

• Mini Squats (No Deep Bending) – Slight knee bends while keeping weight on heels, 10 reps, 2x/day.
• Step-Ups – Step onto a low platform, push through the heel, repeat 10 reps, 2x/day.
• Stationary Cycling – Low resistance for 10-15 minutes/day.
• Balance Exercises – Stand on injured leg for 10-20 seconds, increase as tolerated.

Helpful Books:

1. The Knee Injury Bible: Everything You Need to Know About Knee Pain, Prevention, and Treatment – Kevin R. Stone, MD.
2. Heal Your Knees: How to Prevent Knee Surgery and What to Do If You Need It – Robert Klapper, MD, and Lynda Huey.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.