Meniscus tears in the knee are relatively common, particularly in middle-aged athletic individuals. Arthroscopic surgery is often performed to remove damaged cartilage. Surprisingly, some orthopedic surgeons do not prescribe physical therapy after knee arthroscopy, feeling patients can recover on their own with a few simple exercises. Unfortunately, this may lead to long-term deficits in strength, range of motion, and function. Such deficits may predispose patients to knee osteoarthritis as well.

Scandinavian researchers wanted to evaluate the effects of a functional proprioceptive-based exercise program several years after arthroscopic meniscectomy. 30 patients at 4 years after their surgery were randomly assigned to the functional training group or a non-exercising control group. Both groups were tested for functional performance, strength, and self-reported pain and quality of life before and after the 4 month study.

The exercise group was led by a physiotherapist 3 times per week. A neuromuscular exercise program was developed including foam pads, balance boards and mini-trampolines.  The program emphasized closed kinetic chain exercises, muscular coactivation, reactive neuromuscular training, and functional alignment. After 4 months, the functional exercise group had significantly better function and strength than the control group.

While improvements in strength and function can be expected in an exercise group compared to a non-exercising control group, this study had 2 interesting results. First, the authors found a ‘dose-response’ effect because improvement was progressively greater with an increased number of exercise sessions: those performing more exercise got more benefit. Secondly, the exercise group had significant improvements in muscular strength and endurance, even though they didn’t perform isolated strengthening exercises. This finding is consistent with many other sensorimotor training studies demonstrating increases in strength without strength training.

According to the authors, “As the exercises require little equipment, the program can easily be adopted in clinical settings.” The progression offered by Thera-Band® Stability Trainers and Balance Boards are ideal for neuromuscular training programs.

Reference: Ericsson YB, Dahlberg LE, Roos EM. Effects of functional exercise training on performance and muscle strength after meniscectomy: a randomized trial. Scand J Med Sci Sports. 2009 Apr;19(2):156-65

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