Another BFR Success Story: Meniscus Repair

 

Demand is coming-Are you ready?

Another BFR Success Story: Meniscus Repair
Nicholas M. Licameli, PT,DPT

 

A torn meniscus…it’s like the “I got a bulging disc” or “I got a torn rotary cup” of the knee.  When a patient or athlete comes to me with fears, imaging, or a Dr. Google diagnosis indicative of a torn meniscus, 99% of the time I explain that it is quite normal and usually is not something serious.  There is, however, the rare occasion when this is not the case…

This case study involves a 31-year-old active male who felt a sharp pain in his knee while kneeling down to host a meditation session.  He noticed difficulty weight bearing and an inability to fully straighten his knee. His symptoms worsened over the next few days, which led him to seek an orthopedic consult.  MRI’s were (+) for a bucket handle tear of the medial meniscus.  The patient received two opinions from different doctors and both agreed that surgery was inevitable. 

I began treating the patient about 2 weeks post operatively.  His brace was locked in full extension and he was non-weight bearing.  I reached out to the surgeon and asked if he would be on board with blood flow restriction (BFR) training.  He agreed, and off we went!

Pillar 1: Passive BFR

We started with quad sets with 60% LOP.  The patient loved the feeling of “working hard” and having to overcome discomfort while keeping calm.  We soon increased the pressure to 80% LOP and added NMES to his quad sets.  The patient was hooked on both the sensation of BFR as well as the results.  We noticed significant improvements in quadriceps activation and knee extension ROM.

Pillar 2: Aerobic Training

We then moved onto Pillar 2 and used a stationary bike.  We kept the pressure at 80% LOP and started with 5 min of gentle cycling.  As you can probably imagine, we soon were up to 10 and 15 min on the bike!

Pillar 3-4: Resistance Exercise and High Intensity Training

Ah yes!  Pillar 3!  The fun part!  The patient and I were both extremely excited to begin BFR leg extensions.  We completed a typical strengthening program including squats, step ups, heel raises, etc and finished the session with BFR leg extensions.  That only lasted a few visits until we added BFR leg presses, too.  All was tolerated well and the patient could see how much progress he was making.  

Once we were able to tolerate heavy loads, we dropped the BFR and continued with traditional heavy load resistance training and agility ladder drills.  In the end, this patient made a full recovery and gained a new perspective from having gone through the experience.  Oh, and on his final visit, his surgical thigh had a greater circumference than his non-surgical side…oops!

 

 

****Remember, the use of BFR training should not be based solely on a success story.  The decision to use BFR, or any treatment for that matter, should be based on the pillars of evidence-based practice.

Are you ready to meet the growing demand as a Confident BFR Provider?

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****Remember, the use of BFR training should not be based solely on a success story.  The decision to use BFR, or any treatment for that matter, should be based on the pillars of evidence-based practice.

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