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  • Bob and Brad

  • The two most famous physical therapists

  • On the internet

  • - Oh hi folks, I'm Bob Schrupp, physical therapist.

  • - Brad Heineck, physical therapist.

  • - Together we are the most famous physical therapists

  • on the internet.

  • - In our opinion, of course Bob.

  • - How to tell if your knee pain is

  • meniscus or a ligament injury.

  • This is an updated video, we did it once before,

  • we're gonna try to improve upon it, make it better.

  • - That's right and we will, Bob.

  • - By the way, if you're new to our channel,

  • please take a second to subscribe to us.

  • We provide videos on how to stay healthy, fit, pain free

  • and we upload every day.

  • Go to our website, BobandBrad.com, 'cause we're always doing

  • a give away, what it is, I don't know.

  • Look and you'll find out, go to the give away section.

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  • a 60 second version of our program.

  • - All right, Bob.

  • No give away?

  • Oh it's the future.

  • - Yeah, you gotta figure out what it is.

  • - Oh that's right, okay.

  • Let's get on to this.

  • Knee pain and people are always wondering, you know,

  • "jeez, I wonder is it my meniscus."

  • - Well cartilage, if they say meniscus, cartilage.

  • - There you go, cartilage or is it that darn ACL

  • or is it a ligament problem?

  • So we're gonna show you that very clearly.

  • - The ACL is a ligament by the way.

  • - Yeah, exactly, but you know there's three other ones

  • that could be the problem

  • and that's what we're gonna show you.

  • First of all, let's take a look at Sam here.

  • - Let's do a little anatomy, just real quick.

  • - So all the muscles are removed, we've got the bone

  • and we do have the tendon to the patella.

  • We're gonna take that patella and the tendon,

  • remove it, pull it over here.

  • - [Bob] You got it?

  • - [Brad] And then we're gonna open up the knee joint

  • and we're gonna look at the meniscus first.

  • So that's this cartilage and it's between the tibia

  • and the femur and to me, they always look

  • like kind of two horseshoes, the bigger one--

  • - [Bob] Yeah and they aren't that pointed,

  • like this thing is.

  • It's a little weird.

  • - [Brad] It's a little exaggerated

  • but the shape is pretty much there,

  • it's pretty similar to that.

  • That is there for a cushion, it stabilizes the knee,

  • offers some cushion

  • but we're gonna jump now to the ligaments,

  • there's four ligaments that stabilize the knee

  • and we've got it open, the ACL, which is

  • probably the ligament that you hear about in sports,

  • very often being injured and oftentimes tore.

  • - [Bob] Or stretched.

  • - [Brad] Yep.

  • Surgery can replace it, it's right here, it's this one.

  • Then also right next to it, there is the PCL.

  • ACL means anterior cruciate ligament,

  • PCL, which is, I'm gonna move this out of the way.

  • It's hard to see but it's back there,

  • it's the posterior cruciate ligament and they work together.

  • They stabilize the knee from moving forward and backwards.

  • - [Bob] And cruciate means cross, so the ligaments do cross.

  • - [Brad] Yes they do.

  • This doesn't show that real well but believe us.

  • Now we're gonna look also at the MCL,

  • the medial collateral ligament

  • and here it is, right here.

  • What that does is that stabilizes your knee,

  • so it doesn't go out this way.

  • What would that be?

  • - [Bob] That'd be valgus.

  • - [Brad] Valgus, what's the, what's the?

  • - [Bob] Not varus.

  • - [Brad] Knock-kneed would be the slang term

  • and then the LCL, the lateral collateral ligament,

  • does just the opposite, keeps it from going

  • in this way to get, if you're like, bow legged.

  • - [Bob] Bow legged, right.

  • - [Brad] So that's the anatomy.

  • - [Bob] That's the things that can get injured.

  • - Right, now we're gonna talk about symptoms

  • and there is somewhat of a clear difference in symptoms.

  • For example, meniscus--

  • - Or again, cartilage.

  • - Yep, or cartilage.

  • You like the cartilage, I like meniscus

  • but you're probably right, most people think--

  • - I think a layperson's gonna think...

  • - Yeah, you're right

  • but if the cartilage actually gets tore, it can flip over

  • and if you ever hear someone say "my knee locks up,"

  • and then eventually it unlocks

  • and then it feels pretty good again and they're fine

  • and then it happens again.

  • I had one patient, up and down steps, always locking up

  • and she did it right in front of me, I had some stairs

  • and she locked up and she went like this.

  • - And got it back in place.

  • - And then we're fine and I said we're done.

  • I did a few other things but I said you've gotta go

  • to the doctor, I feel confident it's a meniscus and it was.

  • The next thing is, usually a meniscus

  • does not have any bruising or ecchymosis, we call it.

  • - So for the recent injury, you may get some bruising

  • with the ligament but not as likely with meniscus.

  • - Also with the meniscus, it can kind of happen

  • without any particular reason.

  • Over time, it just starts getting sore

  • and then some little thing might happen or maybe nothing

  • and then it's just there

  • and you get the locking and whatnot.

  • - I'm just gonna add this too, Brad.

  • You know, if it's an acute injury, one that just happened,

  • you may hear a pop with the ligament.

  • You probably aren't gonna hear one

  • with meniscus or cartilage.

  • - Exactly right, very common with ACLs, you know.

  • People at football stadiums say, "I heard it in the stands!"

  • - I heard it in the stands, yep.

  • - Meniscus typically is not gonna have that

  • but also with ligaments, whether it's ACL, MCL or LCL,

  • usually it's a traumatic episode or incident.

  • Oftentimes it's sports but it doesn't have to be.

  • - Yeah they don't often tear over time.

  • It's usually, yeah like you said,

  • it could be an athletic event or trauma.

  • - Right, yeah a fall, et cetera.

  • Ligaments will feel unstable--

  • - When you're walking, right.

  • - Slow things down, that leg just does not feel,

  • you don't feel comfortable on uneven surfaces,

  • that kind of thing.

  • - And we should point this out too.

  • It's very common to often injure

  • a ligament and meniscus together in an athletic event.

  • - Right, that's a good point.

  • - The terrible triad, you can take it--

  • - Oh yeah, that's right.

  • Yeah and oftentimes there's gonna be a surgery

  • and they'll address it all while they're in there

  • and take care of it.

  • Now we've gotta talk about some tests.

  • So should we go through the meniscus first?

  • - Sure.

  • - Now these tests, there's three of them

  • we're gonna show you, you can do all by yourself

  • and they're relatively easy.

  • I like to do them, I use them on my patients

  • on a regular basis.

  • The first one is the Thessaly.

  • - Sure.

  • - Okay, so Bob's gonna do it and I'm gonna do it.

  • First of all, you do it on the leg that doesn't hurt

  • and see how it responds and then the knee that does hurt.

  • You're gonna stand on one leg, have the patient

  • hold on to the wall or you may have a stick or whatever.

  • Bend the knee five degrees, which if you see--

  • - Very slight.

  • - Yeah, you just get it so it starts to bend

  • and then rotate your body like this.

  • We call this, like in the other video, the disco dance.

  • - Yeah and think about, you're grinding the joint together

  • while you're doing this.