Heal Yourin M eniscus 3 Easy Steps

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Heal Your Meniscus in 3 Easy Steps

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Contents 1

3 Easy Steps to Healing Your Meniscus Tear

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A Look Inside the Knee Joint

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Knee and Meniscus Functions . . . . . . . . . . . . . . . . . . . . . . . . . 3 What is Fibrocartilage? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Knee Ligaments (ACL, MCL, PCL and LCL) . . . . . . . . . . . . . . . . . . . . 6 3

What Causes Meniscus Tears?

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Who Is At Risk? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Acute Trauma. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Degeneration of the Fibrocartilage. . . . . . . . . . . . . . . . . . . . . . . 9 4

What Does a Torn Meniscus Feel Like?

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Symptoms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Pain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Pain Worsens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 Stiffness and Weakness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Swelling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Grinding, Popping, Clicking, or Locking. . . . . . . . . . . . . . . . . . . . . . 11 Degeneration of the joint . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Should you seek medical attention?. . . . . . . . . . . . . . . . . . . . . . 12 5

Diagnosing Meniscus Tears

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Common Meniscus Physical Examinations. . . . . . . . . . . . . . . . . . . 13 McMurray’s Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Joint Line Tenderness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

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Ege’s Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Common Meniscus Diagnostic Tests. . . . . . . . . . . . . . . . . . . . . . 14 X-rays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 MRIs (Magnetic Resonance Imaging) . . . . . . . . . . . . . . . . . . . . . . . 14 Cat Scans (or CT - Computerized Tomography) . . . . . . . . . . . . . . . . . . . 15

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Meniscus Tear Descriptions

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Types of Meniscal Tears . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Partial Meniscus Tear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Complete Meniscus Tear. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Degenerative Meniscus Tear. . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Meniscus Tear Patterns. . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Longitudinal Tear (Circumferential Tear) . . . . . . . . . . . . . . . . . . . . . .17 Horizontal Tear (Cleavage Tear) . . . . . . . . . . . . . . . . . . . . . . . . . 17 Radial Tear (Free-Edge Transverse Tear) . . . . . . . . . . . . . . . . . . . . . . 18 Discoid Meniscus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Meniscus Tear Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Red-on-Red Meniscus Tear. . . . . . . . . . . . . . . . . . . . . . . . . . . .19 Red-on-White Meniscus Tear. . . . . . . . . . . . . . . . . . . . . . . . . . . 19 White-on-White Meniscus Tear. . . . . . . . . . . . . . . . . . . . . . . . . .20

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Do I Need Surgery?

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How Can I Treat My Meniscus Tear in 3 Easy Steps?

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Non-Invasive, Natural, Painless Therapies . . . . . . . . . . . . . . . . . . . 22 Step 1 – Cold Compression Therapy . . . . . . . . . . . . . . . . . . . . . . . 22 Step 2 – Blood Flow Stimulation Therapy (BFST). . . . . . . . . . . . . . . . . . 23 Step 3 – Ultrasound Therapy. . . . . . . . . . . . . . . . . . . . . . . . . . . 23

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In only 7 days, I Notice Results . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Two Family Members Successfully Treated Their Knee Injuries . . . . . . . . . . . . 24 MendMeShop Helped Me Avoid a $13,000 Meniscus Surgery . . . . . . . . . . . . 25

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Understanding Therapeutic Ultrasound

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Why is Ultrasound Therapy Important?. . . . . . . . . . . . . . . . . . . . . 26 Fast Facts about Ultrasound Therapy: . . . . . . . . . . . . . . . . . . . . . . . 26

Understanding How Ultrasound Therapy Works . . . . . . . . . . . . . . . . . 27 Frequency and Penetration Depth. . . . . . . . . . . . . . . . . . . . . . . . 27 Continuous vs. Pulse Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . .28 Conductive Gel - Why You Need it. . . . . . . . . . . . . . . . . . . . . . . . . 28 Phonophoresis Enhances Your Ultrasound Treatment . . . . . . . . . . . . . . . . 29

Proof Ultrasound Therapy Works. . . . . . . . . . . . . . . . . . . . . . . . 30 Ultrasound Increases Range of Motion. . . . . . . . . . . . . . . . . . . . . . 30 The Importance of Therapeutic Ultrasound for Osteoarthritis. . . . . . . . . . . . 30 Speeding Recovery of Damaged Cartilage with Ultrasound . . . . . . . . . . . . . 31 Ultrasound Increases the Rate of Tissue Regeneration. . . . . . . . . . . . . . . .31 Ultrasound Shown to Speed Healing and Relieves Pain and Inflammation . . . . . . 32 Damaged Cartilage can be Repaired with Ultrasound . . . . . . . . . . . . . . . .32 Range Of Motion Increase On Torn Meniscus With Ultrasound Treatment . . . . . . . 33 Ultrasound Can Increase Range Of Motion In The Knee . . . . . . . . . . . . . . . 33 Ultrasound will Break Down Scar Tissue. . . . . . . . . . . . . . . . . . . . . . 34 Painful Muscular Condition Responds to Noninvasive Ultrasound Treatment!. . . . . 34 Osteoarthritis Sufferers Respond Well to Ultrasound . . . . . . . . . . . . . . . . 35 Ultrasound Prevents and Repairs Damage Caused by Arthritis. . . . . . . . . . . . 35 Relief of Shoulder Tendonitis and Calcification with Ultrasound Therapy. . . . . . . 36 Ultrasound Therapy is Helpful in the Treatment of Rheumatoid Arthritis. . . . . . . 36 Hot-Pack and 1-MHz Ultrasound Treatments Have an Additive Effect on Muscle

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Temperature Increase. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Therapeutic Ultrasound Relieved the Pain Associated with Arthritis. . . . . . . . . 37 The Effect of Low-Intensity Pulsed Ultrasound Therapy on Time-to-Heal on Fractures. 37 Therapeutic Ultrasound Linked To Knee Tissue Repair. . . . . . . . . . . . . . . . 38 Effects Of Ultrasound Treatment In Carpal Tunnel Syndrome & Tips From Other Journals.39 Ultrasound Effective In Managing Rheumatoid Arthritis . . . . . . . . . . . . . . 39 Ultrasound Treatment On Fractured Fibulas in Rabbits. . . . . . . . . . . . . . . 40

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Step #1 Cold Compression Therapy – Fast Pain Relief

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Benefits of the Knee Freezie Wrap™. . . . . . . . . . . . . . . . . . . . . . 41 Reduces Pain, Swelling and Inflammation with No Side Effects. . . . . . . . . . . 41 Minimizes Further Damage and Prepares the Knee for Healing . . . . . . . . . . . 42 Some Conditions the Freezie Wrap™ Treats. . . . . . . . . . . . . . . . . . . . .42

Here’s What Freezie WrapTM Users Have To Say:. . . . . . . . . . . . . . . . . 43 Really Pleased With The Results. . . . . . . . . . . . . . . . . . . . . . . . . 43 Within 9 Days I Was Walking Without A Reminder Of Achilles Tendonosis . . . . . . . 44 Reduction in Shoulder Pain In Only One Week. . . . . . . . . . . . . . . . . . . 45

Contact Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 11

Step #2 Blood Flow Stimulation Therapy – Faster, Natural Healing

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Benefits of The Inferno Wrap. . . . . . . . . . . . . . . . . . . . . . . . . 48 Speeds Recovery of Meniscus, ACL and MCL Tears 10 Times Faster . . . . . . . . . . 48 Effective Healing Before and After Surgery . . . . . . . . . . . . . . . . . . . . 48 Helps You Avoid Consuming Dangerous Drugs. . . . . . . . . . . . . . . . . . . 48 Reduces the Risk of Chronic Pain. . . . . . . . . . . . . . . . . . . . . . . . . 49 Eliminates Toxins From the Knee. . . . . . . . . . . . . . . . . . . . . . . . . 49

Some Conditions the Knee Inferno Wrap™ Treats. . . . . . . . . . . . . . . . 49 Here’s What Inferno WrapTM Users Have To Say:. . . . . . . . . . . . . . . . . 49 I am Impressed With The Inferno Knee Wrap . . . . . . . . . . . . . . . . . . . .50

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Knee Inferno Wrap Made A Difference After Only Two Days. . . . . . . . . . . . . 51 I Could Feel Relief With The Inferno Wrap After One Use. . . . . . . . . . . . . . . 51 Help Treat and Prevent Various Knee Injuries. . . . . . . . . . . . . . . . . . . .52 Basketball Referee Solves Achilles Tendonitis With Ultrasound and Inferno. . . . . . 52 I Cannot Believe How Fast My Knees Are Responding. . . . . . . . . . . . . . . . 53 Only Ultrasound and the Inferno Worked For My Sprained Ankle. . . . . . . . . . . 54 The Back Inferno Wrap Is Amazing . . . . . . . . . . . . . . . . . . . . . . . . 54 Sport Taekwondo Athletes at London Southbank University use Ultrasound / Inferno Wrap. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Your Inferno Wrap is now My Inferno Wrap . . . . . . . . . . . . . . . . . . . . 55

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Step #3 Therapeutic Ultrasound - Effective for Meniscal Therapy

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Why Do So Many Meniscus Tear Sufferers Consider Ultrasound A Must-Have Treatment? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 It Speeds Recovery of Meniscus Tears. . . . . . . . . . . . . . . . . . . . . . . 56 It Breaks Down Scar Tissue . . . . . . . . . . . . . . . . . . . . . . . . . . . .56 Effective Healing Before and After Surgery . . . . . . . . . . . . . . . . . . . . 57 It Helps You Avoid the Use of Harmful Medications and Further Damage. . . . . . . 57 It Helps You Reduce Pain to Function Throughout the Day. . . . . . . . . . . . . . 57 It Energizes Your Life and Overall Well-Being. . . . . . . . . . . . . . . . . . . .57 MendMeShop Ultrasound Specifications: . . . . . . . . . . . . . . . . . . . . . 58

Contact Information: . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 13

Surgery… a Last Resort

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Types of Meniscus Surgery. . . . . . . . . . . . . . . . . . . . . . . . . . 60 Meniscal Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Meniscectomy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Meniscal Replacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

Rehabilitation Following Surgery. . . . . . . . . . . . . . . . . . . . . . . 61

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A Word of Caution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 14

Preventing Further Meniscus Injury

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Avoid Doing too Much too Soon . . . . . . . . . . . . . . . . . . . . . . . . 65 Maintain a Strong, Flexible Knee . . . . . . . . . . . . . . . . . . . . . . . 64 Invest in Proper Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . 64 Always Warm Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 Avoid Activities That Cause Pain . . . . . . . . . . . . . . . . . . . . . . . . 64

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3 Easy Steps to Healing Your Meniscus Tear

Is the pain and inconvenience of a meniscus injury getting you down? Are you tired of constant knee pain? Do you want to get back to your normal routine?

They can also trigger other serious side effects and even inhibit the body’s natural ability to heal itself.

If you are suffering from a torn meniscus, you have probably been advised to avoid activity and reduce the weight put on your knee. With time and care your tear may eventually heal, however, it is usually a slow process with many setbacks and the pain can drag on for months or years. Fortunately, there are alternatives to the traditional methods of treating meniscus tears that are becoming more popular every day. With these alternative methods, people are reducing knee pain faster and healing meniscus tears more completely than ever before! Pain medications (analgesics) and non-steroidal anti-inflammatory drugs (NSAIDs) can be used to help manage your meniscus pain. Unfortunately, these medications will not cure your condition; they will merely treat some of your symptoms. In addition, these drugs aren’t recommended for long term use, as pain medications can cause liver damage and NSAIDs can cause gastrointestinal difficulties (such as upset stomach, diarrhea, ulcers and intestinal bleeding).

Cortisone or steroid injections may initially help reduce inflammation and swelling of your meniscus. However, as you probably know, injections can be painful and often become ineffective over time. Multiple injections have been shown to cause tendons to weaken and cartilage to soften. As well, injections can trigger a ‘cortisone flare’ where the cortisone crystallizes in your knee causing more pain or an infection inside your joint. In more severe cases, your physician may recommend surgery which involves suturing or cutting the meniscus. Although surgery may be necessary in some situations, avoiding surgery is preferred. Suturing can take an extended amount of time to heal and cutting of the meniscus reduces its functional effectiveness considerably leaving your

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joint open to further injury and pain.

method to reduce pain and swelling.

If left untreated, there is a risk that meniscus tear pain will become chronic which can possibly lead to a host of other issues.

These treatments are safe, painless and effective. They are also much less expensive than constant visits to a doctor or surgery, and the technologies have been widely used and accepted by medical professionals for many years.

Typically, what happens in the knee directly impacts the proper functioning of the hips and back as you change your body mechanics to adjust for the pain or discomfort. As well, over time a meniscus tear can lead to osteoarthritis in your knee. The good news is there are steps you can take right in your own home to speed your recovery time and prevent further knee damage. All you Quick Fact need is the right In the US, information and the meniscal right tools. injury occurs By reading this book in 61 of every you’ll learn about 100,000 people 3 breakthrough at some point treatment options in their life. that have helped other people like you who suffer from meniscus tears.

Read on and find out how to treat your knee pain in the comfort of your own home. Don’t let your meniscus pain force you to make drastic lifestyle changes, pay far too much for treatment, or put your health at further risk- Take charge!

You’ll be presented with research conducted at leading universities and medical facilities worldwide that support the use of ultrasound therapy for treatment of soft tissue injuries. You will also read about how the revolutionary technology of Blood Flow Stimulation Therapy has helped other people with meniscus tears that were once in the same situation as you. In addition, you will learn how people suffering with meniscal pain have found a natural and effective MendMeShop 1866-237-9608 | [email protected] Copyright© 2010, In.Genu Design Group Inc.

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A Look Inside the Knee Joint

Knee and Meniscus Functions The knee (tibiofemoral) joint is one of the most complex joints in the body as it allows movement in a flexion/extension motion as well as rotating horizontally. The knee must provide both strength and flexibility while being loose enough to allow the freedom for quick movements and changes in directions. It is not the bone that provides stability within the knee joint, rather the soft tissue (tendons, ligaments, muscles, menisci) that holds the femur (thigh bone), the tibia (shinbone), the fibula (the slender bone in the lower leg) and the patella together at the joint. The knee cap patella is a bone embedded within a tendon (sesamoid) that rests over a groove at the bottom of the rounded femur and the top of the flat

tibia. It protects the bones and soft tissue in your knee joint and slides when your knee moves, giving leverage to your leg muscles. The tendons in the knee are tough cords of tissue that connect muscle to bone and help control movement of your joint. The upper leg muscles provide your knees with mobility (extension, flexion and rotation) and strength. The quadricep muscles (rectus femoris, vastus lateralis, vastus medialis, vastus intermedius) located on the front of your thigh straighten your legs, and the hamstring muscles (located on the back of your thigh semitendinosus, semimembranosus, biceps femoris) bend your knees. As well as providing stability, the tendons, ligaments, articular cartilage, meniscus and other soft tissue in the joint provide cushioning and protect the bones. A type of slick, hard but flexible connective tissue

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known as articular cartilage (also called hyaline cartilage) covers the surface ends of the tibia and femur at your knee joint, allowing them to move easily against one another. It is generally 1/8 to 1/4 inch thick. A thick, stringy, egg-like fluid (synovial fluid) found inside the knee capsule, lubricates your knee joint and, along with the meniscus and articular cartilage, reduces friction. The soft tissue structure in the knee includes 2 menisci, the medial meniscus (located on the inside of the knee) and lateral meniscus (located on the outside of the knee). These crescent-shaped pads of fibrocartilage rest on the tibial condyles (rounded ends of the tibia bone) and form a concave surface for the femoral condyles (rounded ends of the femur bone) to rest on. These cover approximately 2/3 of the tibia surface and are thicker on the outside and thinner on the inside appearing triangular in cross section. They fill the space between these bones and cushion the femur so it doesn’t slide off or rub against the tibia.

The two menisci are joined together within the knee joint by the transverse ligament. The menisci also attach to leg muscles which help the menisci maintain their position during movement. The semimembranosus and quadriceps attach to both menisci. The lateral meniscus attaches to the

popliteus below the knee and the femur via the posterior cruciate ligament (PCL). On the inner part of the knee, the ends of the menisci (known as the anterior and posterior horns) are attached to the tibia and joint capsule and along the exterior edge of the meniscus by the coronary ligaments. These ligaments are loose which allows the meniscus to pivot freely. However, the medial meniscus does not move as freely in the joint as the lateral meniscus and as a result is torn more frequently. The menisci play a very important role in the proper working of the knee. Essentially, they serve as cushions to decrease the stress caused by weight bearing and forces on the knees. They work like shock absorbers, supporting the load by compressing and spreading the weight evenly within the knee. Even while walking, the pressure put on the knee joints can be 2-4 times your body weight; when you run these forces increase up to 6 - 8 times your body weight and are even higher when landing from a jump. By increasing the area of contact inside the joint by nearly 3 times, the menisci reduce the load significantly (dispersing between 30 and 55% of the load). As weight is applied to the meniscus they are compressed and are forced to extend out from between the femur and tibia. However, the circular design of the menisci provides circumference tension (referred to as ‘Hoop Stress’) to resist this extension and provide stability as the load compresses. If the meniscus is torn at the peripheral rim, circumference tension is compromised and the meniscus loses its ability to transfer the load and the joint begins to suffer. In fact, if part of the peripheral

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is removed or the tear extends to the periphery of the meniscus, the load on the knee may increase by 350% causing stress and pain. However, if the tear remains on the interior without disrupting the periphery of the meniscus, the meniscus can still perform its load transferring function and less stress and pain occurs in the joint. The menisci also assist with the proper movement (arthrokinematic) of the femur and tibia during flexion and extension. They help stabilize the knees when in motion, reduce friction within the joint, and protect the articular cartilage surrounding the tips of the bones from damage due to wear and tear.

The blood flow to the menisci comes from the inferior genicular artery. This artery supplies blood to the perimeniscal plexus which provides oxygen and nutrients to the synovial and capsular tissues around the menisci and within the knee joint. The coronary ligaments attached to the meniscus transport blood from the perimeniscal plexus (network of blood vessels) into the peripheral of the menisci. The anterior and posterior horns of the menisci receive a good amount of blood as they are covered by a vascular synovium. The interior part of the meniscus is avascular, having no direct blood supply.

What is Fibrocartilage? The menisci are composed of tissue called fibrocartilage which is tougher and contains more fiber than other types of cartilage in the body. The collagen fibers are woven into a dense tissue that is resistant to stretching and extending in various directions. This makes fibrocartilage excellent for cushioning the knee joint that is required to move multidirectionally. The amount of blood vessels in the fibrocartilage throughout the meniscus varies. The outer one-third of the meniscus is vascular, which means there is an abundance of blood vessels to allow blood to the area. The central part of each meniscus has fewer blood vessels and the inner third does not contain any. As a result, a tear on the outer peripheral of the meniscus can heal faster than one on the inner portion. Tears in the innermost part of the meniscus may not heal completely due to the lack of blood supply.

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Without proper nutrition (blood supply) the menisci may partially disintegrate resulting in less cushioning and protection within the joint.

Proper blood flow ensures nutrients and oxygen reach the area and metabolic waste is removed from the fibrocartilage. When functioning properly, the knee joint naturally receives blood flow through movement and the pumping action of body weight shifting from knee to knee. However, other therapies such as Ultrasound and Blood Flow Stimulation Therapy will promote more blood flow, even when the knee is at rest. Greater blood flow results in faster and more complete healing when meniscus or ligament damage occurs. See chapters 9, 11-12 for more about these therapies.

Knee Ligaments (ACL, MCL, PCL and LCL) Ligaments are strong, elastic-like tissues that connect bone to bone and provide stability and protection to your knee joint by limiting the forward and backward movement of the shin bone. The knee has 2 collateral (parallel) ligaments and 2 cruciate

(crossing) ligaments. The medial collateral ligament (MCL) and the lateral collateral ligament (LCL) provide support to the knee by limiting the sideways motion of the joint and resisting extreme rotation in a partially flexed position. The anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) stabilize the knee by limiting the rotation and the forward and backward movement of the joint. The MCL is the most commonly injured of the collateral ligaments. Injury is often a result of a blow to the outer side of the knee during sports. Since the MCL is attached to the medial meniscus, damage to the medial meniscus often occurs when the MCL is injured during a hard hit to the knee. The cruciate ligaments (ACL and PCL) are strong and thick providing stability to the joint. Together they work to prevent extreme knee motions of any kind. As a result, any damage Quick Fact to a cruciate Up until about ligament can the age of 11, cause noticeable the entire instability in the meniscus is knee. An ACL supplied with injury, the most blood. By common cruciate adulthood only ligament injury, 10-25% of the occurs when the meniscus is knee is locked with vascular (has the foot planted blood vessels). and the knee is twisted quickly. Athletes required to make sudden directional changes or to slow down quickly as well as those

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in contact sports are at high risk for ACL tears. Minor tears may go unnoticed immediately and will appear a few hours later with pain and swelling. More serious ACL tears are accompanied by severe pain and often a popping sound. The knee may feel as though something has snapped and walking or bending the knee is usually impossible. The medial collateral ligament (MCL) and anterior cruciate ligament (ACL) are ligaments of interest to meniscus tear sufferers because meniscus tears that occur due to force trauma are sometimes accompanied by tears to the MCL and/or ACL. When the meniscus, MCL and ACL are injured in combination it is referred to as the “unhappy triad”.

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What Causes Meniscus Tears?

Who Is At Risk? Although knee injuries are more common in women than men, men experience more meniscus injuries and tears (approximately 2.5 males: 1 female). This is believed to be due to men’s participation in more aggressive sports and manual activities. For men, meniscal injuries occur most Quick Fact often between the Meniscus ages of 31 to 40; for injuries are females mensical more prevalent tears usually occur in men than between 11 and 20 women. years. Occupations such as mining or carpet-laying (where you spend a lot of time in the squat position), or participation in contact sports or repetitive stress activities (such as running and skiing) increase the risk of meniscus injuries.

soccer, basketball or racquet sports when you twist your knee, or slow down too quickly. A meniscus injury can result during a hit by forceful rotation of the knee while the foot is firmly planted and bearing weight. A meniscus tear may also occur from hyper-flexion or hyper-extension of your knee (flexion or extension beyond your knee’s normal range of motion). Hyperflexion or hyper-extension can occur during a car accident, while participating in sports or exercising, or during other low-impact activities if the knee is unstable. These types of tears generally affect athletes or those under 40 years of age.

The 2 most common causes of meniscus injuries are acute trauma to the knee and degeneration of the knee joint tissue.

Acute Trauma Forceful blows to the knee occur most frequently during activities such as rugby, football, baseball,

A medial meniscus tear will frequently occur along with other injuries such as an ACL and/or MCL

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tear. The combined injuries are seen most often in contact sports, when an athlete gets hit on the outside of a bent knee. A lateral meniscus tear will result more often from a knee that is bent (flexed) excessively and experiences full weight bearing, while the thighbone is turning outward; seen in sports such as skiing.

Degeneration of the Fibrocartilage

menisci decreases by 20% by the age of 40 and the body’s ability to heal itself becomes inhibited. As a result, it is more difficult to heal a tear caused by deterioration than an acute trauma that occurs earlier in life. With the use of Blood Flow Stimulation Therapy and Ultrasound Therapy, blood flow can be increased to promote faster and more complete healing of a meniscus tear. You can read more about these therapies in chapters 9, 11-12 of this book.

In younger people, the meniscus is very flexible and pliable (like a new rubber tire). Over time, the menisci tissue weakens and becomes less flexible, more brittle and develops small cracks in it (like those seen in an aged car tire). In addition, normal wear and tear on the knee tissue can lead to osteoarthritis. If osteoarthritis sets in, destructive chemical substances are released in the joint cavity which further breakdown the collagen fibers. As the menisci degenerate they become more susceptible to tears which can lead to a meniscus tearing without any associated injury. Approximately 60% of people over 65 years of age will experience some form of degenerative meniscus tear. Unfortunately, the blood supply to the MendMeShop 1866-237-9608 | [email protected] Copyright© 2010, In.Genu Design Group Inc.

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4

What Does a Torn Meniscus Feel Like?

The most common symptom of a torn meniscus is pain; although knee pain can be caused by a number of different injuries or conditions. Symptoms you may experience with a meniscus tear include:

Symptoms • • • • • •

Pain Pain worsening with use Stiffness and weakness Swelling Grinding, popping, clicking, or locking Degeneration of the knee joint over time

Pain If you experience a meniscus injury, pain can either be gradual or immediate depending on how severely the damage to the meniscus is and/or how quickly it happened. Often you will feel pain and tenderness in your joint, especially when you touch your knee with slight pressure. You may feel a sharp pain along the joint line in the area of your tear (usually the inside or outer part of the knee). Pain in the middle of your knee often indicates a medial meniscus tear. In some cases you may even experience pain throughout your entire knee joint.

Pain Worsens Pain will become worse when you try to bend, straighten or twist your knee, during or after exercise (especially activities involving deep knee bends) and sometimes even just by putting weight on your knee. Your doctor may recommend that you use a crutch or cane to minimize the load placed on your torn meniscus to alleviate pain and further damage while you are trying to heal.

Stiffness and Weakness You may find that your range of motion is limited and that you are not able to bend or straighten your knee all the way. You may also experience a buckling or weakness in your knee that occurs when a torn meniscus fragment slips out from being lodged between your bones. A reflex relaxation of the thigh muscles creates weakness in your knee joint resulting in poor stability.

Swelling You will experience swelling either immediately if your blood vessels are disrupted because of a traumatic event, or within 12 hours after your joint

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tissues become inflamed. Swelling over time or recurring is a result of synovial fluid filling the joint cavity as your body tries to protect itself (this is often called “water on the knee”).

osteoarthritis (degenerative arthritis) over time. There are different stages of symptoms dependent

Grinding, Popping, Clicking, or Locking These symptoms can range from being annoying to downright painful and can last a few seconds or be persistent for a few weeks. Joint locking occurs when a fragment of torn meniscus does not work its way out of being lodged between your femur and tibia resulting in an inability to straighten or bend your knee. This can be painful and may cause weakness in the knee. You may have to manually move or manipulate your knee to get relief and you will feel a click or snap when it eventually unlocks.

Degeneration of the joint Once injured, the meniscus is more susceptible to slowly wearing away with regular knee movements. When this happens more friction occurs against the articular cartilage and it wears away from the surface of the femur and tibia.

Quick Fact In Greek, the word meniscus means “little moon”

With less protective covering, the joint begins to deteriorate. If your knee tissue begins to degenerate you have an increased risk of developing

on the severity and type of meniscus injury you experience. If you have a minor tear you will often experience pain and slight swelling within the first 12 hours of noticing the discomfort. These symptoms often go away within a 2 - 3 week period. If you have a moderate tear you will often have pain near the location of your meniscus tear, especially when twisting or squatting. Swelling will generally increase over 2 - 3 days, as will your stiffness, which will result in a limited range of motion when bending your knee. Symptoms will eventually go away but will tend to recur with minor twisting or overuse. If you have a severe tear, pieces of torn meniscus can move into your joint space and lead to a locked knee that is very swollen, stiff and painful. These

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symptoms come on quite quickly. Bruising and swelling with severe pain within minutes of an injury generally indicate a tear of your ligament as well as your meniscus. If you suffer from a degenerative tear, it may not have resulted from one specific incident, but rather from wearing over the years. You may not recall when or how your symptoms started, however it is often from a squatted position. Pain and minimal swelling are often the only signs you will experience, which last indefinitely. You may also have some knee grinding or catching, depending on the extent of the degeneration.

Although your symptoms may disappear on their own, they often carry-on or return and eventually require treatment. If a meniscus tear goes untreated, the situation can lead to a complete tear and long-term damage. Read on to find out about the 3 incredible therapies that will help you treat your meniscus tear and avoid chronic knee problems. These therapies can be used to heal your tear noninvasively, prior to surgery if it is necessary, and/ or for post-operative recovery for faster and more complete healing.

Should you seek medical attention? It is recommended that you see a physician with any continued discomfort and/or pain in your knee. As well, if you experience any of the symptoms below it is recommended that you seek professional medical attention: •

Increased or constant instability or inflammation of the knee (swelling, pain, heat or redness) that lasts longer than 2-3 days

•

Locking, catching or buckling of your knee on a regular basis, or very limited range of motion (can’t fully extend, bend or rotate your knee or lower leg)

•

Constant clicking, popping or grinding sounds in your knee

•

Unable to participate in activities or work due to the pain or limited range of motion

•

Knee looks deformed or you have significant bruising around that area

•

A traumatic accident that may have broken or dislocated a bone

•

Any other unusual symptoms

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5

Diagnosing Meniscus Tears

Your medical professional (orthopedic surgeon or physician) will be able to test whether you have a meniscus injury and will then determine what type you have through a variety of assessments. It is more difficult to diagnose a lateral meniscus tear than a medial meniscus tear because of its tear shape and location (it may go unnoticed until it is much larger). To help your doctor achieve a proper diagnosis, he/ she will begin with a medical history about you, your current condition and symptoms, the intensity of your pain, the duration of your symptoms and the limitations you are experiencing. Details about what instigated the problem, when it started, and whether or not you have ever had treatments, for this or a similar condition in the past, are very helpful in assessing your injury.

Common Meniscus Physical Examinations A physical examination will be performed to determine if you have any signs of a meniscus injury or possibly another knee injury. Your doctor will visually assess and palpate (feel) the bones and soft tissue in and around both of your knees to evaluate symmetry and spot any differences. This will identify abnormalities such as inflammation, bone deformity, and atrophied muscles. He / she will press on the injured side of your knee joint to test for point tenderness and help determine the location of your injury or tear. He/she may ask you to complete a series of knee and leg movements such as moving your knee from a straight to bent position (or vice versa), or rotating your knee to see what motions cause pain, weakness, instability and/ or grinding, catching, popping or locking. Your knee will also be inspected for fluid, swelling and warmth.

McMurray’s Test McMurray’s Test is performed while you lie flat on your back. The doctor will hold your knee with one hand and your ankle in the other. He/she will lift MendMeShop 1866-237-9608 | [email protected] Copyright© 2010, In.Genu Design Group Inc.

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your knee slightly while flexing it to a 45 degree angle. The doctor will feel the medial joint line while pulling your leg toward him/her and rotating your knee. The knee is then brought from full flexion to 90 degrees. If you feel a click during this movement the test is positive; you have a meniscus injury.

Joint Line Tenderness Joint Line Tenderness is simply performed by applying pressure over the meniscus area while you are laying flat on your back. If pain occurs, the test is considered positive.

Ege’s Test

information, and assess the amount and/or type of damage done to your knee and meniscus. There are a variety of tests available to help analyze the knee damage; the 3 common tests are:

X-rays X-rays will provide an image of the overall structure of your knee. It is helpful in identifying abnormal bone shapes, fractures, arthritis, and degeneration (wear and tear) within the joint. It can identify a discoid meniscus, or loose bones and bone abnormalities that may mimic a torn meniscus.

Ege’s Test is performed while you are standing and putting weight on your knees. You begin by standing with your feet 8-10 inches apart. To test the lateral meniscus the doctor will ask you to turn your feet and knees in as far as possible; for medial meniscus tests, you turn your feet and knees outward. In the appropriate position, you will then squat down and stand up slowly. If you experience pain and/or a clicking sensation (you may even hear it) when your knees are at approximately 90 degrees, the test is considered positive and a meniscus tear is suspected.

Common Meniscus Diagnostic Tests A medical professional will sometimes recommend diagnostic testing to obtain more detailed

MRIs (Magnetic Resonance Imaging) MRIs (magnetic resonance imaging) will provide more detailed information and will help to evaluate the soft tissues in and around your knee joint (muscles, tendons, ligaments, menisci, other connective tissues).

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It can identify ligament and meniscal damage, and help to determine the extent of your injury, the displacement and degree of your tear, fluid on your knee, a discoid meniscus, ACL or MCL tear, and/or other associated conditions.

Cat Scans (or CT - Computerized Tomography) CAT scans (CT - computerized tomography) can be used to provide a 3-dimensional assessment of the bones and soft tissues in and around your knee joint and may be used to identify a meniscus tear. The type of test recommended will depend on your symptoms and the opinion of your medical professional. Further tests such as diagnostic ultrasound, electromyogram, or arthroscopic surgery can be used to determine the degree and location of your injury if required.

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6

Meniscus Tear Descriptions

How your meniscus tear is described will vary depending on which meniscus is injured and the type, pattern and location of the tear.

Types of Meniscal Tears

can eventually tear in multiple directions and can lead to a completely degenerated meniscus. Often, a piece in the body of the meniscus moves about in the joint.

Partial Meniscus Tear

Meniscus Facts

A partial meniscus tear (partial thickness – meniscus still remain attached) tends to be smaller and more stable because it stays connected to the front and back of your knee and doesn’t move about freely. Depending on the location, a partial tear can heal well with non-invasive methods.

Complete Meniscus Tear A complete meniscus tear (full thickness - tissue separates from your meniscus and tear goes all the way through) tends to be larger and less stable because it hangs by a thread of cartilage. The torn part moves about in your joint which can lead to further complications and damage if not treated.

Degenerative Meniscus Tear

The medial meniscus is more often injured than the lateral meniscus. Medial meniscus tears generally occur in the posterior (back) horn, which is prone to injury and harder to manage than tears in the body (center), the anterior (front), or on the periphery (outside). The posterior horn is more contained and carries more of the load than the other areas and it is difficult to reach because there are bones in the way. Peripheral tears occur on the outside near the attachment to the knee capsule. They receive a greater blood supply, so they are easily repaired. These tears often occur in conjunction with an ACL or MCL injury.

Degenerative meniscus tears have frayed edges on the inner rim, where the meniscus is thinnest, which MendMeShop 1866-237-9608 | [email protected] Copyright© 2010, In.Genu Design Group Inc.

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Meniscus Tear Patterns The pattern of your meniscus tear is important because it will determine the type of treatment you receive; some tears will heal without surgery, some can be treated surgically and some can’t be fixed. Tears come in many shapes and sizes however there are 3 basic shapes for all meniscal tears: Longitudinal • Horizontal • Radial If these tears are not treated, they may become more damaged and develop a displaced tear often referred to as a bucket handle tear (longitudinal), flap tear (horizontal) or parrot beak tear (radial). •

If a longitudinal tear doesn’t heal properly it can lead to a displaced tear, known as a bucket handle tear. This is a complete tear that goes all the way through and never touches the inner rim of your meniscus. There is a risk that the handle may flip over and can catch on the femur, locking the joint and increasing pain. This tear accounts for 10% of all meniscus tears, and causes your knee to lock in flexion. It is seen most often in young athletes, and happens in conjunction with 50% of ACL injuries.

Complex tears are a combination of two or more of these basic shapes with damage occurring in more than one direction and depth.

Longitudinal Tear (Circumferential Tear) A longitudinal tear extends lengthwise, following the collagen fibers that run parallel to the contour of the meniscus. This tear does not go all the way through the meniscus and it divides your meniscus into an inner and outer section; the tear generally never touches the rim of the meniscus. It tends to be more medial than lateral and results from repeated movements. Generally, it starts as a partial tear in the posterior horn, which can sometimes heal on its own.

Horizontal Tear (Cleavage Tear) A horizontal tear starts as a horizontal split deep in your meniscus. This tear divides your meniscus into a top and bottom section (like a sliced bun). It is often not visible and moves from the posterior horn or mid section to the inside of your meniscus. Horizontal tears are rare and often start after a minor injury from rotation or degeneration and occurs most often in your lateral meniscus.

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A displaced horizontal flap tear can develop if your tear is overlooked or left alone.

edge of your meniscus and eventually runs part way or all the way through your meniscus, (across the middle body instead of down the length). This tear generally occurs between the posterior horn and middle section and is seen frequently in your lateral meniscus. A small tear is difficult to notice, but when it grows and becomes a complete tear it will open up and look like a part is missing. This is called a Parrot’s Beak tear. It generally occurs in the thicker portion of your lateral meniscus. As it gets larger, it will catch or lock more frequently, and prevent your meniscus from protecting the articular cartilage during weight bearing.

This type of tear is horizontal on the surface of your meniscus and creates a flap that flicks when your knee moves. It is a result of a strong force that tears your meniscus from the inner rim and it can easily become a complex tear if left untreated.

This tear is the result of a traumatic event or forceful and repetitive stress activities and it is often associated with other injuries such as ACL tears. Young athletes tend to suffer from combination tears called radial/parrot beak tears (the meniscus splits in 2 directions).

Often, the flap is trimmed away during surgery to prevent further tearing. Since the periphery of the meniscus is not compromised the cushioning function of the meniscus is maintained. If this tear extends from the apex of your meniscus to the outer rim, you may develop a meniscal cyst (a mass that develops from a collection of synovial fluid along the outside rim of the meniscus).

Radial Tear (Free-Edge Transverse Tear) A radial tear starts as a sharp split along the inner

Discoid Meniscus When we are in the womb our menisci are flat and disc shaped rather than crescent shaped wedges. When the meniscus does not develop into a crescent shape it is referred to as a discoid meniscus.

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A discoid meniscus generally occurs in the lateral meniscus (1.5-3% of the general population) but can appear in the medial meniscus (0.1-0.3%) with greater frequency in the Asian population (approximately 17% of lateral discoid menisci reported). The meniscus will often change to a c-shape with maturity so kids/ teens will usually grow out of their symptoms. The symptoms associated with a discoid meniscus can vary greatly depending on the type, location and presence of a tear. A stable discoid meniscus may be asymptomatic; only becoming symptomatic if a tear occurs. If there is a tear present, clicking, snapping, buckling and/or locking of the knee joint, decreased range of motion, joint pain and tenderness, and atrophied quadriceps (muscles wasting away) may be experienced. A discoid meniscus has also been referred to as “snapping knee syndrome”.

Meniscus Tear Location Blood supply to the injured area is critical in healing; where the tear is located will determine its ability to heal. The fibrocartilage of the meniscus has limited blood flow compared to other soft tissue in the body

and this can make it difficult for the body to heal a meniscus tear on its own. As discussed in earlier chapters, the amount of blood vessels throughout the meniscus varies. The meniscus can be broken into the red zone (outer portion of the meniscus that is vascular), the middle (central part with fewer blood vessels), and the white zone (inner third containing no blood vessels); tears in the red zone have the best chance of healing because they have a greater blood supply.

Red-on-Red Meniscus Tear A Red-on-Red meniscus tear is completely in the red zone. Both sides of the tear are in tissue that receives a lot of blood supply and will heal the fastest.

Red-on-White Meniscus Tear A Red-on-White meniscus tear runs between the red zone and the middle (includes the outside rim and center portion of your meniscus). This type of meniscus tear heals slower than a complete Red Zone tear as the outer edge of the tear generally receives good blood supply and the inner part of the tear doesn’t. Surgeons will often suture when a tear occurs in this zone to assist with healing.

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White-on-White Meniscus Tear A White-on-White meniscus tear is completely in the white zone (the middle and inner part of your meniscus). It receives little blood supply and has a poor healing rate. A bucket handle tear in the white-on-white zone is usually removed surgically as healing is very unlikely.

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7

Do I Need Surgery?

Once your medical professional has diagnosed your tear, he/she will recommend the most effective treatment. He/she will consider your activity level, age, the location, type, severity of your tear, the symptoms you are experiencing and any other associated knee injuries to determine whether conservative or surgical treatment options are more appropriate. Conservative treatments are generally recommended for partial, stable and degenerative meniscus tears. Surgical options are used more often for larger, complex or displaced tears.

At one time, surgeons removed injured menisci believing they served no purpose, however doctors now know the importance of the meniscus to the knee joint mechanics and function. Removing part of the meniscus should be avoided if possible, especially if it will weaken the periphery; compromising the load absorption capabilities and increasing the risk of degeneration. However, if the meniscus is at risk of further damage or the knee cannot flex or extend properly, surgery many be required to minimize damage (i.e. remove the flap to prevent more tearing) and restore joint function. It is beneficial to try to heal a meniscus tear prior to surgery to avoid it if possible or to minimize the amount of meniscus that needs to be repaired or trimmed.

Meniscal tears are graded on 3 levels; 1 being the least severe and 3 being the most. Grade 1 and 2 tears may not even be apparent during an arthroscopic exam and can usually be repaired without surgery. Grade 3 tears generally require surgery.

If an anterior cruciate ligament (ACL) injury occurs when the medial meniscus is Quick Fact torn surgery may be The medial required to repair the meniscus is ACL. Once again, the injured 4 severity of the tear times more along with the patient’s often than age and activity level are the lateral all factors considered meniscus. when determining treatment.

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8

How Can I Treat My Meniscus Tear in 3 Easy Steps?

Non-Invasive, Natural, Painless Therapies

Step 1 – Cold Compression Therapy

Some small meniscus tears have no symptoms at all and may disappear on their own. Other less severe or complex tears will subside with conservative treatments, especially if your knee is stable and doesn’t lock.These incredible conservative treatments are cold compression, blood flow stimulation therapy (BFST), and ultrasound therapy. It is the blood in your body that heals and repairs damage to your tissue. By transporting oxygen and nutrients to the damaged tissue and flushing away toxins and dead cells, your blood helps your body to heal itself. Unfortunately, when an injury occurs you need to prevent further injury and rest the area to allow it to heal. By resting, you actually limit the flow of blood and slow the healing process. The trick is to generate blood flow to your injury without causing further damage. It is estimated that a tear in the outer part of the meniscus takes approximately 10 weeks to heal without using therapeutic devices that speed healing. Using the following therapies can reduce your recovery time and heal your meniscus more completely.

When a tear first occurs and/or when it is irritated you experience swelling and inflammation in your knee. At this time, the best course of action is treating your injury with RICE (Rest, Ice, Compression and Elevation). Applying a cold compression wrap to your knee keeps swelling to a minimum and numbs pain while you rest and elevate your injured knee. It is important to reduce swelling because the buildup of fluid in the tissue interferes with proper blood flow.

Once swelling is reduced, blood can flow easily and healing can begin. See Chapter 9 for more on cold compression therapy and medical grade cold compression Knee Freezie Wraps.

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Step 2 – Blood Flow Stimulation Therapy (BFST) After the acute (or severe) swelling is gone it is time to promote blood flow to speed healing and reduce further inflammation. Remember, the meniscus is cartilage and does not receive much blood flow naturally and when you rest your knee, you are not creating the natural blood flow your knee usually receives. With the use of and Inferno Wrap’s Blood Flow Stimulation Therapy (BFST) you can increase your body’s blood supply to the knee and healing power. In addition, the fresh blood flow whisks away dead cells and toxins that have built up from the injury leaving the area clean and more prepared for healing. See Chapter 10 for more on Blood Flow Stimulation Therapy and the patented technology of the Knee Inferno WrapTM.

Step 3 – Ultrasound Therapy As your meniscus tear heals with BFST, scar tissue naturally builds up in the fibrocartilage. At this stage, using therapeutic ultrasound will not only assist with blood flow it will also soften scar tissue and improve t i s s u e elasticity. Scar tissue develops naturally throughout the healing process. As your damaged knee tissues heal dead, fibrotic scar tissue will develop instead of forming brand new healthy tissue. This tissue adheres to your meniscus and ligaments in your knee and can cause pain and prevent your joint from moving properly (this limits your range of motion, flexibility and strength). Ultrasound reduces scar tissue, leaving a more normal elasticity in the meniscus making it healthier and less prone to re-injury. In addition, less scar tissue build up means less knee pain. Ultrasound can also administer therapeutic medicines deep into the body through a process called phonophoresis. See Chapters 8 and 11 for more information on the effectiveness of ultrasound therapy and how it can treat your meniscus tear.

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During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort in your knee until your pain and inflammation subside. With these 3 easy therapies you will notice great knee improvement within a few weeks, with most meniscus patients seeing some improvement within days. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results. If you start using your knee before it has a chance to heal properly (even though it may feel better), you can end up doing a lot more damage than good! Younger patients tend to have a higher success rate healing meniscus injuries than older individuals, as their conditions are generally a result of trauma to healthy tissue rather than degeneration over the years.

In only 7 days, I Notice Results In February of this year, I injured my knee while exercising. Since I lost my health benefits through my job due to the economy, I wasn’t able to afford a professional diagnosis. The outside area of my left knee was swollen, stiff and painful and I could not put any weight on that area. After mowing my lawn, gardening, exercising or any other physical activity the swelling, stiffness and pain were much worse. I was using a bag of frozen crinkle cut carrots attached by a rubber band

Two Family Members Successfully Treated Their Knee Injuries My son injured his knee last summer playing baseball, ended up being a very slight tear of his patella tendon. We sat him down from all sport activities until he recovered. After the Dr. follow up, physical therapy he was still experiencing discomfort (Scar tissue build up) at the injury. We spoke to a friend that had recently purchased the Inferno Wrap, Freezie Wrap and Ultrasound and was very pleased with the results. Once we got ours, my son started to use it per the instructions and almost immediately noticed improvements in his knee. It has been about a month now and the scar tissue seems to be broken away. He will still use it as a preventive tool but is now experiencing “0” pain or discomfort in his knee where there was scar tissue build up. In fact my wife has started to use it for her knee and has seen & felt immediate improvement. I would and will recommend your products and services to family & friends. Thanks again for all your help. Pat Davis, Washington

David Gross, California

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MendMeShop Helped Me Avoid a $13,000 Meniscus Surgery I injured both knees two years ago while kneeling to tile my family room and entry. Subsequently, a simple twisting squat ripped my left meniscus with a huge bucket tear that required surgery to trim so it wouldn’t keep catching and re-tearing. I am not one to undergo surgery unless it is unavoidable, and even after a “simple” scope operation, it took me a full year to get full extension back on that knee, and I doubt I will ever be able to squat again. I run a cleaning business. A couple of months ago I had to mop some hardwood flooring for a client on my hands and knees. That simple ten-minute job put me back out of commission. The kneeling re-injured the area, and when I stepped back onto my good leg two days later, I felt that familiar burn of a fresh meniscus tear. I was heartsick, dreading another surgery and the attendant expense, pain, and down time. I knew it was just a matter of time before I tore it further.Delighted to discover MendMeShop and their professional healing devices, I ordered the Inferno Wrap, Ice [Freezie] Wrap, and Ultrasound immediately. $400 would be a pittance relative to the $13,000 it costs to repair a torn meniscus (and that doesn’t include rehab and lost income). The minute that I put that Inferno wrap around my bad knee, I was in love! The penetrating warmth felt amazing. I kept it by my desk and strapped it on when I would sit and work at the computer. The ultrasound I believed in because of the help it gave me in therapy for a shoulder injury, and this device worked just like the one used on me in therapy. Every time I used it before bed, I awoke feeling so good I had to remind myself I had an injury and to be careful. And I kept icing the knee. Within two weeks I was walking evenly on both legs, if gingerly lest I inadvertently twist or bounce. But I was definitely healing. ... And so it goes to this day, some six weeks later: the injury is there, but it is gradually improving. The more I use the therapy devices, the faster it improves. The more I get lazy and feel perfect and neglect them, the more I slow down. But I work a full schedule without breaks and only occasionally am reminded of the injury. By God’s grace and with many thanks to MendMeShop, I have avoided surgery! I have to say, too, how much the whole family has made use of the ultrasound unit. I have used it on my bad shoulder, wrists, my daughter’s scapula. It brings instant relief that lasts a good 24 hours. I love having in-home access to this equipment. It payed for itself in only three or four uses and will serve us well for years to come with our active lifestyles. A single ten-minute session with the physical therapist costs $180 ($50 out of pocket) - and that is if she decides to treat that way and the doctor continues to prescribe treatment! I so prefer to take charge of my own health. Pat Davis, Washington MendMeShop 1866-237-9608 | [email protected] Copyright© 2010, In.Genu Design Group Inc.

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9

Understanding Therapeutic Ultrasound

Why is Ultrasound Therapy Important? Ultrasound therapy has helped thousands eliminate the pain and inflammation caused by meniscus tears. Despite this, many people are unaware of what ultrasound therapy is, or the outstanding results it produces. The use of ultrasound for therapeutic purposes dates back to the 1940’s, when it was first researched by a French physicist named Paul Langevin. Ultrasound therapy uses high frequency sound waves to reduce pain and inflammation in your knee. It can be used to heal grade 1 and grade 2 meniscus tears as well as reduce inflammation caused by any tear. In addition, ultrasound therapy will break up and soften scar tissue that has developed throughout the many healing, re-injury and re-healing cycles. By treating the cause of the pain – damaged tissue, inflammation and scar tissue – you can eliminate your meniscus pain with ultrasound therapy and no longer suffer from the symptoms of tenderness, swelling, weakness and grinding.

tendonitis, bursitis or fibromyalgia. This section of the book is dedicated to help you gain a clear understanding of what ultrasound therapy is, how it works, why it works, and the amazing results that come about with its usage.

Fast Facts about Ultrasound Therapy: 1. Promotes faster healing

2. Reduces pain in the treated area

3. Increases cellular metabolism improves circulation

and

4. Breaks up and softens scar tissue and adhesions

5. Shrinks or diminishes inflammation and swelling 6. Reduces irritation to nerve roots

7. Improves the body’s natural healing process

It can even be used to treat other soft tissue conditions such as musculoskeletal injuries, arthritis, MendMeShop 1866-237-9608 | [email protected] Copyright© 2010, In.Genu Design Group Inc.

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Understanding How Ultrasound Therapy Works Ultrasound therapy is the use of deep cellular, high frequency sound wave vibrations that cause a slight increase in the core temperature of soft tissue. In order to create these ultrasound waves, the ultrasound device applies an electrical current to a quartz crystal. This expands and contracts, producing the ultrasound waves, which are then transmitted from the device to the injured tissue. As the sound vibrations create a gentle heating effect (thermotherapy) the body responds by increasing blood flow to the site of the injury. When blood flow increases, so does the amount of healing oxygen and nutrients reaching the damaged tissue. This speeds healing by promoting the body’s natural curative process. Throughout the treatment the sound waves continually work at breaking down and softening the scar tissue that has built up in the area. As a result, ultrasound therapy speeds the healing of tissue, reduces inflammation, softens scar tissue and minimizes pain all at the same time. With ultrasound therapy you can heal your low grade meniscus tear properly, leaving it less prone to re-injury and chronic pain. In addition, this gentle warmth and increased blood flow relaxes the muscles in the treated

area, easing stress and reducing muscle spasm. This process is known as vasodilation. The cellular heating effects of ultrasound therapy have been found to be very helpful in the treatment of musculoskeletal injuries, breaking down scar tissue and helping to exercise tendons. Therapeutic ultrasound may be used to treat a variety of conditions. It has anti-inflammatory effects that can relieve the pain and stiffness of arthritis and other inflammatory conditions. It may be used to treat impingement (compression) of nerve roots and various types of neuritis (nerve inflammation) and may be useful in the care of post-traumatic injuries. Therapeutic ultrasound is very different from its well known counterpart, diagnostic ultrasound. While therapeutic ultrasound is used to treat injuries, diagnostic ultrasound uses lower intensity sound waves to produce images of the inside of a patient’s body. The most well known use is for examining babies inside their mothers’ womb.

Frequency and Penetration Depth Therapeutic ultrasound is usually delivered at frequencies between 0.8 to 3 megahertz (800 to 3,000 kilohertz). The frequency of the ultrasound waves is actually opposite to how deep they will penetrate the body. A lower frequency provides deeper penetration, up to about 3 inches (7 centimeters). For therapeutic applications, 1MHz is the optimal frequency for both effect and penetration. This allows for deep heating of tissues such as muscles,

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tendons, ligaments, joint capsules and bone. A 3MHz frequency is recommended for more superficial damage, such as skin surface scarring.

treatment of pain and inflammation. There are four important properties to look for in an ultrasound gel including:

Continuous vs. Pulse Mode

Peppermint – Widens blood vessels to enhance blood flow to the treatment area.

There are two important settings when using ultrasound therapy: continuous mode and pulse mode. Continuous mode means the ultrasound waves are transmitted continuously throughout the treatment, and pulse mode means the waves are delivered in pulses (short bursts) with a short rest between them. If pulse mode is used less heat is generated making it appropriate for treating acute inflammation when less heat is desired.

Conductive Gel - Why You Need it Ultrasound treatment cannot be applied over bare skin. In order for it to work properly, there needs to be a conductor, or something for the ultrasound waves to be transmitted through, such as ultrasound gel. This gel is applied over the injured area, and the transducer head is used in slow circular motions using the gel to create a seal between it and the skin. Ultrasound therapy is made even more effective if you use a conductive gel that contains natural medicinal ingredients used to further enhance the

Menthol – Numbs the nerves, keeping them from reacting to pain. In addition, menthol provides a soothing, slightly cooling sensation to the injured tissue. Lavender - Beginning in ancient Egypt, this ingredient has been used throughout the world for centuries, but was initially only used in perfumes and incense. As the world evolved, many societies discovered the medicinal value of lavender, particularly for the treatment of stiff joints and sore muscles. In the past few decades, lavender has also been recognized as a natural way to help control muscle spasms. Eucalyptus – Everything from sore muscles to arthritis, from meniscal tears to stiff tendons and ligaments can be relieved by eucalyptus. This versatile compound will provide a slight warming sensation to the area you are treating, helping to keep your muscles and connective tissue feeling loose and relaxed.

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Phonophoresis Enhances Your Ultrasound Treatment

technology, phonophoresis is currently being studied to administer a vast array of medications.

Medicinal ingredients within the gel penetrate into the tissue during the ultrasound treatment through a process called phonophoresis. Phonophoresis is the use of ultrasound to enhance the delivery of topically applied drugs. Ultrasound waves drive the therapeutic molecules deep into the knee to where they work most effectively. Phonophoretically administered medications can penetrate the body to a much deeper level than those massaged by hand over the surface of the skin.

One of the greatest benefits to using medicated gel with phonophoresis is that the pain relieving ingredients can be applied specifically to a desired area. Consuming drugs like oral painkillers and antiinflammatories means applying them to the entire body in equal amounts. With oral medication, you end up drugging your entire body (including your vital organs) even if you only need pain relief in one specific area. Therefore, pain killers and antiinflammatory drugs, when used over a period of time, can cause other problems. When consuming these potentially dangerous drugs, you can increase your chances of heart disease, strokes, and skin reactions. Many doctors state that painkillers and anti-inflammatory drugs are the second leading cause of stomach ulcers. When combining the use of ultrasound therapy with a phonophoretically administered ultrasound gel containing natural, medicinal ingredients you’ll receive maximum benefits and no unpleasant side effects.

Typically, when using a 1Mhz ultrasound device, these medicinal ingredients can reach up to 3 inches into the body. Phonophoresis is most commonly used by physical therapists and chiropractors for the treatment of localized physical injuries. As a cutting edge

Taking this combined two-step approach in relieving your pain and inflammation will help you recover faster and reduce chances of future injury! For more information, along with direct links to many phonophoresis and ultrasound studies, please visit www.aidmymeniscus.com/links.php

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Proof Ultrasound Therapy Works Consumers today are constantly subjected to hype and outrageous claims made by some sellers of medical products. Smart consumers want to see proof that a certain treatment option works as claimed.

and increasing walking speed. Arthritis Care Res. 1992 Mar; 5(1):29-35. Effect of ultrasound on mobility in osteoarthritis of the knee. PMID: 1581369 [PubMed indexed for MEDLINE].

The next study was also conducted at the Kaohsiung Medical College in Taiwan. It concluded that ultrasound therapy can facilitate the repair of damaged cartilage and prevent further deterioration.

We here at MendMeShop.com are no different, and this is why we are presenting you with a number of medical studies that were conducted at leading universities, medical centers, and hospitals throughout the world.

The Importance of Therapeutic Ultrasound for Osteoarthritis

Therapeutic ultrasound has been successfully used by medical professionals to treat a variety of soft tissue injuries and conditions, including meniscus tears.

In 1997 the Department of Rehabilitation Medicine at Kaohsiung Medical College in Taiwan conducted studies that found ultrasound helps cartilage repair in early stages of osteoarthritis and prevents deterioration in later stages. They determined that therapeutic ultrasound enhances the synthesis of arthritic cartilage which facilitates the repair and prevents further damage.

The next study was published in the Arthritis Care & Research Journal. It shows that ultrasound can be an effective tool for increasing range of motion in the knees, as well as reducing pain and inflammation.

Ultrasound Increases Range of Motion Arthritis Care & Research Journal In 1992, the journal Arthritis Care & Research published a study analyzing the effect of ultrasound on mobility in osteoarthritis of the knee. They determined that ultrasound in conjunction with exercise increases soft tissue extensibility and may be an effective therapy in improving knee range of motion (flexion and extension), decreasing pain

Kaohsiung Medical College (Taiwan)

Kaohsiung J Med Sci. Huang MH, Tsau JC, Ding HJ, Chai CY, Yang RC. The role of mucopolysaccharide induction in treatment of experimental osteoarthritis in rats by ultrasound. 1997 Nov; 13(11):661-70.PMID: 9425864 [PubMed - indexed for MEDLINE]

The next study was published in Swiss Medical Weekly. It concluded that a 30% improvement was seen in patients who used ultrasound therapy to reduced their pain and inflammation. Additionally, it increased the range of motion in their knees, giving them an increase in walking speed.

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Knee Arthritis Relieved By Ultrasound Swiss Medical Weekly In June 2003, Swiss Medical Weekly published a study by the Department of Physical Medicine and Rehabilitation at Cukurova University. The study concluded that there was a 30% improvement noted patients with knee osteoarthritis who received ultrasound therapy. Their pain levels, knee range of motion and walking speed all improved after 10 sessions. The following study from the Chongqing University in China has indicated the benefits of ultrasound in repairing damaged cartilage.

Speeding Recovery of Damaged Cartilage with Ultrasound Chongqing University (China) The Chinese journal of traumatology published a study from the Institute of Ultrasonic Engineering in Medicine at Chongqing University of Medical Sciences in 2005 that examined the effects of low intensity pulsed ultrasound in repairing injured articular cartilage. They concluded that lowintensity pulsed ultrasound can accelerate the repair of injured articular cartilage. Jia XL; Chen WZ; Zhou K; Wang ZB 2005; 8(3):175-8 (ISSN: 1008-1275). Effects of low-intensity pulsed ultrasound in repairing injured articular cartilage. PreMedline Identifier: 15896276.

Ultrasound Increases the Rate of Tissue Regeneration University of Oxford, England Oxford University concluded that ultrasound is of great use therapeutically. It helps repair the injured tissue, is a painless application, and does not have any apparent side effects. The study proved that ultrasound therapy increased the rate of tissue regeneration (cell growth) favorably compared with the group that received mock therapy. It affected the flow of blood through regenerating cells, which appeared to improve the injured area and stimulate healing. This was quite dramatic in treating early scar tissue. The ultrasound therapy resulted in an increased amount of procollagen deposits, a little generation of heat in the tissue, micro-massage and changes in membrane permeability (changes in the thin layer around cells to allow molecules to pass through it). It noted that increase in temperature is unlikely to be an important factor in stimulating regeneration. However, continuous movement of the ultrasound transducer head while treating the injured area, was essential to success (eliminates standing waves). Next, the University of Iowa shows that ultrasound therapy is an excellent choice in healing soft tissue injuries as well as the symptoms associated with it.

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Ultrasound Shown to Speed Healing and Relieves Pain and Inflammation University of Iowa, USA In 1998, a medical study conducted at the University Of Iowa declared that ultrasound is the best form of heat treatment for soft tissue injuries. It is used to treat joint and muscle ailments, bursitis, and tendonitis. Ultrasound treatment is used to: Relieve pain and inflammation Speed healing

Copyright (c) 1998. HBO & Company (602) 230-7575. All Rights Reserved. University Of Iowa Hospitals & Clinics - http://www. uihealthcare.com/topics/sportsmedicine/spor3358.html

The next study was conducted at Tulane University in New Orleans. In this study, ultrasound therapy was shown to help repair damaged cartilage. Remember, damaged cartilage leads to arthritis if not effectively treated early on. This is why early ultrasound treatment is so important.

Damaged Cartilage can be Repaired with Ultrasound Tulane University, New Orleans

Reduce muscle spasms and Increase range of motion Ultrasound makes high frequency sound waves. The sound waves vibrate tissues deep inside the injured area. This creates heat that draws more blood into the tissues. The tissues then respond to healing nutrients brought in by the blood and the repair process begins. Treatment is given with a sound head that is moved gently in strokes or circles over the injured area. It lasts just a few minutes. The procedure may be performed with the sound head alone or combined with a topical anti-inflammatory drug or gel. Ultrasound treatment is often used by physical therapists, trainers, and many other healthcare providers. It is very safe and is never used around the eyes, ears, ovaries, testicles, or spinal cord, or where there is an active infection.

In the journal of clinical orthopedics and related research, a study was done by Tulane University School of Medicine in New Orleans to investigate improved cartilage repair after treatment with low-intensity pulsed ultrasound. It found that low-intensity pulsed ultrasound accelerated bone healing via cartilage formation and bone formation. They determined that ultrasound treatment significantly improved features and characteristics of the repair cartilage compared with the non-treated controls. Better repair with less degenerative changes were seen in damages treated with ultrasound. Also, they noted that ultrasound treatments of 40 minutes per day significantly increased the quality of the cartilage repair and had a positive effect on healing. Cook SD; Salkeld SL; Popich-Patron LS; Ryaby JP; Jones DG; Barrack RL. Tulane University School of Medicine, Department of Orthopedic Surgery, New Orleans, LA 70112, USA. Improved cartilage repair after treatment with low-intensity pulsed ultrasound. Clin Orthop Relat Res. 2001; (391 Suppl):S231-43 (ISSN: 0009-921X)

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Loyola University in Chicago stated that ultrasound treatment conducted on a patient in their care increased the range of motion in the patient’s knees. They also concluded that ultrasound might be beneficial in the reduction of pain and inflammation. Not only that, it is implied that torn tissue can lead to osteoarthritis, so this makes it important to begin ultrasound treatments as soon as possible.

Range Of Motion Increase On Torn Meniscus With Ultrasound Treatment Loyola University A study found in the Archives of Physical Medicine and Rehabilitation conducted by Loyola University Medical Center in Illinois, investigated the efficacy of therapeutic ultrasound treatment of a meniscus tear in a severely disabled 21 year-old patient. This study reported that the patient experienced decreased pain with ultrasound therapy. Further more the study reported that the patient experienced an increased range of motion of his knee with ultrasound therapy. The study concluded that therapeutic ultrasound may be a beneficial method to decrease pain and increase mobility of the knee in an acutely torn meniscus (a torn meniscus can lead to osteoarthritis). Much© JA, Loyola University Medical Center, Hines, IL, USA. Efficacy of therapeutic ultrasound treatment of a meniscus tear in a severely disabled patient: a case report. Arch Phys Med Rehabil. 2003; 84(10):1558-9 (ISSN: 0003-9993). PreMedline Identifier: 14586926

The next study was conducted in Taiwan, at the National Taiwan University. Not surprisingly, ultrasound treatment was proven to be very significant in helping arthritis patients increase the range of motion in their knees.

Ultrasound Can Increase Range Of Motion In The Knee National Taiwan University A study from the School of Rehabilitation Medicine at the National Taiwan University was published by the Journal of Formosan Medical Association. It investigated the effect of ultrasound with therapeutic exercise on 94 osteoarthritic knees. They concluded that all patients had significant improvement in both functional capacity and peak torque (application of force in rotation) when an exercise program was used along with ultrasound diathermy. Jan MH; Lai JS. The effects of physiotherapy on osteoarthritic knees of females. J. Formos Med Assoc. 1991; 90(10):1008-13 (ISSN: 0929-6646)

Here is an interesting study conducted at two U.S. hospitals which concluded that ultrasound therapy, particularly when used with medicated ultrasound gel, will reduce pain, increase blood flow, reduce muscle spasm, and allow for cell membrane permeability.

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Ultrasound will Break Down Scar Tissue Sewlicky Valley Hospital & Ohio General Hospital, USA Emedicine published an article by Milton J. Klein from the department of physical medicine and rehabilitation at the Sewickley Valley Hospital and Ohio Valley General Hospital about deep heat therapy. He stated that for a 5 - 10 minute ultrasound treatment with an ultrasound gel, the patient should experience a comfortable heating or no sensation at all. He noted that therapeutic ultrasound will cause temporary analgesia (absence of sense of pain), increased blood flow and cell membrane permeability (allow cells or fluid to flow through membrane), and relief of muscle spasms. Ultrasound used with a medicated gel (phonophoresis) and a physical therapy exercise program will help breakdown scar tissue and joint adhesions, permitting more movement in the joint. The next medical study was published in the American Journal of Physical Medicine and Rehabilitation. It showed that ultrasound therapy can be beneficial in treating myofascial pain.

Painful Muscular Condition Responds to Noninvasive Ultrasound Treatment! American Journal of Physical Medicine and

Rehabilitation Ultrasound treatment of a painful muscular condition known as myofascial pain is as effective as an earlier therapy, which consists of injecting painful places in the muscle called trigger points, according to Turkish investigators. Their findings, which were published in the American Journal of Physical Medicine and Rehabilitation, suggest that physicians offer patients ultrasound, which is less invasive than injection therapy. “The effectiveness of ultrasound therapy is comparable to trigger point injections and should be offered as a noninvasive treatment of choice, especially to the patients who want to avoid injections” - quoted from the study. This study involved 102 patients who had trigger points on one side of the upper trapezius. The individuals’ pain had lasted from six months to seven years. The subjects were grouped randomly to receive ultrasound with neck-stretching exercises, trigger point injections with neckstretching exercises, or neck-stretching exercises only. The average age of the 38 men and 64 women was 31 years. Pain intensity was assessed by patients describing their pain on a scale of 0 to 10. Compared with controls, both treatment groups had a statistically significant reduction in pain intensity and an increase in both PT and range of motion at two-week and three-month follow-up assessments after treatment. Controls showed no improvement; there were no differences between the ultrasound and the trigger point injection

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groups. Vital Information: • Myofascial pain is a chronic condition that affects the connective tissue covering muscles. • Ultrasound is just as effective a treatment as trigger point injections and should be offered as an alternative since it is a less invasive procedure. A leading school in Korea, Inha University, concluded in the next study that therapeutic ultrasound could reduce the severity of osteoarthritis-induced structural damages in the cartilage and synovium.

Osteoarthritis Sufferers Respond Well to Ultrasound The Journal of Ultrasound in Medicine & Biology, Korea The journal of Ultrasound in Medicine & Biology published a study by the Department of Physiology at Inha University’s College of Medicine in Korea. They investigated the alleviation of osteoarthritis by ultrasound with hyaluronate injection. They applied 10-minute low-intensity ultrasound to subjects’ knees in combination with hyaluronate injections and found that it reduced the synovial fluid volume in their synovium (soft tissue lining the knee joint) and also alleviated the growth of proteins in the fluid. Overall the combined hyaluronan and ultrasound treatment reduced the severity of osteoarthritis-induced structural damages in the cartilage and synovium

The next study, from Taiwan, emphasized the importance of therapeutic ultrasound for the treatment of osteoarthritis, which can be an issue that causes knee pain.

Ultrasound Prevents and Repairs Damage Caused by Arthritis Kaohsiung Medical College, Taiwan In 1997 the Department of Rehabilitation Medicine at Kaohsiung Medical College in Taiwan conducted studies that found ultrasound helps cartilage repair in early stages of osteoarthritis and prevents deterioration in later stages. They determined that therapeutic ultrasound enhances the synthesis of arthritic cartilage which facilitates the repair and prevents further damage. Kaohsiung J Med Sci. Huang MH, Tsau JC, Ding HJ, Chai CY, Yang RC. The role of mucopolysaccharide induction in treatment of experimental osteoarthritis in rats by ultrasound. 1997 Nov; 13(11):661-70.PMID: 9425864 [PubMed - indexed for MEDLINE]

In addition to treating knee ailments, ultrasound is shown to be very beneficial in treating many other soft tissue injuries or other conditions. Many people suffer from more than one injury at any given time. The following study conducted in Austria concluded that therapeutic ultrasound can be beneficial for the treatment of calcific tendonitis of the shoulder.

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Relief of Shoulder Tendonitis and Calcification with Ultrasound Therapy University of Vienna, Austria Background: Although ultrasound therapy is used to treat calcific tendonitis of the shoulder, its efficacy has not been rigorously evaluated. We conducted a randomized, double-blind comparison of ultrasonography and sham insonation in patients with symptomatic calcific tendonitis verified by radiography. Results: We enrolled 63 consecutive patients (70 shoulders). Fifty-four patients (61 shoulders) completed the study. There were 32 shoulders in the ultrasound-treatment group and 29 in the sham-treatment group. After six weeks of treatment, calcium deposits had resolved in six shoulders (19 percent) in the ultrasoundtreatment group and decreased by at least 50 percent in nine shoulders (28 percent), as compared with respective values of zero and three (10 percent) in the sham-treatment group (P=0.003). At the nine-month follow-up visit, calcium deposits had resolved in 13 shoulders (42 percent) in the ultrasound-treatment group and improved in 7 shoulders (23 percent), as compared with respective values of 2 (8 percent) and 3 (12 percent) in the sham-treatment group (P=0.002). At the end of treatment, patients who had received ultrasound treatment had greater decreases in pain and greater improvements in the quality of life than those who had received sham treatment; at nine months, the differences between the groups were no longer significant.

Conclusions: In patients with symptomatic calcific tendonitis of the shoulder, ultrasound treatment helps resolve calcifications and is associated with short-term clinical improvement. This next reference, from the Cochrane Database of Systemic Reviews, further indicates that ultrasound is quite beneficial in treating arthritic conditions.

Ultrasound Therapy is Helpful in the Treatment of Rheumatoid Arthritis Cochrane Database of Systematic Reviews Ultrasound therapy has been proven to be helpful in the treatment of rheumatoid arthritis because it has analgesic (painkiller) properties and helps with inflammation. As a result of this, it is used frequently by qualified health professionals. The research in this study concluded that ultrasound alone increased strength and flexion, decreased morning stiffness, and reduced the number of painful and swollen joints. In this Brigham Young University study, the conclusion was that a combination of a hot pack and therapeutic ultrasound allowed muscles to warm more quickly, potentially preventing injuries related to stiff muscles such as strains, and allowing for a larger range of motion.

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Hot-Pack and 1-MHz Ultrasound Treatments Have an Additive Effect on Muscle Temperature Increase Brigham Young University, Utah Objective: Therapeutic ultrasound is an effective deep heating modality commonly applied alone or after cooling or heating of the treatment area. The purpose of this study was to examine the tissue temperature rise in the human triceps surae muscle group after ultrasound with prior heating via a silicate gel hot pack. Subjects: Twenty-one uninjured male and female college student volunteers were randomly assigned to one of the two pack groups. Measurements: The hot packs were stored in 75°C water. A 1-MHz ultrasound treatment was administered for 10 minutes at an intensity of 1.5 W/cm. Results: At both tissue depths, there was a 0.8°C greater increase in tissue temperature with hot packs and ultrasound. At 1 cm, ultrasound increased temperature 3.5°C after a 0.5°C rise during the room temperature-pack application, but only 0.6°C after a 3.8°C increase during hotpack application. At 3 cm, ultrasound increased temperature 3.85°C following a slight (-0.26°C) decrease during the room temperature-pack application and 3.68°C after a 0.74°C increase during hot-pack application. Conclusions: Vigorous increases in deep muscle temperature (=4°C) can be reached with 2 to 3

minutes less total sonation time when preheated with a hot pack. Thus, ultrasound and hot packs have an additive effect on intramuscular temperature, but the characteristics of the additive effect are different, primarily because there appears to be a tissue temperature plateau. Department of Physical Education, Brigham Young University, Provo, UT 84602 - Preventive

In this Italian study, therapeutic ultrasound was shown to help relieve pain associated with arthritis.

Therapeutic Ultrasound Relieved the Pain Associated with Arthritis The AIMCA Study A study on treatment strategies for Osteoarthritis in General and Specialist Practices in Italy found that there is evidence of pain relief when using ultrasound and other thermotherapy applications (treatment of disease by local application of heat through hot packs, hydrotherapy, ultrasound therapy, laser therapy, radiant heat, diathermy). Next, a leading Canadian hospital shows therapeutic ultrasound could be beneficial in treating bone fractures.

The Effect of Low-Intensity Pulsed Ultrasound Therapy on Time-to-Heal on Fractures Oncidium Health Group Inc., Burlington,

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Ontario Background: The effect of low-intensity ultrasonography on fracture healing is controversial, and current management of fractures does not generally involve the use of ultrasound therapy. We describe a systematic review and meta-analysis of randomized controlled trials of low-intensity pulsed ultrasound therapy for healing of fractures. Results: Three trials, representing 158 fractures. The pooled results showed that time to fracture healing were significantly shorter in the groups receiving low-intensity ultrasound therapy than in the control groups. The weighted average effect size was 6.41 (95% confidence interval 1.01-11.81), which converts to a mean difference in healing time of 64 days between the treatment and control groups. Interpretation: There is evidence from randomized trials that low-intensity pulsed ultrasound treatment may significantly reduce the time to fracture healing for fractures treated nonoperatively. From *the Oncidium Health Group Inc., Burlington, Ont.; the Departments of Clinical Epidemiology and Biostatistics, Orthopaedics and Psychiatry, McMaster University, Hamilton, Ont.; the Department of Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ont.; and **the Chedoke Rehabilitation Centre, Chedoke - McMaster Hospital, Hamilton, Ont. http://www.cmaj. ca/cgi/content/abstract/166/4/437.

The next study, from the American Journal of Sports Medicine further shows the effectiveness of therapeutic ultrasound as a treatment option for injured soft tissues. While the study focused on knee

tissue, the same concepts would still apply to other soft tissue injuries, including those located in the back.

Therapeutic Ultrasound Linked To Knee Tissue Repair American Journal of Sports Medicine A lot of osteoarthritic knee conditions result from previous knee injuries and improper healing. In 2005, a study was published in the American Journal of Sports Medicine that analyzed “The effects of low-intensity ultrasound on medial collateral ligament healing”. It found that ultrasound appears to increase the amount of type I collagen and improve some structural properties. The study concluded that ultrasound treatments after a knee ligament injury might help people return to activities earlier and decrease their risk of re-injury. Karen J. Sparrow, PT, PhD, Sheryl D. Finucane, PT, PhD, John R. Owen, PE and Jennifer S. Wayne, PhD First published on May 11, 2005, doi:10.1177/0363546504267356 This version was published on July 1, 2005 The American Journal of Sports Medicine 33:1048-1056 (2005) © 2005 American Orthopedic Society for Sports Medicine.

The following study outlines the beneficial results in treating patients with Carpal Tunnel Syndrome. Along with back injuries, CTS affects millions of workers every year, especially those who work in a job that requires a lot of repetitive tasks.

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Effects Of Ultrasound Treatment In Carpal Tunnel Syndrome & Tips From Other Journals American Academy of Family Physicians The use of splints, local corticosteroid injections and surgical decompression has limited effectiveness in the treatment of carpal tunnel syndrome. Ultrasound therapy applied to the wrist may induce an anti-inflammatory effect that could provide relief of symptoms of carpal tunnel syndrome. Ultrasound therapy was administered daily for 10 days, followed by twice-weekly treatments for five weeks. At the end of treatment, satisfactory improvement or complete remission of symptoms was noted in 23 of 34 wrists (68 percent) treated with ultrasound and in 13 of 34 wrists (38 percent) receiving sham treatment. Thirty of the 34 patients completed the six-month follow-up assessment. At that time, satisfactory improvement or complete relief of symptoms was noted in 74 percent of the actively treated wrists (22 of 30 wrists). This degree of improvement was noted in 20 percent of the wrists receiving sham treatment (six of 30 wrists). Motor distal latency and velocity of sensory nerve conduction were both significantly improved in the active treatment group but remained unchanged in the sham group. Hand grip, finger-pinch strength and the patients’ overall impressions were significantly better in the active treatment group, both immediately following

therapy and at the six-month assessment. No side effects were reported, and use of analgesics was low. The authors conclude that ultrasound therapy provides good short-term relief of symptoms in patients with moderate carpal tunnel syndrome and that the beneficial effects persist for at least six months. Ebenbichler GR, et al. Ultrasound treatment for treating the carpal tunnel syndrome: randomized “sham” controlled trial. BMJ March 7, 1998;316:731-5.

Next is another Canadian study, showing that therapeutic ultrasound is beneficial in managing rheumatoid arthritis.

Ultrasound Effective In Managing Rheumatoid Arthritis The Ottawa Panel The journal of Physical Therapy published a study completed by the Ottawa Panel that found the use of low-level therapeutic ultrasound, laser therapy; thermotherapy, electrical stimulation and transcutaneous electrical nerve stimulation were effective for the management of rheumatoid arthritis. Ottawa Panel Evidence-Based Clinical Practice Guidelines for Electrotherapy and Thermotherapy Interventions in the Management of Rheumatoid Arthritis in Adults. Phys Ther. 2004 Nov;84(11):101643. PMID: 15509188 [PubMed - indexed for MEDLINE]

Finally, the next study conducted in Taiwan indicated that ultrasound can speed healing rates of fibula fractures.

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Ultrasound Treatment On Fractured Fibulas in Rabbits Institute of Biomedical Engineering, ChungYuan Christian University (Taiwan) In recent research, the Institute of Biomedical Engineering at Chung-Yuan Christian University in Taiwan, scientists divided 45 adult New Zealand White rabbits with uniformly fractured fibulas into control, microwave-treated, and ultrasoundstimulation groups. After ultrasound stimulation, new bone formation at the fracture site was 23 to 36% faster, compared with the sham-treated bone; in addition, torsional stiffness of the ultrasound limb was up to 80% greater than the stiffness of the ultrasound-free bone. Meanwhile, the microwave-hyperthermia treatment was unable to produce statistically significant improvements in bone healing or strength.

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10

Step #1 Cold Compression Therapy – Fast Pain Relief

The first thing doctors and therapist learn in school is the RICE (Rest, Ice, Compression, Elevation) formula for treating pain, swelling and inflammation. It is a therapy that has been used for centuries and when you first experience a meniscus injury, cold compression is the right way to treat it. Not only will cold compression reduce your pain and swelling, it minimizes inflammation reducing further damage to the area.

Compression therapy works in combination with cryotherapy to maximize the effectiveness of the cold on your injured knee joint. With the compression that a Knee Freezie Wrap™ provides, the cold is driven deep into the meniscus and knee ligaments. The compression also prevents the pooling of blood in the knee capsule, allowing nutrient rich blood flow to the area and damaged cells to be whisked away.

Cold therapy (also known as Cryotherapy) is the use of low temperatures to remove heat from the body. Using cryotherapy when an injury occurs will reduce pain, swelling and inflammation. Not only will this make you feel better, it will allow for faster healing by opening up the area for more blood flow. Swelling and inflammation reduces blood flow and you need blood to heal.

Benefits of the Knee Freezie Wrap™ Reduces Pain, Swelling and Inflammation with No Side Effects As mentioned earlier, using NSAIDs to reduce pain and inflammation can have serious side effects, such as stomach ulcers and/or accelerating cardiovascular diseases. Using cold compression on your pain treats the injured area naturally. Here’s how it works. When a cold pack is placed over your inflamed knee joint, the heat is absorbed from the body through the transfer of thermal energy using conduction. As the area cools, pain is reduced because the

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nerve endings in your knee become numb; thereby decreasing the impulses you brain receives as pain. In addition, the blood vessels constrict, slowing the build-up of excess fluid that can cause swelling and excess pressure.

Minimizes Further Damage and Prepares the Knee for Healing By applying cold compression therapy to your tender knee you can significantly reduce your inflammation and tissue damage, helping to prepare your body for the healing process. But how does cold compression help in the healing process? Well, damaged blood vessels cannot deliver blood or remove waste effectively. In fact, the cells around an injury consume more oxygen eventually exhausting the supply and dying. These cells and excess fluid, having nowhere to go, leak into the surrounding area causing a buildup of damaged tissue and swelling, restricting blood flow within your knee. The Freezie WrapTM slows cellular metabolism and lowers oxygen consumption, decreasing cell damage. With inflammation reduced and damage minimized, the body is better prepared to begin healing. A Freezie WrapTM is a very effective way of delivering cryotherapy and compression in one 15-20 minute treatment. The non-migrating gel inside the wrap does not freeze solid giving you a flexible, comfortable therapy that covers your tender knee for the entire treatment. The cold compression will make your meniscus feel better quickly.

Some Conditions the Freezie Wrap™ Treats •

Meniscus tears

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Meniscus cysts

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Anterior cruciate ligament (ACL) injury

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Medial collateral ligament (MCL) injury

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Patellar tendonitis

•

Patellar chondromalacia

•

Osgood-Schlatter disease (OSD)

•

Post-operative recovery

•

Bursitis

•

Gout

•

General knee joint pain

•

Twisted knee

•

Other soft tissue injuries and chronic knee conditions

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Here’s What Freezie WrapTM Users Have To Say: Really Pleased With The Results Just a quick note to say thanks for your products (Knee Freezie Wrap and MendMeShop Ultrasound)......even though it was I who purchased them. “my ultrasound is I have been dealing with a small meniscus tear (left knee) for almost a year giving me relief and a half and didn’t want the surgery and the down time, crutches and that I haven’t ‘til also that I have stairs in my home and at my gym. now experienced” I believe I have been useing your products for 3-4 weeks now and am really pleased with the results thus far. With the exception of the temporary relief I had from cortizone shots at the VA Hospital my ultra sound is giving me relief that I haven’t ‘til now experienced. I am still taking stairs one at a time to reduce any impact on the knee and only do low impact cycling at the gym. David Gross, California

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44 |  Heal Your Meniscus in 3 Easy Steps

Within 9 Days I Was Walking Without A Reminder Of Achilles Tendonosis I purchased this device along with the Inferno wrap and Freezie wrap to treat a chronic Achilles tendonosis (microscopic tears of the tendon at the insetion). During the later part of 2008 I was experiencing a lot of tight muscle and tendons and usually working out (running) tired and not properly warmed up and limber. I started the new year with good intention and determined to work on stretching that included following a home yoga program. I am familiar with yoga but admit that I was too aggressive with the stretching that comes from the “downward dog” position. I believe this aggravated an “within 7 days already existing condition in the Achilles insertion area, this combined I started to with the stress of a late January 5KM road race caused enough pain in the experience a Achilles tendon to force me to discontinue running. I sought medical attention from my family physician who referred me to reduction in the constant pain” physiotherapy. Through the early stage of therapy I continued to do regular bike workouts. Unfortunately the pain increased to the point that I had to stop both running and cycling. I attended physiotherapy for just over two months going once a week receiving massage to the injured area, ultrasound, cortisone by patch and ice. I was religious in following the gentle stretching and strengthening routine at home between physio visits.

After these two months with little improvement they released me with the instruction to continue with the stretching, strength exercises and ice. I was still in pain and could not run or cycle without causing further damage, walking was painful. I search for other solutions and found the information on the “MendMeShop” web site. Although skeptical, I purchased the full package out of desperation, received the product, read all the literature for use and started into a daily routine using the ultrasound device one a day followed by use of the Freezie Wrap. Within 7 days I started to experience a reduction in the constant pain. Within 9 days I was walking without a constant reminder of the injury. I tried doing a ride and although the short 13 mile ride was enjoyable I started to feel the injury flair up again. The injury is not completely healed but the progress I am experiencing gives me hope that with a continued discipline of home treatment using the products, gentle stretching and the use of wearing a brace on my foot while sleeping to prevent the tendon from retracting, will in time bring about the full healthy healing of the injured area. John Carey, Florida USA

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45 |  Heal Your Meniscus in 3 Easy Steps

Reduction in Shoulder Pain In Only One Week Over the past eight months I have been suffering from shoulder and arm pain. I just kept thinking that the pain would go away on its own. When I reached the point where I was unable to raise my arm over my head without assistance and forget about putting my arm behind my back. I decided that a trip to the doctor was due. She ruled out that I had an injury to the Rotator Cuff itself and determined that I had a soft tissue injury. Due to repetitive movement and heavy lifting. She suggested that I try physical therapy. With my work schedule and family obligations I knew that was going to be very difficult and I wanted something that I could fit into my schedule. So I began doing research on the internet for alternative treatments and exercises. That’s when I found your product on the internet. I was somewhat skeptical as to rather it would perform as stated, but decided to give it a try. It was stated that it could take up to three weeks to feel results. BUT I am here to say that for myself it has done better. I have been using the Ultrasound and the Freezie Wrap for a week and have already felt some improvement. I can now raise my arm to just about shoulder height unassisted, and can now almost get my finger tips back behind my back.

“I have been using the ultrasound and Freezie Wrap for 1 week and have already felt some improvement”

I use the Ultrasound first thing each morning and try to throw in a second treatment in the early evening if possible. I make a point of using Freezie Wrap as soon as I get home from work to relieve the stress to my muscles from work and to keep the inflammation down. Now that I have gotten some of the inflammation gone I intend to incorporate the Inferno Wrap treatment to my regiment to just before going bed to aid the healing process and aid in a better night’s sleep. Nancy Jensen, Washington

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Contact Information To learn more about and/or possibly obtaining your own Freezie WrapTM for less than the cost of a chiropractor visit, please call MendMeShop directly toll free at: 1-866-237-9608 Are phones not your thing? Feel free to send us an email instead, anytime! Our address is: [email protected] We hope to hear from you soon!

MendMeShop 1866-237-9608 | [email protected] Copyright© 2010, In.Genu Design Group Inc.

47 |  Heal Your Meniscus in 3 Easy Steps

11

Step #2 Blood Flow Stimulation Therapy – Faster, Natural Healing

Your body can heal itself ! In fact, your body starts healing itself the moment you are injured and it’s the blood in your body that makes it all happen. It carries oxygen and nutrients to the injured meniscus and ligaments in your knee to begin the healing process. Unfortunately, circulation is limited to the tough dense fibrocartilage in the meniscus and, in addition, you begin to limit movement because of pain. As a result, blood flow to the meniscus slows to a trickle. To speed up the healing process, you need to keep your blood flowing to your torn meniscus and this is where Blood Flow Stimulation Therapy becomes a powerful tool. Blood Flow Stimulation Therapy, or BFST, compliments your body’s natural healing process by promoting the flow of blood to your knee while you give it the rest it needs. The Knee Inferno Wrap™ is the only Blood Flow Stimulation device available to treat your meniscus and torn ligaments. Using a patented process it generates the same energy that is part of the sun’s invisible spectrum of light, the same energy that is necessary to all living things for optimum health. If we do not receive enough of this energy from the sun, we become ill and depressed. All life forms on this planet; animals, plants and humans, need this abundant energy to be completely healthy. The

sun’s energy rays heat our body by a process called conversion. Through conversion, these rays can penetrate organic substances such as the human body without heating the air in between. The energy emitted from the patented technology of the Energy Web™ inside the Inferno Wrap works the same, penetrating deep into your meniscus, Anterior Cruciate Ligament (ACL), Medial Collateral Ligament (MCL) and other tissues speeding blood flow and increasing circulation. The Inferno Wrap is more effective that other traditional heating methods because the energy waves penetrate deep into your body. By reaching the tissue deep below the skin’s surface, deeper than hot water, hot towels, traditional heating pads and topical pain relief gels/creams can reach, you are able to heal the source of your pain so you will never have to deal with it again.

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48 |  Heal Your Meniscus in 3 Easy Steps

Benefits of The Inferno Wrap Speeds Recovery of Meniscus, ACL and MCL Tears 10 Times Faster The Inferno Wrap gives you the most effective Blood Flow Stimulation Therapy. It does this in two ways. First, a larger surface area is covered by the Inferno Wrap’s Energy Web™, stimulating more tissue during the treatment. Second, an Inferno Wrap treatment can be used safely for a longer period of time than ultrasound, prolonging the blood flow and healing process. The nutrient and oxygen rich blood will heal your meniscus tear, ACL and MCL injuries while reducing inflammation faster than allowing your body to heal itself or when using ultrasound therapy alone.

Effective Healing Before and After Surgery If surgery is necessary to treat your meniscus tear, the Inferno Wrap can be used pre-op to do as much healing as possible. That way, less trimming or suturing will be needed during the operation. This will reduce healing time and help to maintain strength and function in the meniscus. In addition, once the incisions from your surgery have healed, the Inferno Wrap can be used to speed recovery from surgery. The increased blood flow will help to heal the point of the surgery as well as create an overall healthier environment in your knee joint.

Helps You Avoid Consuming Dangerous Drugs Blood Flow Stimulation Therapy is a natural way to reduce pain and inflammation in your knee. With BFST you can minimize or eliminate the need for potentially harmful medications. By treating the source of your pain instead of just masking it temporarily, you reduce pain and prevent further damage which can occur if you use your knee while using pain killers and/or NSAIDs. There is no need to medicate your entire body when you experience knee pain, you just need an Inferno Wrap. If you suffer from chronic meniscus pain it is dangerous to use medication over a long period of time without the risk of side effects such as stomach ulcers, heart problems and stroke. Daily Inferno Wrap treatments allow you to manage

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49 |  Heal Your Meniscus in 3 Easy Steps

your chronic knee pain without putting the rest of your body at risk.

Reduces the Risk of Chronic Pain When a meniscus, ACL or MCL injury goes left untreated and tissue is damaged over and over again, you are at greater risk of chronic conditions developing. Tendonitis or osteoarthritis can become a lifelong problem when you do not treat your knee properly. The Knee Inferno Wrap promotes faster and more complete healing, reducing the risk of these painful conditions that can leave you with pain and less activity for the rest of your life.

Eliminates Toxins From the Knee We all want to keep our body as healthy as possible and one way to do that is to eliminate the buildup of toxins. By increasing blood flow to your knee, the damaged cells and other toxins are whisked away from the site. The Inferno Wrap assists the body’s natural elimination process and keeps the area clean for more complete healing.

Some Conditions the Knee Inferno Wrap™ Treats •

Meniscus tears

•

Meniscus cysts

•

Osteoarthritis

•

Anterior cruciate ligament (ACL) injury

•

Medial collateral ligament (MCL) injury

•

Patellar tendonitis

•

Patellar chondromalacia

•

Osgood-Schlatter disease (OSD)

•

Post-operative recovery

•

Arthritis pain and inflammation

•

Bursitis

•

Gout

•

General knee joint pain

•

Twisted knee

•

Other soft tissue injuries and chronic knee conditions

Here’s What Inferno WrapTM Users Have To Say:

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50 |  Heal Your Meniscus in 3 Easy Steps

I am Impressed With The Inferno Knee Wrap Thank you for spending time answering my questions and concerns. I appreciate that, and I am impressed with your company’s personal availability to personally talk with customers. In a fast pace, seemingly no care, “all out for “my” benefit” mentality in our society it is refreshing to know I can go on-line and there are people doing business who do care for their product and customers. I went on-line to find help in treating my very painful meniscus and other issues Arthroscopic surgery on my right knee,...so I could find help in speeding up my recovery and get back on my feet again. Having had the same surgery on my left knee only 6 months prior, I was not able to recover as fast as my left knee had not yet fully recovered enough to take the full load of both knees. The Dr. said nothing about recovery only that I could not even put toe weight on my right knee for 4 weeks. So, with my left knee still in recovery this made life extremely difficult. So much so, I had to go to a wheel chair so I would not ruin either of my knees or my back which is suffering from degenerative discs. I am an active person and was not going to consign myself to a wheel chair for the rest of my life. I had no access to physical therapy treatments in my personal situation. So, I took the bull by the horns and got busy finding out what I could do to help myself recover faster and get back in action physically. And I found your company. The fully guaranteed refund was a plus to me so that I would not spend a lot of money for something that I would be stuck with and as well did me no good. You also had a personal way to contact your company to discuss any concerns I might have in using it. ...You really came through on your end and I had my Inferno Knee Wrap in just a few days. That really firmed up to me that you back up your claims about your product and that you truly cared about me and so I could get onto faster recovery sooner. After receiving the Inferno Knee Wrap, I was having personal issues in how often to use the Knee Wrap and so I called you to help me with this. ...You helped me and from your recommendations, ...I found a workable solution for me personally. Each person is unique and what works for one person may not work for another. So, I recommend not giving up and returning this product until you find what works for you. ...I am plugging away and using the Inferno Knee Wrap along with stationery bike exercise and I am seeing progress each day. Thank you for being there when I needed help in recovery of Arthroscopic Knee Surgery. I appreciate you and your company. Ann Block, Louisiana USA MendMeShop 1866-237-9608 | [email protected] Copyright© 2010, In.Genu Design Group Inc.

51 |  Heal Your Meniscus in 3 Easy Steps

Knee Inferno Wrap Made A Difference After Only Two Days I have had my Inferno Wrap for nine days and I love it. I noticed a small difference in only two days. I have a small tear in my meniscus and was in pain most of the time. My knee would slip a lot and it was extremely painful. After one treatment I noticed the difference. I am looking forward to how much better I will get after I really use it for a period of time. P Jackson, Rockwall Texas USA

“after only 1 treatment I noticed the difference”

I Could Feel Relief With The Inferno Wrap After One Use I have been using the inferno wrap for about 3 weeks now and the results are outstanding. I could feel relief after the first use of the inferno wrap. About 2 years ago the doctor told me I had plantar fasciitis and heel spurs. The heel of my feet hurt so badly, I could hardly walk. Getting out of bed in the mornings was pain beyond belief. After going to the doctors and getting cortizone “the results are injections, ordering custom made insoles, exercises, taping my arch, and outstanding” therapy, my feet were still hurting. I stopped the doctor visits for lack of relief. I was paying out so much money with no results. Not knowing what else to do, I prayed and asked God to show me what I could do to get relief. I came across the mendme website and read the entire article on foot problems and the products. What it said made so much sense to me. I love the way it talks about the body and explain how it should work. What really drew me the most and encouraged me to order was: the site said your body was designed to heal itself. I am a firm believer in organic healing and avoiding medication and surgery whenever possible. When I read about the blood flow I was sold on the product. I know that blood is the life of the body. When I wear the inferno wrap I don’t want to take it off. It gives relief and warmth right where it hurts. I will be ordering other products for the feet as well. Yolanda, Georgia

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52 |  Heal Your Meniscus in 3 Easy Steps

Help Treat and Prevent Various Knee Injuries I sustained a re-injury to the lateral right knee in a hiking incident on a wet path. Initially, I treated with anti-inflammatory medication, ice, elevation and knee brace. This injury was very similar to the previous knee injury, so I thought my knee would heal without “I am now seeking orthopedic evaluation. I started using a heating pad with a massage pain free” feature to relieve pain and found that the heat helped tremendously, but did not radiate deep enough into my knee. Since I am a Certified Rehabilitation RN, I started researching the Internet looking for a product that would provide radiant heat. I was happy to discover your Inferno Knee Wrap. I have been using it several times a day for several weeks and I am now pain free and functionally able to resume all activities. I still continue using the Inferno Knee Wrap on a daily basis in hopes that I can prevent another knee injury. Thank you for such a wonderful product. Ann Block, Louisiana USA

Basketball Referee Solves Achilles Tendonitis With Ultrasound and Inferno At the age of 48 I have figured out that my body is not keeping up with the activities that I want to pursue. I am very active and referee high school and college basketball. At 44 I ruptured my right Achilles tendon while refereeing a ball game. After surgery I was determined to keep this from happening again. Four years later I started experiencing burning and pain in the other Achilles tendon. I went to the orthopedist and he started me on physical therapy. PT consisted of ultrasound treatments. After spending over $400, $80 a week (2 PT treatments a week) I was released from therapy. I did some research on the internet, and I found a personal ultrasound unit from Mendmeshop.com. I purchased the unit along with an Inferno Wrap, and started using the units daily. My pain has gone away and I am running on the treadmill again. Thanks.

“My pain has gone away”

Jeff Darr, Monroe NC

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I Cannot Believe How Fast My Knees Are Responding I just spoke to you on the phone in regard to my results in the use of the Inferno Knee Wrap and the Ultrasound I received about 3 weeks ago. I cannot believe how fast my knees are responding. I was diagnosed with osteoarthritis several years ago and was told I would probably need knee replacement in a few years. I just took Advil, Aleve, Chondroitin, Glucosamine, MSM to help limit the discomfort ( I will add that I have ordered a number of supplements that promised the end of knee pain but they have not worked). I have had the famous steroid injections that helped for a few weeks. I have been riding my stationary bike up to 30 minutes a day (about 3-4 times per week) since November. In November my left knee swelled to twice its size and I could hardly walk. I saw an Orthopedic Sports Physician and was given an injection after the MRI and x-rays confirmed I had a Baker’s Cyst and a slightly torn meniscus (Do not know how I tore it). I did the ice “I give the and heat treatment and Aleve (800 mg every 6 hours). The swelling went down Inferno Knee and discomfort was not as bad. I could not sit or stand for any length of time Wrap and without my knees hurting and being very stiff. The physician recommended Ultrasound 5 surgical repair. I was not ready for that yet so I did not do anything until March when I scheduled knee surgery. The Orthopedic Surgeon stated he stars!” could not promise to get rid of the pain and I did not need knee replacement yet. He also said at my age, 63, I do not have enough blood flow to the knee to heal the meniscus tear. I prepared myself for surgery but then started thinking there had to be another answer since I would still have pain in my knees. I Googled natural healing of meniscus tear and MendMeShop opened up and I read about the Inferno Knee Wrap to increase blood flow to the knees and also the Ultrsound to help heal the meniscus tear. I called the number on the web page and spoke to 2 very informative people. I was assured if I was not satisfied with the products I was ordering, I could return them for a full refund. I also read several testimonials and felt it was worth the investment. If the next few weeks go as well as the past 3 weeks, I should be down to 1 treatment per day and not have the stiff knees I have had after sitting or standing for an extended period of time. Thank you MendMeShop. I look forward to increased activity so I can keep up with the 7 grandchildren that keep us busy. I give the Inferno Knee Wrap and the Ultrasound 5 stars!!! Kerlene Ross, USA

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54 |  Heal Your Meniscus in 3 Easy Steps

Only Ultrasound and the Inferno Worked For My Sprained Ankle I’m treating a recent ankle sprain. The injury occurred while playing volleyball. RICE (Rest, Ice, Compression, Elevation) alone or in the past did not seem to really help. I’ve tried other herbal remedies that didn’t appear to help or still took a long time to recover. I did an internet search for a quicker recovery process.

“I would definately recommend both items”

I can tell immediately after each use that there is definitely less pain to the touch. Using Ultrasound as a means of therapy was a totally new concept to me. And I always felt heat therapy worked better for me. Now I know why, because it promotes circulation and healing. That’s why I also purchased the Inferno Ankle Wrap. At first I did not feel it was providing enough heat. However, my foot was always sweating after each use! With other solutions the temperature was never constant and sometimes I would burn my foot. I knew from my past ankle sprain on my other leg that it took forever to heal. Even 2 years later, I still felt it move. This time I wanted to make sure it did not happen again. I’m doing surprisingly well with my ankle so far. I played volleyball the following week and back to usual routine the week after, snowboarding one day and volleyball the next. Even though I’m not 100% yet after 3 weeks, I feel the Ultrasound plus Inferno Ankle Wrap combination has greatly attributed to my quick recovery! I would definitely recommend both items and the customer service has been truly exceptional! Thank you! Ching Vue

The Back Inferno Wrap Is Amazing So far we are very pleased with the size, light weight, flexibility and comfort of the Inferno wrap. It is very convenient the way the cord is set up. If one has to leave the area for a moment it is much easier now because instead of removing the entire wrap or unplugging the “we are very whole thing from the wall, you can just detach at the segment. I like the on/off pleased” switch, too. It is much easier to see which setting it is on. Everything about this new product seems more intelligent and user friendly. A lot of thought was put into improving on the old product. Well done to all involved!!! Rebecca Page, Texas

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55 |  Heal Your Meniscus in 3 Easy Steps

Sport Taekwondo Athletes at London Southbank University use Ultrasound / Inferno Wrap Hi Deb, i was forwarded your email from Jo Taylor as she purchased the Platinum Knee Therapy Kit for the Sport Taekwondo focus group at London Southbank University, which I head up. The Ultrasound has been used extensively already for all kind of knocks associated to Taekwondo. However the greatest benefit has been for our athlete who represents GBR at World level. This athlete has lateral meniscus damage and a very slight ACL tear.

“by using the ultrasound coupled with the inferno wrap this problem has reduced significantly”

However, such is the nature of the competition season surgery is not something we can really look to at this point. As such he gets periods where the lateral aspect is sore and slightly inflammed, by using the ultrasound coupled with the inferno wrap this problem has reduced significantly (he was able to spar 33 rounds over two days very recently with no problems). I believe the increased intra-articular blood flow induced by these systems has enabled such activity. I have subsequently placed the purchasing of two more sets on the agenda of the next focus groups meeting for the other sports of rugby and basketball that are priority at the University. Many thanks, Dr. David Cook - Course Director Sport & Exercise and Senior L, London United Kingdom

Your Inferno Wrap is now My Inferno Wrap I thank the One Above for having your website befall on me. My Inferno Wrap is absolutely perfectly designed, and absolutely perfectly works as advertised. My first-20 minute treatment tells it all: My Inferno Wrap, from the get-go, provided complete relief, and unquestionable will keep doing the same on the other parts of my injured body. My Inferno Wrap: Just Perfect. Period. Also, thank you for your patience, as I unloaded my many questions on you. Regards and Best of Success, Bruce, North Woodmere New York

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“My Inferno Wrap, from the get-go, provided complete relief ”

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12

Step #3 Therapeutic Ultrasound Effective for Meniscal Therapy

Until recently, proper ultrasound therapy was only available in doctors’ offices, physical therapist clinics and chiropractor clinics. However, thanks to MendMeShop’s innovative team of doctors and engineers, you can now benefit from this powerful and precise technology in the privacy and comfort of your home. It’s no longer necessary to attend inconvenient and costly appointments. High quality therapeutic ultrasound is available using a MendMeShop Ultrasound unit! As you have read in Chapter 9, there is a vast quantity of research available from leading universities and top medical institutions that prove the many benefits of therapeutic ultrasound treatments.

Why Do So Many Meniscus Tear Sufferers Consider Ultrasound A Must-Have Treatment? It Speeds Recovery of Meniscus Tears Ultrasound treats your meniscus pain at the source; it does not merely mask the pain like many other

treatments do. Therapeutic ultrasound treatment increases nutrient and oxygen rich blood flow to the knee, nourishing injured cells while flushing wastes and toxins away from the area. This increased blood flow treats the tears and inflammation that are causing your pain. In addition, by healing the tissue you reduce the risk of further re-injury and future chronic knee conditions.

It Breaks Down Scar Tissue Scar tissue is a major problem in all soft tissue injuries. Although, it may seem contradictory because scar tissue develops as a result of the healing process; it can cause pain and it makes the area more prone to re-injury. When you sustain a soft tissue injury, your body begins to heal itself. As it does this, scar tissue builds up on the meniscus. The buildup of scar tissue decreases elasticity which makes the tissue susceptible to re-injury. Every re-injury delays the healing process, but what’s worse is that with each healing cycle the amount of scar tissue increases. Scar tissue is hard, inflexible, and tough to get rid of ! But don’t despair; ultrasound therapy is proven to break down deposits of scar tissue and help prevent new scar tissue from forming!

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Effective Healing Before and After Surgery Like Blood Flow Stimulation Therapy, ultrasound therapy is beneficial prior to surgery. By treating your meniscus beforehand you can assist with healing as much as possible to reduce the amount of trimming or suturing necessary during the operation. This will reduce healing time and help to maintain strength and function in the meniscus. In addition, once the incisions from your surgery have healed, ultrasound therapy can be used to reduce the scar tissue build up at the site of the tear and around your incision. This will help to reduce pain and recovery time and get your knee operational faster.

It Helps You Avoid the Use of Harmful Medications and Further Damage Pain and anti-inflammatory medications may be effective at reducing your knee pain; however, there are other issues to consider. First, we know that when used over a long period of time, pain and anti-inflammatory medications can have serious side effects such as ulcers and even heart problems and strokes. As well, they only mask the cause of your pain which can result in more damage. Here’s why. With the pain in your knee reduced, you continue to use it as though it isn’t injured. This only causes more damage to your meniscus leaving you with more pain and a longer recovery. Why use medications if you don’t have to? With

therapeutic ultrasound you can treat your injury without treating your entire body. This way you reduce your pain and heal your torn meniscus at the same time.

It Helps You Reduce Pain to Function Throughout the Day Let’s face it, many of us can’t afford to take a number of weeks off to rest an injured knee. Ultrasound greatly increases your chances of a quick recovery, plus it provides you with some immediate pain relief. Whether you need to go to work, shopping, or even travelling, MendMeShop’s portable ultrasound unit can make it easier to function and enjoy yourself, no matter where your busy life takes you! For example, we have a dedicated group of arthritis sufferers who use our ultrasound device to ease the pain during flare-ups. Ultrasound obviously can’t cure arthritis, but it does lessen pain during flareups and helps combat atrophy. Atrophy is the weakening and reduction in body tissue when not used/exercised on a regular basis.

It Energizes Your Life and Overall Well-Being When you feel good, you have a more positive outlook on life. If you’re in constant pain, you carry around a mental and physical burden every waking hour. It might almost seem like the pain takes over your life - don’t let this happen! Take control of your own therapy and put knee pain behind you.

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58 |  Heal Your Meniscus in 3 Easy Steps

The versatility of therapeutic ultrasound makes it an ideal choice in treating most forms of muscle and soft tissue injuries. Ultrasound is a safe and effective treatment option to help you treat any soft tissue injuries you may have. The facts cannot be disputed - ultrasound is recommended by many doctors and physical therapists as the treatment of choice, backed by a significant amount of research!

MendMeShop Ultrasound Specifications: •

Input Power: 120VAC/24VDC 200mA adaptor

•

Timer: 5/10/15 minutes, three timer settings, default levels 15 minutes

•

Ultrasound Frequency: 1+-10% M Hz

•

Pulsed Duty cycle: L~12.5% ; M~25% ; H~40%

•

Pulse Repetition Rate: 60Hz

•

Pulse Mode: Pulse 50% and intermittent pulse 25%

Contact Information: To learn more about therapeutic ultrasound and/or possibly obtaining your own ultrasound device for less than the cost of a few doctor visits, please call MendMeShop directly toll free at: 1-866-237-9608 Are phones not your thing? Feel free to send us an email anytime at: [email protected]. We hope to hear from you soon!

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59 |  Heal Your Meniscus in 3 Easy Steps

13

Surgery… a Last Resort

If conservative treatments are unable to treat your tear completely, your physician may recommend surgery.

they usually don’t require an overnight hospital stay. Your orthopedic surgeon will determine which surgery is most suited to your condition.

A comprehensive arthroscopic exam is usually performed prior to surgery to determine the location and nature of the tear and whether or not it can be repaired.

Arthroscopic surgery involves making tiny incisions around your knee joint and inserting a pencil-thin, fiber optic camera with a small lens and lighting system in one hole, and small surgical instruments in the other holes.

You are generally a candidate for surgery if you have injured your meniscus and you: •

Experience disabling symptoms that interfere with your daily living after 2 - 3 months (knee catching or locking, very stiff and painful, major instability).

•

Have a larger, complex or displaced tear.

•

Have major instability in your knee (often due to a combined meniscus/ACL injury)

•

Are a high-level athlete

Treating a torn meniscus is one of the most common of all knee surgeries. The type of surgery you require will depend on the size, shape and location of your meniscus injury. There are generally 3 types of meniscus surgery: a meniscectomy, a meniscal repair, or a meniscal replacement. All of these will be performed by arthroscope while under some type of anesthesia;

The surgeon will take a look inside your joint to investigate all the soft tissues and bones. These images will then be transmitted to a TV monitor, which allow the doctor to make a diagnosis and/or perform the meniscus surgery under video control. At the end of surgery, your incisions are closed, and a dressing is applied. Most surgeries will require extensive rehabilitation utilizing the conservative treatments discussed in the previous chapters. Ultrasound therapy and Blood Flow Stimulation Therapy can begin once your incisions have healed, with permission from your doctor. Physical therapy and strengthening normally begin a few weeks after surgery (depending on the type of surgery). Your surgeon should provide a treatment plan to help you regain normal use as soon as possible.

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60 |  Heal Your Meniscus in 3 Easy Steps

Types of Meniscus Surgery Meniscal Repair A meniscal repair is generally preferred over a meniscectomy, as it fixes the damage and helps prevent deterioration of your meniscus. However, this involves a more complex surgery, the recovery is longer and it is not always possible (depending on the location). Early diagnosis definitely can affect the outcome of this surgery. Younger people tend to be the best candidates for repairs as their tears are often stable and located near the periphery of the meniscus. These tears have a better chance of healing than those farther in the joint because of the blood supply. After surgery and with permission from your surgeon, ultrasound therapy and Blood Flow Stimulation Therapy can help promote blood circulation to the injured areas to help you heal faster. •

Trepanation (Abrasion Technique) involves making small holes or shaving torn edges in your meniscus to promote bleeding and enhance healing. Longitudinal tears or bucket handle tears often won¹t heal unless they are abraded.

•

Suturing involves using stitches to reconnect the tear, repair the damage, and save your meniscus. The sutures are spaced 3-4 mm apart to prevent gapping and sewn while your knee is fully extended (or at 10 degrees maximum) to allow for full extension after surgery.

Meniscectomy The most common meniscus surgery is a Partial Meniscectomy or Resection, which involves removal of the torn or damaged part of your meniscus. It is generally used for degenerative and horizontal tears located in the inner 2/3 of your meniscus (the white-on-white zone). This area has a poor healing rate because it receives little or no blood supply, therefore it is better to remove Quick Fact the damaged part 850,000 meniscus rather than try to surgeries are fix it. performed in The goal of the USA each this surgery is year. Estimates stabilization, indicate that which will prevent at least twice catching, buckling this number and locking in of meniscus your knee joint. procedures The surgeon will are performed trim and smooth internationally out frayed edges on the inner rim (which can be difficult to reach), and remove the damaged part or flap of your meniscus. In the case of a discoid meniscus that did not heal through conservative treatments, part of your meniscus may be removed to relieve symptoms, prevent further tearing and preserve some of your meniscus cushioning function. A Complete Meniscectomy or Resection may be

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61 |  Heal Your Meniscus in 3 Easy Steps

required if there is extensive damage to the meniscus and it is determined unsalvageable. This involves surgical removal of your entire meniscus.

If you have your meniscus removed, the rest of your joint gets overloaded (resulting in a 200%-350% increase in contact pressure). This surgery is only performed if necessary, as removal of the meniscus can lead to joint narrowing, ridging, flattening, and becoming bow-legged or knock-kneed. Complete meniscectomy patients often express dissatisfaction with the corrected knee as time goes on. Although recovery from meniscectomies is faster recovery than other meniscus surgeries, they can often lead to arthritis as the size of your meniscus (shock absorber) is reduced and/or removed. Normal knees have 20% better shock-absorbing capacity than meniscectomized knees.

Meniscal Replacement A meniscal replacement involves implanting a new

meniscus into your knee. There are two different replacements that can be used: An allograft is a transplant from a donor. A good candidate for this type of replacement is someone who is young, has minimal ACL damage, is a previous menisectomy patient, and has developed pain in the knee capsule. If the patient is obese, suffers from gout or arthritis, has an infection, or any metabolic disease (being unable to convert food to energy) they are not likely candidates for this procedure. The success of this surgery is dependent on proper knee alignment, ligament stability, and amount of articular cartilage that is present at the end of the femur and tibia. A collagen implant is put in the knee and stitched into place. The hope is that your body’s own cells will begin to regenerate new meniscal tissue and attach itself to the porous surface of the implant. In this way, the implant works as a scaffold to assist the body with it’s own repair process.

Rehabilitation Following Surgery Initially following a meniscal repair, the knee is immobilized in full extension with a postoperative immobilizer which is eventually replaced with a long leg brace. This brace is worn continuously (except during rehabilitation exercises) for at least 2 weeks, with the range allowance of the brace increasing as the weeks progress. This continues until the knee can be fully flexed. In some cases such as a central zone repair or a mensical transplant the brace may be necessary for

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62 |  Heal Your Meniscus in 3 Easy Steps

6 weeks or longer. Following a partial meniscectomy, immobilization is not required and full extension with 90 degree flexion is possible approximately 10 days after surgery.

pivoting, squatting, twisting and deep lunging exercises for at least 4-6 months following surgery. Jogging or running should be avoided for 5-6 months.

With a meniscus repair you may be allowed to bear some weight on your repaired knee with the assistance of crutches and a brace immediately following surgery. The amount of weight and progression of weight allowed will depend on your

Generally you will be able to return to normal activities and sports approximately 6 weeks after a partial meniscectomy and 3-4 months after a meniscal replacement. However, it is always recommended that you get your surgeon’s approval before beginning any exercises or activities following meniscus surgery. Research indicates pain relief after a partial meniscectomy or abrasion is about 50 - 75%. Healing and recovery time is generally dependent on the degree of damage done, your age, pre-injury level of function, and your rehabilitation. However, a strong commitment to rehabilitation utilizing the conservative treatments discussed above is essential to faster and more complete healing

specific case. However, you will be able to bear full weight within 4-8 weeks if your quadriceps control is good. In the case of a partial meniscectomy, you should be able to bear full weight within 4-7 days.

A Word of Caution

The goal of physical therapy during the first month of rehabilitation is to regain range of motion in the joint, regain muscle control in the leg, ensure the patella does not lose mobility, maintain flexibility and strength in the hip and ankle, and restore stability.

There are always risks associated with any surgery, which include but are not limited to possible infection, allergic reaction to medications, blood clots, and damage to surrounding nerves (peroneal nerve with a lateral repair, saphenous nerve with a medial repair) or blood vessels. However, modern techniques have significantly minimized the occurrence of these problems.

You doctor, surgeon or physical therapist will assist you with these exercises to achieve these goals without causing re-injury.

If you feel any clicking in your knee during exercise or weight bearing activities following surgery, let your surgeon know immediately.

Following a meniscal repair, you should avoid

Although surgery is often successful at repairing any

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63 |  Heal Your Meniscus in 3 Easy Steps

damage and/or relieving pain, it does not necessarily return strength to your knee. There are occasions where surgery is not necessary, or not worth the potential for further damage. As with all surgical procedures, it is usually recommended that you get a second opinion before making a decision.

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64 |  Heal Your Meniscus in 3 Easy Steps

14

Preventing Further Meniscus Injury

Treating meniscus injuries properly is important but preventing the injury in the first place and/or preventing re-injury should be your priority. There are a number of things you can do to keep your knees and menisci healthy and prevent further damage.

Maintain a Strong, Flexible Knee To stabilize your knee joint and increase your range of motion, maintain and build the strength and flexibility of your quadriceps, hamstrings, calf muscles and hip flexors. Strengthening and stretching exercises will help to keep your knee strong to reduce the risk of injury. In addition, balancing exercises will help retrain your position or “joint sense”. A regular exercise program that focuses on total body fitness and includes lowimpact aerobic activity such as walking, swimming or biking will also strengthen your knee and keep you healthier overall.

Invest in Proper Equipment Invest in footwear that fit properly and is suitable for your activities or sports. Cushioning in the shoes will help to keep your knees stable during activity

and reduce some of the impact. If your knee is weak or unstable, a knee brace, strapping or taping can provide extra support. If you are kneeling, wearing knee padding will help protect your joint from damage.

Always Warm Up Your body is less prone to injury during exercise when your heart, muscles and joints are gently warmed ahead of time. To protect your knees, warm up and cool down your leg muscles before and after working them and learn the proper form and techniques for your activity. You can use the Inferno Wrap or Ultrasound prior to activity to help warm up the deep tissue and prepare them for use.

Avoid Activities That Cause Pain If you are experiencing knee pain during any activity,

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65 |  Heal Your Meniscus in 3 Easy Steps

stop and see a doctor to find out why. Listen to your body and decrease, modify and/or avoid any activities or motions that cause pain and irritation (twisting, squatting, kneeling, jumping, heavy lifting, climbing and running, walking on uneven terrain). If you are required to perform these motions at work or play and cannot avoid them, make sure you take frequent breaks and rest your knees to prevent fatigue.

Contact Information: To learn more about MendMeShop’s therapeutic devices and/or possibly obtaining your own therapeutic device for less than the cost of a few doctor visits, please call MendMeShop directly toll free at: 1-866-237-9608. Are phones not your thing? Feel free to send us an email anytime at: [email protected]. We hope to hear from you soon!

Avoid Doing too Much too Soon Following a knee injury, give your body an opportunity to build up its endurance. Progress through exercises gradually and work slowly when increasing the load or intensity. Allow your body adequate time to recover after exercise to repair any soft tissue damage that may have occurred. You can use an Inferno Wrap or Ultrasound Therapy for more complete and faster repair after exercise.

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66 |  Index

Index Symbols 1MHz 25

A Acute Trauma 6 Allograft 59 Anterior Cruciate Ligament 19 Anterior Cruciate Ligament (ACL) 4 Arthroscopic Surgery 57 Articular Cartilage 2, 29 Atrophy 55

B BFST 45 Blood Flow Stimulation Therapy 4, 45 Blood Supply 17 Bone Formation 30 Bucket Handle Tear 15

C Calcific Tendonitis 33 Carpal Tunnel Syndrome 36 Cartilage Repair 28 CAT Scans (CT - Computerized Tomography) 13 Cold Compression 20, 39 Cold Compression Therapy 40 Cold Therapy 39 Collagen Implant 59 Complete Meniscectomy 59 Complete Meniscus Tear 14 Compression Therapy 39 Conduction 37 Conductive Gel 26

Conservative Treatments 20 Continuous Mode 26 Conversion 45 Coronary Ligaments 2, 3 Cortisone 1 Cryotherapy 39

D Damaged Cartilage 30 Degeneration 6 Degenerative Meniscus Tears 14 Degenerative Tear 10 Diagnosis 11 Diagnostic Testing 12 Diagnostic Ultrasound 25 Discoid Meniscus 16

E Ege’s Test 12 Energy Web 46 Eucalyptus 26

F Femur 1 Fibrocartilage 3, 21 Fibula 1 Fracture Healing 36 Freezie Wrap 39 Frequency 24, 25

H Hoop Stress 3 Horizontal Flap Tear 15 Horizontal Tear 15

I

Inferior Genicular Artery 3 Inferno Wrap 45

J Joint Line Tenderness 12

L Lateral Collateral Ligament (LCL) 4 Lateral Meniscus 2, 7 Lavender 26 Load Transferring Function 3 Longitudinal Tear 15

M McMurray’s Test 11 Medial Collateral Ligament (MCL) 4 Medial Meniscus 2, 6 Medical Studies 28 Medicinal Ingredients 26, 27 Meniscal Repair 58 Meniscal Replacement 59 Meniscectomy 58 Meniscus Repair 60 Meniscus Tear 1, 20 Meniscus Tears 6 Menthol 26 Minor Tear 9 Moderate Tear 9 MRIs (Magnetic Resonance Imaging) 12 Muscle Spasms 26, 30 Myofascial Pain 32

N NSAIDs 1, 39, 46

67 |  Index

O

T

Osteoarthritic 31, 36 Osteoarthritis 2, 7, 28, 31, 33

Therapeutic Ultrasound 25 Thermotherapy 25 Tibia 1 Tissue Regeneration 29 Toxins 47 Transverse Ligament 2 Trepanation 58 Trigger Points 32

P Parrot’s Beak Tear 16 Partial Meniscectomy 60 Partial Meniscus Tear 14 Patella 1 Penetration 25 Peppermint 26 Perimeniscal Plexus 3 Phonophoresis 27, 32 Physical Examination 11 Posterior Cruciate Ligament 2 Posterior Cruciate Ligament (PCL) 4 Pulse Mode 26

U Ultrasound Gel 26, 27 Ultrasound Specifications 56 Ultrasound Therapy 2, 24, 25, 28, 54 Unhappy Triad 5

V

R

Vasodilation 25

Radial Tear 16 Range of Motion 31 Rehabilitation 59 Rheumatoid Arthritis 34, 37 RICE 39 RICE (Rest, Ice, Compression and Elevation) 20

X

S Scar Tissue 21, 24, 29, 32, 54 Sesamoid 1 Severe Tear 9 Snapping Knee Syndrome 17 Sound Wave 25 Stages Of Symptoms 9 Steroid Injections 1 Surgery 1, 19, 46, 55, 57, 58, 59 Suturing 58 Symptoms 1, 8, 10 Synovial Fluid 2

X-rays 12