An Evidence Supported Alternative Manual Therapy Intervention for Individuals with Signs of Knee Meniscus Involvement
Do you use the Mulligan Concept Squeeze Technique?
The 'Knee Squeeze' is considered a "soft tissue Mobilization With Movement™!”
As noted in the 2022 Reep et al. systematic review, the MWM ‘Squeeze’ technique, tibial IR, and/or tibial ER demonstrated the ability to reduce pain, improve function, and improve patient-perceived disability following treatment of a clinically diagnosed meniscal pathology.
How to Apply:
Step 1: Test a functional movement that provokes symptoms, ie, squat, or active or passive ROM resulting in pain and or restricted motion; perhaps a positive Thessaly and/or McMurray test.
Step 2: Perform the manual Squeeze Technique to assess for responders. (See Video)
-Place the reinforced side of the thumb at a possibly swollen and tender spot at the tibiofemoral joint line, pressing directly into the joint with the overlapped thumb
- Sustain that pressure through the entire ROM with overpressure at end-of-range if asymptomatic (except for palpation tenderness) until the patient returns to previously neutral knee posture.
-If knee extension is restricted, release the pressure into the joint as the joint space closes
-Re-apply as the patient moves back into flexion.)
Step 3: Re-test and reassess the previously positive test and note the change.
Step 4: Consider an appropriate amount of reps depending on the patient's presentation using your clinical reasoning. The repetition range may vary from 6 on the first day to 3 x 10 on the following visits if effective.
Application Examples:
- Hudson R, Richmond A, Sanchez B, et al. An Alternative Approach to the Treatment of Meniscal Pathologies: A Case Series Analysis of the Mulligan Concept "Squeeze" Technique. International Journal of Sports Physical Therapy. 2016;11(4):564-574.
Special Note from this Case Series:
"Of importance to the athletic population, each of the participants continued to engage in sport activity as tolerated unless otherwise required during the treatment period. The outcomes reported in this case series exceed those reported when using traditional conservative therapy and the return to play timelines for meniscal tears treated with partial meniscectomies.”
- Hudson R, Richmond A, Sanchez B, et al. Innovative treatment of clinically diagnosed meniscal tears: a randomized sham-controlled trial of the Mulligan concept ‘squeeze’ technique. The Journal of manual & manipulative therapy. 2018;1-10. http://dx.doi.org/10.1080/10669817.2018.1456614
Give it a try!
Don Reordan PT, MS, OCS, CMP, MCTA, CIDN