Chronic inflammatory diseases affect 5% to 7% of the population, regardless of age or gender, from children to the elderly. Chronic inflammatory diseases include a range of conditions. The most common inflammatory diseases include rheumatoid arthritis, Crohn’s disease, psoriasis and multiple sclerosis.
Few of the current therapies for chronic inflammatory diseases are effective and while some can control the disease, they do not provide a cure. To overcome these problems, researchers and physicians are focusing on several topics to improve patient care in therapeutic antibody treatment.
The landscape of treating chronic inflammatory diseases has undergone a significant transformation with the advent of targeted therapies using therapeutic antibodies. However, a significant proportion of patients do not respond adequately to treatment or experience a decrease in response over time. This challenge mainly relates to issues such as suboptimal dosing, immunogenicity and variations in pharmacokinetics (how the drugs circulate through the body) in different patients.
In response to this critical need for more effective treatment, researchers have initiated a strategic shift toward personalized treatment approaches. This includes the development of patient stratification tools and the use of therapeutic drug monitoring (TDM) to adjust dosages based on serum drug concentrations.
The potential for substantial improvement in patient care is enormous by implementing individualized (TDM-guided) dosing regimens of therapeutic antibodies into routine clinical practice for the treatment of chronic inflammatory diseases. This tailored approach will ultimately lead to more efficient use of these valuable but expensive medicines “the right medicine in the right dose for the right patient”.
However, Europe faces a challenge in the fragmentation of expertise regarding individualized (TDM-guided) treatment optimization. The knowledge and techniques required for effective implementation are concentrated in a limited number of pioneering centers, which makes dissemination to other centers difficult. In particular, the lack of standardization in TDM testing contributes to the complexity.
Introducing ENOTTA COST promotion
To address these challenges and promote a more coherent approach, a comprehensive, interdisciplinary pan-European network is being established. ENOTTA COST Action, which stands for “European Network on Optimizing Treatment with Therapeutic Antibodies in chronic inflammatory diseases”,” brings together 156 experts from 31 countries, including key scientific disciplines such as physicians, basic researchers, biologists, computer scientists, pharmacometrists, patients, small and medium-sized enterprises (SMEs) and health authorities, to cover all aspects of the challenge.
ENOTTA advocates personalized use of therapeutic antibodies to become the new standard of care for patients with chronic inflammatory diseases.”
Prof. Denis Mulleman, chairman of ENOTTA
This initiative aims to consolidate and structure scientific research in this area and thus promote collaboration and knowledge exchange. The ultimate goal is to facilitate the seamless integration of individualized (TDM-guided) cost-effective dose optimization of therapeutic antibodies into daily clinical practice for the treatment of chronic inflammatory diseases.
Added value with ENOTTA
The ENOTTA COST action is groundbreaking and aims to create a distinctive framework, unlike all existing initiatives. This innovative initiative is designed to facilitate networking, sustainable collaboration and expansion of partnerships between participants across Europe.
ENOTTA stands ready to catalyze progress in this therapeutic area, facilitating the exchange of expertise and the wide dissemination of valuable knowledge for the benefit of patients suffering from long-standing inflammatory diseases. By fostering scientific collaboration between key players in the European research landscape, this initiative will play a crucial role in advancing the field of personalized use of therapeutic antibodies. Furthermore, it will establish critical connections with leading experts on a global scale.
Taken together, the innovative nature of this action will come from the ability of the entire group to create tools for patient stratification, test harmonization, universal standards and the availability of guidelines and treatment algorithms that are accepted by health insurers, physicians and patients. . These developments will be crucial for implementing individualized (TDM-based) dose optimization of therapeutic antibodies in daily clinical practice. Ultimately, the optimal use of therapeutic antibodies using TDM will alleviate the burden on the healthcare system. Furthermore, the insights gained from this action can also guide future research in other disciplines, such as oncology, metabolic diseases and cardiovascular diseases, using therapeutic antibodies.
Source:
European cooperation in science and technology (COST)
Healthy Knee Bone And How maintaining Strong Resilient Joints
As we age, our bones become more prone to damage and injury. One of the most important joints in our body is the knee joint. The knee joint is made up of bones, cartilage, and ligaments that work together to provide stability and mobility. It is essential to take care of our knees to maintain their health and prevent injuries.
Understanding Knee Anatomy is crucial in maintaining healthy knees. The knee joint is made up of three bones: the femur, tibia, and patella. The femur is the thigh bone, the tibia is the shin bone, and the patella is the kneecap. These bones are connected by ligaments and surrounded by cartilage, which acts as a cushion and helps absorb shock. The muscles around the knee joint also play a crucial role in movement and stability. By understanding the anatomy of the knee, we can take better care of our knees and prevent injuries.
Key Takeaways:
Understanding Knee Anatomy is essential for maintaining healthy knees.
The knee joint is made up of bones, cartilage, and ligaments that work together to provide stability and mobility.
The muscles around the knee joint also play a crucial role in movement and stability.
Understanding Knee Anatomy
The knee joint is a complex structure that connects the thigh bone (femur) to the shin bone (tibia) and is responsible for supporting the weight of our body and allowing us to move our legs. To understand how to maintain a healthy knee, it is essential to have a basic understanding of its anatomy.
Bones and Joints
The knee joint consists of three bones: the femur, tibia, and patella (kneecap). The femur and tibia meet at the knee joint and are held together by several ligaments, including the anterior cruciate ligament (ACL) and collateral ligaments. The patella sits in front of the knee joint and is connected to the femur by the patellar tendon.
Muscles and Ligaments
Several muscles surround the knee joint and are responsible for moving the leg. The quadriceps muscles are located at the front of the thigh and are responsible for extending the leg. The hamstrings are located at the back of the thigh and are responsible for flexing the leg. The calf muscles are located at the back of the leg and are responsible for pointing the foot downwards.
In addition to the ligaments that hold the bones together, there are also several ligaments that provide stability to the knee joint. The cruciate ligaments are located inside the knee joint and help to prevent the femur and tibia from sliding back and forth. The collateral ligaments are located on the sides of the knee and help to prevent the knee from moving too far from side to side.
Cartilage and Membranes
Articular cartilage is a smooth, shiny substance that covers the ends of the bones in the knee joint. It helps to reduce friction between the bones and allows them to move smoothly. The synovial membrane is a thin layer of tissue that lines the inside of the knee joint. It produces synovial fluid, which lubricates the joint and reduces friction.
Maintaining a healthy knee requires taking care of all the components that make up the knee joint. By understanding the anatomy of the knee, we can take steps to prevent injuries and keep our knees healthy and pain-free.
Common Knee Problems and Causes
As we age, our knee joints may experience wear and tear, leading to common knee problems. Knee pain is one of the most common knee problems that people experience, which can be caused by a variety of factors. Knee pain can be caused by an injury, such as a fracture, dislocation, or ligament tear, or by an underlying medical condition, such as arthritis or gout.
Osteoarthritis is a common type of arthritis that affects the knee joint, causing joint damage, inflammation, and stiffness. Rheumatoid arthritis is another type of arthritis that can affect the knee joint, leading to joint damage and weakness.
Injuries to the knee, such as a meniscus tear, can also cause knee problems. The meniscus is a piece of cartilage that acts as a cushion between the thigh bone and the shin bone. When the meniscus is torn, it can cause pain, swelling, and stiffness in the knee.
Excess weight can also be a risk factor for knee problems, as it can put extra pressure on the knee joint, leading to pain and disability. Infections can also cause knee problems, leading to swelling, pain, and stiffness in the knee.
Symptoms of knee problems can include pain, swelling, stiffness, weakness, popping, and difficulty walking. It is important to seek medical attention if you are experiencing any of these symptoms, as early intervention can help prevent further damage to the knee joint.
In summary, knee problems can be caused by a variety of factors, including injury, arthritis, excess weight, and infection. Symptoms can include pain, swelling, stiffness, weakness, popping, and difficulty walking. Seeking medical attention early can help prevent further damage to the knee joint.
Prevention and Care of Knee Health
Maintaining healthy knees is crucial for overall mobility and independence. Here are some tips to prevent and care for knee health:
Exercise and Physical Activity
Regular physical activity, including weight-bearing exercises such as walking, running, and cycling, can help keep our knees healthy. However, it is important to start slowly and gradually increase intensity to prevent injury. Swimming and yoga are also great low-impact exercises that can help strengthen the muscles around the knee joint.
Body Weight
Maintaining a healthy body weight is essential for knee health. Excess weight puts extra pressure on our knees, which can lead to wear and tear over time. Eating a balanced diet that includes fruits, vegetables, and whole grains, while avoiding processed foods, can help us maintain a healthy weight.
Good Posture
Good posture is important for knee health as it helps distribute weight evenly across our joints. It is important to stand and sit up straight, keeping our shoulders back and our hips aligned.
Knee Braces
Knee braces can be helpful in preventing knee injuries, especially during sports or other physical activities. They provide support and stability to the knee joint, reducing the risk of strain or sprain.
Care for Lower Leg and Hips
The health of our knees is closely linked to the health of our lower leg and hips. Regular stretching and strengthening exercises can help keep these areas healthy, reducing the risk of knee injury.
When to Seek Medical Attention
If we experience persistent knee pain or swelling, it is important to seek medical attention. This may be a sign of a more serious condition, such as arthritis or a ligament tear.
In summary, maintaining knee health requires a combination of regular exercise, a healthy diet, good posture, and care for the lower leg and hips. By following these tips, we can help prevent knee injuries and maintain our mobility and independence.
Medical Interventions and Treatments
When it comes to knee health, medical interventions and treatments can be helpful in managing pain and preventing further damage. Here are some common interventions and treatments:
Medication: Over-the-counter medications such as ibuprofen and naproxen sodium can help ease knee pain caused by inflammation. Creams containing a numbing agent or capsaicin can also provide relief. Prescription medications, such as corticosteroids, can be used to reduce inflammation and pain.
Physical Therapy: Physical therapy can help improve knee strength and flexibility, which can reduce pain and prevent future injuries. A physical therapist can also teach you exercises to do at home to improve knee health.
Surgery: In some cases, surgery may be necessary to repair a knee injury or damage caused by arthritis. Common knee surgeries include arthroscopy, knee replacement, and osteotomy.
Joint Injections: Injections of corticosteroids or hyaluronic acid can be used to reduce inflammation and pain in the knee joint.
Lifestyle Changes: Maintaining a healthy weight, staying active, and avoiding activities that put excessive strain on the knee joint can help prevent knee pain and damage.
It is important to talk to a doctor if you are experiencing knee pain or stiffness, especially if it is affecting your daily activities. A doctor can diagnose the cause of your knee pain and recommend appropriate treatments.
Nutrition for Healthy Knee Bones
Maintaining healthy knee bones is essential for overall mobility and quality of life. While factors such as age, genetics, and physical activity levels can all play a role in bone health, nutrition is also a critical component. Here are some key dietary factors to consider for promoting healthy knee bones.
Calcium
Calcium is a mineral that is essential for building and maintaining strong bones. It is found in a variety of foods, including dairy products, leafy greens like kale and broccoli, and certain types of fish like salmon, trout, and sardines. However, it can be challenging to get enough calcium from diet alone, especially if you are lactose intolerant or do not consume dairy products. In such cases, calcium supplements may be recommended by a healthcare provider.
Vitamin D
Vitamin D is another important nutrient for bone health, as it helps the body absorb calcium. The best source of vitamin D is sunlight, but it can also be found in fatty fish like salmon and tuna, egg yolks, and fortified foods like milk and cereal.
Omega-3 Fatty Acids
Omega-3 fatty acids are a type of healthy fat that have been shown to support bone health and reduce inflammation. They are found in fatty fish like salmon and tuna, as well as in some nuts and seeds. Including these foods in your diet can help support knee bone health.
Avoid Processed Foods
Processed foods are often high in sodium and other additives that can be detrimental to bone health. Limiting your intake of processed foods and focusing on whole, nutrient-dense foods can help support healthy knee bones.
Connective Tissue
Connective tissue is the building block of bones and joints. Consuming foods rich in collagen, such as bone broth or gelatin, can help support connective tissue health and promote strong, healthy knee bones.
In summary, a diet rich in calcium, vitamin D, omega-3 fatty acids, and whole, nutrient-dense foods can help support healthy knee bones. Additionally, limiting processed foods and incorporating foods rich in collagen can also be beneficial.
02 Tables for Bone Density All Over the Body, the Best Vegetables for the Bone, and Vitamins and Sports
Maintaining healthy bones is essential for overall health and mobility. Bone density is a measure of how much bone mineral is present in a given volume of bone, and it is an important indicator of bone strength and fracture risk. Here are some tables that show the recommended bone density levels for different parts of the body:
Bone Density Levels
T-score
Normal
-1.0 or higher
Low bone mass (osteopenia)
Between -1.0 and -2.5
Osteoporosis
-2.5 or lower
As we can see from the table, a T-score of -1.0 or higher is considered normal bone density. A T-score between -1.0 and -2.5 indicates low bone mass (osteopenia), while a T-score of -2.5 or lower indicates osteoporosis.
In addition to getting enough calcium and vitamin D, eating a diet rich in vegetables can also help promote healthy bones. Here are some of the best vegetables for bone health:
Spinach
Kale
Broccoli
Bok choy
Collard greens
These vegetables are high in calcium, vitamin K, and other nutrients that are important for bone health. Consuming a variety of these vegetables can help ensure that we are getting the nutrients our bones need to stay strong.
In addition to eating a healthy diet, engaging in weight-bearing exercises and sports can also help promote bone health. Weight-bearing activities force our bones to work against gravity, which can help stimulate bone growth and improve bone density. Examples of weight-bearing activities include:
Running
Jumping rope
Dancing
Tennis
Hiking
In conclusion, maintaining healthy bones is crucial for overall health and mobility. By following a healthy diet rich in vegetables and engaging in weight-bearing activities, we can help promote bone health and reduce the risk of fractures.
Frequently Asked Questions
What are the ligaments that support the knee joint?
The knee joint is supported by four main ligaments: the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). These ligaments connect the thigh bone (femur) to the shin bone (tibia) and help to stabilize the knee joint.
What is the name of the bone below the knee?
The bone below the knee is called the tibia. It is also known as the shinbone and is the second largest bone in the human body. The tibia plays an important role in supporting the weight of the body and connecting the knee joint to the ankle joint.
What are some ways to take care of your knees after 30?
After the age of 30, it is important to take care of your knees to prevent injuries and maintain their health. Some ways to take care of your knees include maintaining a healthy weight, staying active and engaging in regular exercise, wearing proper footwear, avoiding high-impact activities, and stretching before and after exercise.
Can exercises strengthen bones in a bone-on-bone knee?
While exercises cannot directly strengthen bones in a bone-on-bone knee, they can help to improve the strength and flexibility of the muscles that support the knee joint. This can help to reduce pain and improve mobility.
What is the protruding bone on the knee called?
The protruding bone on the knee is called the patella, or kneecap. It sits in front of the knee joint and helps to protect the joint and improve its mechanical advantage.
What does a healthy kneecap look like?
A healthy kneecap should be smooth and have a consistent thickness. It should also be centered in the groove of the thigh bone and move smoothly when the knee joint is flexed and extended. Any abnormalities or irregularities in the kneecap may indicate an underlying issue that requires medical attention.
Annual guidance has been increased to $136 million – $137 million, implying annual growth of 28%-29%
SANTA CLARA, California, November 6, 2023 (GLOBE NEWSWIRE) – SI-BONE, Inc. (Nasdaq:SIBN), a medical device company committed to solving musculoskeletal disorders of the sacropelvic anatomy, today reported financial results for the quarter ended September 30, 2023.
Recent Financial Highlights
Record global revenue of $34.0 million for the third quarter of 2023, representing approximately 29% growth over the corresponding period in 2022
Record US revenue of $32.3 million for the third quarter of 2023, representing approximately 31% growth over the corresponding period in 2022
Gross margin of approximately 79% for the third quarter of 2023
More than 1,040 active surgeons in the US in the third quarter of 2023, representing approximately 30% growth over the corresponding period in 2022
$166.8 million in cash and equivalents at the end of the third quarter; cash used of $2.7 million in the quarter
Recent operational highlights
Patent received for triangular brooch instrument, a crucial technology to place triangular implants in the SI joint and provide protection until 2034
International Journal of Spine Surgery published a meta-analysis of 57 studies involving more than 2,800 patients, reaffirming that the SI-BONE technique produces the highest improvement in pain and disability scores
More than 90,000 procedures performed by more than 3,500 surgeons worldwide
“I am proud of the team’s performance as we defied industry seasonality and delivered another exceptional quarter with a 34% increase in US procedure volume, achieving the first time in the company’s history surpassed 1,000 active surgeons in the US in a quarter. In addition, we continued our progress toward profitability as record revenue in the quarter translated into significant operating leverage and lower cash consumption,” said Laura Francis, Chief Executive Officer. “As we close 2023 with strong momentum, our planned product portfolio expansions, combined with demand inflection in our large addressable market of nearly half a million annual procedures, give me confidence that we are in the early stages of growing demand to our solutions. In addition, we have the operational framework and strong balance sheet to deliver strong and sustainable revenue growth over the long term.”
Third Financial results quarter 2023
Global revenue for the third quarter of 2023 was $34.0 million, up 29% from $26.4 million in the corresponding period in 2022. U.S. revenue for the third quarter of 2023 was $32.3 million, a increase of 31% from $24.6 million in the corresponding period in 2022. International revenue growth for the third quarter of 2023 was $1.7 million, compared to $1.8 million in the corresponding period in 2022.
Gross margin was 79% for the third quarter of 2023, compared to 84% in the corresponding period in 2022. The gross margin in the third quarter of 2023 was influenced by procedure and product mix, given the higher total costs of iFuse-TORQ and iFuse Bedrock Granite . Gross margin also includes the impact of increased depreciation on instrument trays to support business growth and depreciation related to our second facility in Santa Clara.
Operating expenses increased 6% to $38.1 million in the third quarter of 2023, compared to $35.8 million in the corresponding period in 2022. The change in operating expenses was primarily driven by increases in commissions related to revenue growth, research investments and development and commercial expenses. activities to support the turnover and active growth of surgeons.
Operating loss improved 18% to $11.2 million in the third quarter of 2023, compared to an operating loss of $13.6 million in the corresponding period in 2022.
Net loss improved 29% to $10.0 million, or $0.25 per diluted share for the third quarter of 2023, compared to a net loss of $14.2 million, or $0.41 per diluted share in the corresponding period in 2022. Net loss per diluted share for the third quarter of 2023 includes the impact of the increase in the number of shares outstanding resulting from a follow-on issuance of common shares in May 2023.
Adjusted EBITDA loss improved approximately 44% to negative $3.9 million in the third quarter of 2023, compared to an adjusted EBITDA loss of negative $6.9 million in the corresponding period in 2022.
Cash and marketable securities at September 30, 2023 were $166.8 million and borrowings were $36.0 million.
2023 Updated financial guidelines
Based on the strength of the company’s year-to-date performance and momentum exiting the third quarter of 2023, SI-BONE increases its 2023 global revenue guidance to a range of $136 million to $137 million compared to prior expectations from the company. $132 million to $134 million. The updated guidance translates to growth of approximately 28% to 29% compared to fiscal 2022, versus previous revenue growth of approximately 24% to 26%.
Webcast information
SI-BONE will host a conference call to discuss its third quarter 2023 financial results after the market closes on Monday, November 6, 2023 at 4:30 PM Eastern Time. The conference call can be accessed live via webcast at https://edge.media-server.com/mmc/p/jw54nzhx. Live audio of the webcast will be available on the “Investors” section of the company’s website: www.si-bone.com. The webcast will be archived and available for replay for at least 90 days after the event.
About SI-BONE, Inc.
SI-BONE (NASDAQ: SIBN) is a global leader in technology for the surgical treatment of musculoskeletal disorders of the sacropelvic anatomy. Since pioneering minimally invasive SI joint surgery in 2009, SI-BONE has supported more than 3,500 surgeons performing a total of more than 90,000 sacropelvic procedures. A unique body of clinical evidence supports the use of SI-BONE’s technologies, including two randomized controlled trials and more than 120 peer-reviewed publications. SI-BONE has leveraged its leadership in minimally invasive SI joint fusion to commercialize new solutions for adjacent markets including adult deformity, spinopelvic fixation and pelvic trauma.
For additional information about the company or its products, including risks and benefits, please visit www.si-bone.com.
The statements in this press release regarding expectations of future events or results, including SI-BONE’s expectations regarding continued revenue and procedural growth and financial prospects, contained in this press release are “forward-looking” statements. These forward-looking statements are based on SI-BONE’s current expectations and inherently involve significant risks and uncertainties. These risks include SI-BONE’s ability to introduce and commercialize new products and indications, SI-BONE’s ability to maintain favorable reimbursement for procedures using its products, the impact of any future economic weakness on patients’ ability and desire to undergo elective procedures, including those affecting the use of SI-BONE’s devices, SI-BONE’s ability to manage risks to its supply chain, future capital requirements resulting from new surgical systems requiring investment in instrument trays, and the pace of re-normalization of the healthcare work environment, including the ability and desire of patients and physicians to undergo and perform procedures using SI-‘s devices BONE. Actual results and the timing of events could differ materially from those anticipated in such forward-looking statements as a result of these and other risks and uncertainties, many of which are described in the Company’s most recent filings on Form 10-K and Form 10- Q, and the company’s other filings with the Securities and Exchange Commission (SEC), available on the SEC’s Internet site (www.sec.gov), particularly under the heading “Risk Factors.” SI-BONE undertakes no obligation to update any forward-looking statements and expressly disclaims any obligation or undertaking to publicly release any updates or revisions to any forward-looking statements contained herein, except as required by law.
Use of Non-GAAP Financial Measures
SI-BONE uses adjusted EBITDA, a non-GAAP financial measure that excludes the effects of interest income, interest expense, depreciation and amortization and stock-based compensation from net loss. SI-BONE believes that the presentation of Adjusted EBITDA is useful to management because it allows management to more consistently analyze financial performance from period to period and provides meaningful additional information regarding the core operating activities used to drive performance of management to evaluate. SI-BONE also believes that the presentation of Adjusted EBITDA is useful to investors and other interested persons because it allows these persons to use this additional information to assess the company’s performance by using this additional measure that management uses to assess company performance.
Adjusted EBITDA should be considered a supplement to, and not a substitute for, financial information prepared in accordance with GAAP. Because Adjusted EBITDA excludes the effect of items that increase or decrease SI-BONE’s reported results of operations, management strongly encourages investors to review the company’s consolidated financial statements and publicly filed reports in their entirety when they become available. The Company’s definition of adjusted EBITDA may differ from similar measures used by others.
Contact person for investors
Saqib Iqbal Sr. Director, FP&A and Investor Relations investors@SI-BONE.com
In this study, YKL-40 serum levels are influenced by factors such as age, inflammation and diagnosis of autoimmune diseases (RA/MII)3. Currently, due to its participation in tissue remodeling and degradation, attempts have been made to use it as a biomarker in pro-inflammatory states and as an indicator of poor prognosis in inflammatory diseases.6.7. However, its usefulness is still controversial because its full biological effects are still unknown. Furthermore, the specific factors that promote its expression, as well as its interaction with the majority of cytokines and molecules involved in the development and establishment of autoimmune inflammatory diseases, are not well established.17.
YKL-40 serum levels have been reported to increase with age in various cardiovascular, metabolic and systemic inflammatory diseases3. Bojesen et al. found that serum levels of YKL-40 increased exponentially with aging. In subjects with two YKL-40 measurements ten years apart, the average increase in YKL-40 was 1.5 μg/l/year18. Regarding inflammatory diseases, increased serum levels of YKL-40 were reported in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis, which was hypothesized to play a role in promoting chemotaxis, tissue damage and vascular damage.19.
In RA it has been recognized as a potential candidate autoantigen. Furthermore, in these patients it is produced and secreted by monocytes differentiated into macrophages, articular chondrocytes, synovium, peripheral blood mononuclear cells (PBMCs), and endothelium.17,19,20. It has been proposed that the pathogenic mechanism of YKL-40 in RA initiates through its binding to the HLA-DR4 peptide-binding motif promoting mononuclear cell proliferation, and HLA-DM plays a key role in presenting YKL-40 to CD4+ T cells. Furthermore, antigen-presenting cells (APCs) present YKL-40 at early-stage RA sites, suggesting an association for YKL-40 in the pathogenesis of RA.20,21,22. On the other hand, differentiated DR4+ dendritic cells and macrophages are similar to APCs of synovial joints and have the potential to carry out MHC II presentation of YKL-40 epitopes, resulting in higher levels in synovial and serum.21,22. Although the pathogenic mechanism in RA has been elucidated, agents that promote YKL-40 expression in RA are still lacking. It has been associated with the development of chronic, destructive, relapsing arthritis due to its role in tissue remodeling and breakdown. . It is considered an effective marker in estimating RA disease activities and prognostic value, and may be a therapeutic target19.
As for IIM, information is even more limited as few studies have been conducted in this regard and thus the role YKL-40 plays in this area has not yet been established. Regarding the pro-inflammatory effect and its relationship with the diagnosis and phenotype of IIM, Noguchi et al. found significantly increased serum in patients with PM/DM compared to the healthy population, as well as age-adjusted serum YKL-40 levels were significantly increased in patients with PM/DM compared to HC. In muscle biopsies, infiltration of YKL-40-positive inflammatory cells (probably macrophages) in the endomysium and perimysium was found. This suggests that cells other than CD8+ and CD4+ T cells can cause inflammation.23.
Ming-Zhu Gao et al. measured YKL-40 levels in patients with DM/PM and HI and reported significantly higher levels in patients with IIM compared to controls (51.6 vs. 27.8 ng/ml, respectively)6. In a systematic review by Cui et al. reports levels of 84.09 ng/ml in patients with PM and DM versus 27.37 ng/ml in HI24. On the other hand, Carboni et al. analyzed YKL-40 serum levels and its expression in muscle tissue in patients with ASSD. However, serum levels of YKL-40 did not correlate with other clinical, laboratory, disease status, or therapeutic parameters. Furthermore, YKL-40 was expressed by the inflammatory cells of the muscle tissue.13. Our study reinforces these results with serum levels of 187.80 ng/ml in patients with IIM versus 46.82 ng/ml in RA and 57.17 ng/ml in HI, as well as their presence mainly in inflammatory cells. This increase can be explained by inflammation, activation of macrophages, destruction of fibroblasts and existing vascular changes.
As previously mentioned, several biological effects of YKL-40 are known, such as inflammation and tissue remodeling, as well as its main sources, which, however, highlights its exacerbated expression in inflammatory diseases such as RA or SLE; some researchers have pointed out that this expression may vary depending on the disease type, which could be due to the multi-organ damage in IIM compared to RA, where the damage is mainly directed against the joints19.24. Tang et al. found that YKL-40 concentration was significantly higher in IIM patients with myocardial injury than without myocardial injury25.
In addition, YKL-40 plays a role in cardiovascular diseases such as early atherosclerosis, essential hypertension and other progressive vascular complications. In IIM patients, as in many other autoimmune diseases, serum levels of this protein have a positive association, particularly with atherosclerosis, and may predict both overall and cardiovascular mortality.5,26,27.
We wanted to know whether YKL-40 is affected by certain factors in IIM, as mentioned by Tizaoui et al. First, we compared some demographic, laboratory and clinical variables between patients with RA and IIM mentioned in Table 1. Of all After analyzing the variants, we found a significant difference in pDBP (P = 0.024) and pMBP (P = 0.035) which were higher in IIM patients. This may be due to the fact that blood vessels suffer damage in the early stages of the development of inflammatory diseases, altering blood pressure and increasing the risk of cardiovascular damage.28.29. Furthermore, the endothelial changes in IIM progress to microangiopathy, causing blood pressure changes12. Although information on exactly how the process occurs is scarce, it has been suggested that cardiovascular disease and cardiovascular risk increase mortality in IIM patients, but this is becoming controversial because a single center cross-sectional study recently reported that it risk of cardiovascular disease increases. factors in IIM patients are not significant compared to HI, but are significant in IIM if they are related to age, disease duration, duration of therapy and body composition, which could be related to our patients included in our study25.30. Although these evaluated variables were significant between these two groups, serum levels of YKL-40 were the most significant variable (P = 0.010). These were higher in IIM than in RA patients (187.80 ng/ml). vs 46.82 ng/ml, respectively).
Once we established that IIM exhibits higher serum levels of YKL-40 than RA, we examined whether serum levels of YKL-40 were influenced by age or disease duration. Our results show that only aging has a positive correlation with increased YKL-40, but not with disease duration. The reports conducted by Johansen in 2006 and Schultz 2010 have clearly shown that aging is predictive of the increase of YKL-40 in HI, but in our IIM patients the concentration of this protein is higher due to inflammation and damage to multiple organs.2.3.
We evaluated the predictive value of inflammatory state, age and diagnosis of IIM on serum levels of YKL-40 and clarified that CRP has predictive value on serum YKL-40 levels in IIM patients.P= 0.038) which corresponds to a cross-sectional survey and systematic review published by Cui andYou at the . In addition, age and the IIM diagnosis ( P=0.008AndP=0.001respectively) were found to be powerful predictors of YKL-40 serum levels24. On the other hand, we confirmed that age and IIM diagnosis have an important influence on YKL-40 concentration, because YKL-40 serum levels are the highest compared to control and RA groups, thus we know that the presence of the disease or its type influences the disease. the YKL-40 concentration. Some reports state that the YKL-40 concentration in HI is stable for many years, but increases with aging or inflammatory conditions. Other researchers reported that normal YKL-40 serum levels may be different among a healthy population. Therefore, they recommend establishing baseline values for each study, because in addition to environmental factors, genetic load is another variable that can influence the expression pattern. of this protein26. We previously mentioned the pathogenic mechanism by which YKL-40 expression is mediated in RA and its possible role in IIM, but the information is still insufficient.
Regarding the in situ analysis of YKL-40 muscle expression, we observed that YKL-40 is mainly expressed in inflammatory cells rather than in muscle cells. We also observed that YKL-40 expression is associated with higher CPK serum levels and MYOACT score which are often related. to higher inflammation and muscle weakness. This observation is in agreement with the unique previous report of YKL-40 in muscle tissue made by Carboni et al.13It thus supports its role in inflammation, as well as its function as a clinical marker for poor prognosis in inflammatory diseases.
Taking into account all our findings, we demonstrated the expression of YKL-40 in both HI and in patients with RA and IIM and the possible factors that could influence its expression.
WARSAW, Ind., November 6, 2023 (GLOBE NEWSWIRE) — Orthopediatrics Corp. (“OrthoPediatrics”) (NASDAQ: KIDS), a company solely focused on advancing the field of pediatric orthopedics, today announced that the company has entered into an exclusive distribution agreement with Montreal-based Ora Medical to market Ora’s gait trainer. Medical, The Levity, a device designed for children with mobility problems.
The Levity supports a child with an innovative partial weight bearing mechanism. This allows the child to interact with the world using his arms, unlocking countless possibilities. Thanks to the unique design, each child can receive personalized treatment. The Levity comes with versatile features to meet a wide range of needs: body weight support, harness, speed and direction of the device are adjustable, and the foldable design offers easy transportation. The Levity is suitable for most children between the ages of 3 and 12.
The Levity supports a child at the waist, allowing for a unique hands-free experience that strengthens the muscles most important for optimal walking rehabilitation. This opens up a whole new experience for children and therapists, as the latter can now fully concentrate on patient engagement.
Joe Hauser, president of Trauma and Deformity Correction at OrthoPediatrics, added: “Our new partnership with the team at Ora Medical is an exciting step in our non-surgical business. By partnering with great organizations with world-class technology, we can help more children with orthopedic conditions worldwide. The Levity running trainer will be a great addition to our portfolio of mobility solutions under the Specialty Bracing brand.”
Sarah Lambert, CEO and co-founder of Ora Medical, said: “As we begin to expand beyond Canadian borders, our partnership with OrthoPediatrics is perfectly timed. Their established market presence and expertise will facilitate the distribution of our device, furthering our mission to improve the mobility of children worldwide.”
About OrthoPediatrics Corp. Founded in 2006, OrthoPediatrics is an orthopedic company focused exclusively on advancing the field of pediatric orthopedics. As such, it has developed the most comprehensive product offering for the pediatric orthopedic market to improve the lives of children with orthopedic conditions. OrthoPediatrics currently markets 53 products serving three of the largest categories within the pediatric orthopedic market. This product offering includes trauma and deformity, scoliosis and sports medicine/other procedures. OrthoPediatrics’ global sales organization focuses exclusively on pediatric orthopedics and distributes its products in the United States and more than 70 countries outside the United States. For more information, please visit www.orthopediatrics.com.
Contact person for investors Philip Trip Taylor Gilmartin Group philip@gilmartinir.com 415-937-5406
In the current systematic review, we aimed to evaluate the impact of different triathlon events on the profile of cytokines (pro- and anti-inflammatory) and metabolic markers in triathletes. First, we verified the increase in pro-inflammatory cytokines including IL-1, IL-2, IL-6, IL-8, IL-12p40, INF-γ, MCP-1, TNF-α in PBMC, serum and plasma levels after different triathlon competitions. Second, in most studies we observed an increase in the production of anti-inflammatory cytokines (IL-4 and IL-10) at serum and plasma levels after the sprint, long-distance and Ironman races. Third, among metabolic factors, we observed an increase in the concentration of blood and plasma markers of muscle damage (CK, LDH and Myostatin), muscle fatigue (FFA and lactate), physiological stress (Cortisol) and inflammatory phase. (CRP) in athletes from different triathlon events.
Cytokines are signaling proteins produced by immune and non-immune cells that have cell signaling functions, positive and/or negative regulation of various genes and their transcription factors, and even stimulate or restrain inflammation promoted by various stimuli, including bacteria and viruses. [32, 33]. Alves et al. 2022, through a systematic review with meta-analysis, demonstrated that exposure to high running volume (exercise time, duration and distance covered) is associated with a higher concentration of pro-inflammatory cytokines, including IL-1β, IL-8 and TNF -α. Furthermore, serum levels of IL-1ra and IL-10 increased as a result of long-term aerobic exercise [6]. However, the authors only considered long-distance modalities (half marathon, marathon and ultramarathon), with the exception of triathlon. Similarly, from the data in the current systematic table it was concluded that several triathlon races promoted an increase in PMBC, serum or plasma concentration of pro-inflammatory cytokines. [6, 9].
High concentrations of pro-inflammatory cytokines are observed at the end of triathlon races and can be explained by the volume of the race, including the intensity of the exercise. In contrast, they had no association with the triathlon distance. This result confirms studies on endurance athletes. Studies have observed leukocytosis and high serum levels of pro-inflammatory cytokines after marathon races [34,35,36]. The metabolic activity and damage observed in muscle cells as a result of long-distance races, such as triathlon, appear to serve as important catalysts for the migration of some leukocytes, along with the release of cytokines. In addition, there are neuroendocrinological and metabolic multifactorial mechanisms that involve extreme stimuli and underlying consequences. Strenuous physical exertion such as triathlon increases immunosuppression [9, 37, 38]. The possible relationship between exercise and UTRI can be explained and modeled by a “J” curve, which can occur during competitions as well as during training, usually caused by rhinovirus, adenovirus and parainfluenza virus [19, 39, 40]. Furthermore, this profile of disease involvement may affect health and performance-related physical fitness components such as maximum oxygen volume, respiratory coefficient, and lactate threshold. [35, 36].
The anti-inflammatory response was assessed by serum levels of IL10 and IL4. Studies have shown that strenuous exercise can increase IL-10 levels, allowing it to return to basal levels during the rest period [41]. Furthermore, Santos et al. (2019) have shown that the magnitude of plasma IL-10 increases is related to the duration of exercise [42]. Furthermore, there is evidence that increases in serum levels of IL-10 are correlated with low levels of chronic, low-grade inflammation and tissue health. [7]. Huang et al. An increase in plasma IL-4 was found in 2019. Nevertheless, Suzuki et al., 2006 did not see any difference between serum levels before and after IL-4. According to our findings, there is no significant improvement in IL-4 due to the different aerobic exercise protocols [43]. Furthermore, the low serum IL-4 levels observed at the end of triathlon races can be explained by the strong inhibitory effects of IL-10 and IL-6 observed after long-distance triathlon races. These jointly contribute to the prevention of excessive systemic inflammation [44].
Long-term training protocols such as triathlons are known to cause changes in other biomarkers (gene expression and protein levels) [40]. A significant expansion of EGF and VEGF levels in many hematopoietic, endothelial and smooth muscle cells of the vasculature towards epithelial cells was observed. [40]. Furthermore, evidence has shown that aerobic exercise should activate the production and release of EGF and VEGF due to physiological adaptation to exercise, such as angiogenesis, indicating that EGF and VEGF are important biomarkers of aerobic exercise. [45]. At the same time, the studies noted that plasma CK levels increased after the race. As observed in a randomized double-blind crossover study by Galan et al. In 2018, CK serum levels improved after treadmill running to exhaustion [46].
Furthermore, Danielsson et al., 2017 reported an increase in CK levels after an Ironman distance triathlon, which is associated with masculinity [8]. Subsequently, it was known to improve FFA and LDH levels in sprint, Ironman and long-distance triathlons. Finally, cortisol levels were increased during triathlon protocols. It is known that the physiological demands of long-distance running such as triathlon should cause an increase in FFA, LDH, cortisol and lactate levels due to adaptation to the extensive energy expenditure of long-distance training protocols. [47,48,49]. Finally, according to previous evidence, an increased Myostatin level was reported in the aftermath of the Sprint and Iron Man Triathlon. Ben-Zaken et al., 2017 found that Myostatin expression was associated with a favorable outcome in long-distance running performance [50].
Because chronic systemic inflammation can be considered a factor affecting the performance of triathlon athletes, recommendations for managing the pillars of improving physical capacity (nutrient availability, sleep behavior, strength training) are important to modulate the immune response. In addition, it reduces both physical and physiological problems and accelerates the recovery and rehabilitation process after injuries. In this regard, individuals who practice triathlon can benefit from the immunomodulatory effects of a strength training strategy in combination with training for the sport. [51, 52]. Furthermore, adequate nutrient availability is known to benefit immune function, including cell-mediated immunity and a balanced inflammatory response. Finally, studies have shown that good sleep behaviors could be a complementary approach to reducing chronic inflammation [53, 54].
Strengths and limitations
The current systematic review presents important limitations that should be taken into account when generalizing the findings. First, we considered different distances of the triathlon race, which means that the generalization of the findings must be specific. The limitations of this systematic review mainly related to the methods of the studies. For example, the lack of control over the covariates (such as age, nutritional status, sleep quality, etc.) may be an important source of bias among the included studies. Another important point is the characteristics of the recorded sample. Because we only described gender and distance of participation, additional information such as level of competition and training characteristics may be useful in future research.
Therefore, the heterogeneity in the quality of reference sources is the strength of this review, as it observed efforts of serum levels of the inflammatory cytokine, as well as biomarkers associated with performance in different triathlon races. On the other hand, it must be emphasized that the studies did not randomize their populations, a procedure recognized by PRISMA. Some studies have not examined all outcomes considered relevant in this scenario. However, we find our work equally relevant because it systematically summarizes the available evidence for future research.
Dr. Hartl is the Hansen-MacDonald Professor of Neurological Surgery and director of Spinal Surgery at the Weill Cornell Brain and Spine Center in New York, and co-director of New York-Presbyterian Och Spine.
Dr. Hartl becomes Aclarion’s 2NL KOL to gain access to an MRI center authorized to perform Nociscans, adding NYC to Denver as the second active KOL location.
Aclarion will report on year-to-date Nociscan volumes before year-end and add this key metric to quarterly reporting starting in 2024.
BROOMFIELD, CO, November 6, 2023 (GLOBE NEWSWIRE) – via NewMediaWire — Aclarion, Inc., (“Aclarion” or the “Company”) (Nasdaq: ACON, ACONW), a healthcare technology company that uses biomarkers and proprietary enhanced intelligence algorithms to help physicians identify the location of chronic low back pain, today announced that Roger Hartl, MD, Hansen-MacDonald Professor of Neurological Surgery and director of Spinal Surgery at Weill Cornell Brain and Spine Center in New York, as well as New York-Presbyterian co-director Och Spine, will advise the company nationally as a key thought leader (KOL).
The practice of Dr. Hartl emphasizes an interdisciplinary approach to disease processes, and he works very closely with other specialists to personalize patients’ treatments. “My clinical interests focus on simple and complex spine surgery for degenerative conditions, as well as biological approaches for intervertebral disc repair and regeneration,” said Dr. Hartl. “Aclarion’s technology addresses a major gap in the current diagnosis of discogenic low back pain. I expect that Nociscan will provide valuable, objective information for our interdisciplinary approach to the treatment of degenerative intervertebral discs. Furthermore, I believe Nociscan will be equally valuable in our efforts to better understand less invasive surgical and biological treatment strategies for degenerative diseases of the spine.”
Chronic low back pain (cLBP) is a leading cause of opioid addiction in the US and the most expensive diagnosis in the United States. Aclarion’s Nociscan solution is the first science-based SaaS platform that helps physicians non-invasively distinguish between painful and non-painful intervertebral discs in the lumbar spine. Nociscan objectively quantifies chemical biomarkers shown to be associated with disc pain. Biomarker data is fed into proprietary algorithms to indicate whether a disc may be a source of pain. When combined with other diagnostic tools, Nociscan provides critical insights into the location of a patient’s low back pain, giving clinicians clarity to optimize treatment strategies.
“Dr. Hartl is a world-renowned neurosurgeon who continues to make advances in the diagnosis and treatment of low back pain,” said Brent Ness, CEO of Aclarion. “With immediate access to a Nociscan-activated MRI on Park Avenue in New York City, Dr. Hartl is already using Nociscan and will continue to gain clinical insights into the condition of his patients well into the future.”
Over the past 18 months, Aclarion has built a leading consortium of 10 KOL surgeons. Dr. Hartl represents the 10e and latest KOL addition to Aclarion’s panel. The company is now in the critical phase of activating MRIs for each of its KOLs so they can begin using the technology, track clinical outcomes, and advocate for payer coverage decisions to expand access to Nociscan for all expand patients. The company will announce additional MRI activations for the remaining KOLs as they become available and will begin reporting on scan volumes as Nociscan usage increases with these MRI activations.
For information about using Nociscan in New York City, please contact Aclarion at info@aclarion.com.
About Aclarion, Inc.
Aclarion is a healthcare technology company that uses magnetic resonance spectroscopy (“MRS”), proprietary signal processing techniques, biomarkers and enhanced intelligence algorithms to optimize clinical treatments. The company is entering the chronic low back pain market for the first time with Nociscan, the first evidence-based SaaS platform that helps physicians non-invasively distinguish between painful and non-painful discs in the lumbar spine. Through a cloud connection, Nociscan receives magnetic resonance spectroscopy (MRS) data from an MRI machine for each lumbar disc being evaluated. In the cloud, proprietary signal processing techniques extract and quantify chemical biomarkers shown to be associated with disc pain. Biomarker data is fed into proprietary algorithms to indicate whether a disc may be a source of pain. When combined with other diagnostic tools, Nociscan provides critical insights into the location of a patient’s low back pain, giving clinicians clarity to optimize treatment strategies. For more information please visit www.aclarion.com.
Forward-Looking Statements
This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934 about the Company’s current expectations about future results, performance, prospects and opportunities. Statements that are not historical facts, such as “anticipates,” “believes” and “expects” or similar expressions, are forward-looking statements. These forward-looking statements are based on management’s current plans and expectations and are subject to a number of uncertainties and risks that could materially affect the company’s current plans and expectations, as well as its future results of operations and financial condition. These and other risks and uncertainties are discussed in more detail in our filings with the Securities and Exchange Commission. Readers are encouraged to read the section entitled “Risk Factors” in the Company’s April 21, 2022 Prospectus as filed with the Securities and Exchange Commission on April 25, 2022 under Rule 424(b)(4), as well as other disclosures. included in the Prospectus and subsequent filings with the Securities and Exchange Commission. Forward-looking statements in this announcement are made as of this date and the Company undertakes no obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events or otherwise.
Investor contacts: Kirin M. Smith PCG Advice, Inc. 646.823.8656 ksmith@pcgadvisory.com
Media contacts: Jodi Lamberti SPRIG advice 612.812.7477 jodi@sprigconsulting.com
Partnering with a therapist-owned physical therapy practice will improve patient care in Arizona
PHOENIX, AZ / ACCESS WIRE / November 6, 2023 / Foothills Sports Medicine Physical Therapy (Foothills PT) is proud to announce its newest addition with Camelback Sports Therapy, a therapist-owned physical therapy practice based in Phoenix, Arizona. With a combined experience of more than 40 years in the Valley, these two companies have an exciting opportunity to continue to provide comprehensive care to patients and expand their reach across a larger region
“We have been looking for a reputable business partner who can help us continue this growth trajectory, and we couldn’t be more excited to partner with Foothills PT,” said Natalie Semon, PT, MPT, CSCS, Cert. DN, CKTP, CEO of Camelback Sports Therapy. “Their established practice, with a reputation for superior customer service and quality care, is a perfect fit for us. We look forward to what our new collaboration will bring us!”
Patients with Camelback Sports Therapy will continue to receive the same high-quality care from the same familiar faces they know and trust. However, the clinical team will now have access to Foothills PT’s parent company, Confluent Health, and their established ecosystem of management services, as well as education and musculoskeletal healthcare resources. Support services include efficient community outreach, digital innovations, value-based care pathway models, and marketing and financial tools. Resources include best-in-class partnerships in physical therapy, such as the PTPN Network, continuing education programs and workforce development opportunities with Evidence in Motion, a nationally recognized training provider in residency, fellowship and certification in physical therapy and occupational therapy programs, and Fit For Work, the leading provider of worker safety.
“Since we opened our doors, our vision has been to provide the highest level of service to our patients and referring physicians at all of our clinics and throughout the state of Arizona,” said Mike Basten, PT, DPT, MTC, CEO of Foothills P.T. “We are pleased that this partnership will allow us to continue this vision and reach more residents than before.”
This partnership will further expand Foothills PT’s footprint, making it the proud owner of 41 clinics throughout Arizona. Dr. Kristi Henderson, DNP, FAAN and CEO of Confluent Health, stated, “We are extremely proud of our partnership with Foothills PT and welcome Camelback Sports Therapy to the Confluent Health family. The expertise and excellence this practice embodies will undoubtedly enhance our growth trajectory, unlocking countless opportunities for optimizing patient care.”
For more information about Foothills PT, visit their website at foothillsrehab.com. To schedule an appointment with one of Camelback Sports Therapy’s expert therapists, visit their website at camelbacksportstherapy.com or call 602-808-8989.
Rheumatoid arthritis is an inflammatory disease that can cause severe pain and swelling of the joints. But a new exercise intervention could help improve physical function and quality of life in people struggling with this debilitating condition.
In a new trial, researchers from the University of South Australia are working with Arthritis SA to investigate the potential of Blood Flow Restriction (BFR) training to improve the strength and mobility of people with rheumatoid arthritis.
BFR training is an exercise technique in which people wear pressurized bands – much like blood pressure cuffs – to slow blood flow to the muscles while they exercise. The cuff allows blood flow to the limb but slows its outflow, developing muscle strength without the need for heavy weights.
In Australia, rheumatoid arthritis is the second most common form of arthritis, affecting more than 450,000 people. More than 18 million people worldwide live with a condition. Women are two to three times more likely to develop rheumatoid arthritis than men.
Sports scientist Dr. UniSA’s Hunter Bennett says the research hopes to identify interventions that can improve the quality of life for people with rheumatoid arthritis.
“Rheumatoid arthritis can be a particularly debilitating disease. It is caused by the immune system attacking healthy tissues, leading to pain and swelling, joint destruction and loss of muscle mass and strength,” says Dr. Bennett.
Although medications can reduce symptoms, they do not address the loss of muscle strength and function.
The best way to increase strength and combat muscle loss is through resistance training, but this is often problematic for people with rheumatoid arthritis due to pain, fatigue or risk of injury.
Blood flow restriction training (BFR) offers an alternative. BRF is used in many sports and rehabilitation settings in Australia and is considered a safe and effective method for improving strength and function in many clinical populations, including people with osteoarthritis.
Because this technique uses very low loads, it is a viable option for people with rheumatoid arthritis. So in our research we look at how BRF can increase people’s strength and hopefully increase their freedom of movement and overall well-being.”
Dr. Hunter Bennett, exercise scientist, UniSA
The research team is currently seeking expressions of interest from women and men aged 45 to 75 years diagnosed with rheumatoid arthritis.
Exercise intervention eases pain for people with rheumatoid arthritis
We will be discussing meniscus tears, their function, and why surgery might not be the best option. The meniscus is a fibrocartilaginous structure located between the femur and tibia in the knee joint. There are two menisci in each knee, the medial meniscus, and the lateral meniscus. They function to provide shock absorption, force transmission, and stability to the knee joint.
Meniscus tears can be either traumatic or non-traumatic. Traumatic tears have a distinct mechanism of injury, while non-traumatic tears occur secondary to age-related changes. Meniscus tears are often classified according to location and orientation, such as vertical, longitudinal, radial, horizontal, oblique, or complex. Surgery to repair or remove the meniscus was performed in the past to reduce symptoms of pain and mechanical symptoms, such as clicking, catching, and locking of the knee. However, the current scientific literature does not fully support this theory.
If you suspect you have a meniscus tear, it’s important to see a doctor for an accurate diagnosis and appropriate treatment.
Key Takeaways
Mechanical symptoms are not a reliable indicator of the presence of meniscal tears.
Meniscus tears are common in asymptomatic individuals.
Surgery to remove or repair the meniscus has not been shown to lead to better outcomes compared to other interventions.
Understanding Meniscus Tears
We want to provide you with a comprehensive understanding of meniscus tears. The meniscus is a fibrocartilaginous structure located between the femur and tibia bones in the knee joint. There are two menisci in each knee, the medial meniscus located on the inner portion of the knee and the lateral meniscus located on the outer portion. The menisci function to provide shock absorption, force transmission, and stability to the knee joint.
Meniscus tears are either traumatic or non-traumatic. Traumatic tears occur due to a distinct mechanism of injury, whereas non-traumatic tears occur secondary to age-related changes. Meniscus tears are often classified according to location and orientation, including vertical, longitudinal, radial, horizontal, oblique, or complex tears. Vertical or oblique tears that twist and fold over within the joint are termed bucket handle tears.
In the past, the presence of pain and mechanical symptoms such as clicking, catching, and locking of the knee were thought to be caused by a meniscus tear. However, current scientific literature does not fully support this theory. Researchers have found that mechanical symptoms are equally prevalent in patients with and without a meniscal tear and are common in those with knee problems in general. Therefore, these symptoms have limited utility as an indicator for the presence of meniscal tears or are not useful clues to the diagnosis.
Meniscus tears are common in asymptomatic individuals. One study found that in 230 uninjured knees, 30 percent had meniscal tears. If tears are prevalent in a non-painful population, it brings into question the efficacy of surgery in reducing symptoms. Surgery to remove or repair the meniscus has not been shown to lead to better outcomes compared to other interventions. In fact, a brand new Cochrane review concluded that arthroscopic surgery for degenerative meniscal tears provides little to no clinical benefit for pain function and quality of life compared to placebo surgery.
At this moment, current clinical practice guidelines favor conservative management in those with degenerative meniscus tears. Exercise has been shown to be just as effective in the long term for both populations. We have one study that showed exercise led to similar improvements in pain function and quality of life after 12 months in a younger population with mostly traumatic tears and another study that showed no clinically relevant difference in the function after two years in an older population with degenerative tears.
We want to provide you with a comprehensive rehab program that covers multiple categories aimed at increasing your capacity and tolerance to various stressors within each category. The first category is knee range of motion. Ideally, you should be able to fully straighten your knee and touch your heel to your butt. You should aim to restore extension and flexion that is equal to your uninjured side. We recommend three options for knee extension or straightening and three options for knee flexion or bending.
The second category is hip, knee, and ankle strength. We recommend a four-step split squat progression, which will help increase your tolerance to weight-bearing knee flexion in deeper positions. We also recommend a single-leg knee extension and hamstring sliders to work on quadriceps and hamstring strength.
In conclusion, meniscus tears are a common knee injury that can be managed conservatively through exercise. Surgery has not been shown to provide better outcomes compared to other interventions. Our comprehensive rehab program covers multiple categories aimed at increasing your capacity and tolerance to various stressors. We recommend following this program for non-surgical cases. Always talk to your doctor or physical therapist before starting any exercise program.
Myths About Meniscus Tears
We often hear that meniscus tears are the cause of knee pain and mechanical symptoms such as clicking, catching, and locking of the knee. However, recent scientific literature does not fully support this theory. Here are three things you should know about meniscus tears:
There is not a simple cause and effect relationship between symptoms and tears. Patients with and without a meniscal tear have been found to have the same mechanical symptoms, which are actually common in those with knee problems in general.
Meniscus tears are common in asymptomatic individuals. In one study, 30% of uninjured knees had meniscal tears, which brings into question the efficacy of surgery in reducing symptoms.
Surgery to remove or repair the meniscus has not been shown to lead to better outcomes compared to other interventions. In fact, surgery can even lead to an increased risk of developing radiographic knee osteoarthritis.
Given this information, conservative management is favored for those with degenerative meniscus tears. Exercise has been shown to be just as effective in the long term for both younger patients with traumatic tears and older patients with degenerative tears.
We provide a comprehensive rehab program that covers multiple categories aimed at increasing your capacity and tolerance to various stressors. In the knee range of motion category, we recommend exercises such as seated active quad contractions, propping your heel up on an elevated surface, and banded tke. In the hip, knee, and ankle strength category, we recommend exercises such as the four-step split squat progression and single leg knee extensions for the quadriceps, and standing knee flexion with an ankle weight or hamstring sliders for the hamstrings.
It is important to note that these exercises are intended for non-surgical cases. If you had surgery, you should talk to your doctor or physical therapist before starting any exercise program.
Research on Meniscus Tears
The meniscus is a fibrocartilaginous structure that is located between the femur and tibia in the knee joint. There are two menisci in each knee, the medial and lateral meniscus. They provide shock absorption, force transmission, and stability to the knee joint.
Meniscus tears can be either traumatic or non-traumatic. Traumatic tears occur due to a distinct mechanism of injury, while non-traumatic tears occur secondary to age-related changes. Tears can be classified according to their location and orientation, such as vertical, longitudinal, radial, horizontal, oblique, or complex. Bucket handle tears are vertical or oblique tears that twist and fold over within the joint.
In the past, the presence of pain and mechanical symptoms such as clicking, catching, and locking of the knee were thought to be caused by a meniscus tear. Therefore, surgery to repair or remove the meniscus was performed to reduce symptoms. However, current scientific literature does not fully support this theory.
There is not a simple cause and effect relationship between symptoms and tears. Mechanical symptoms are equally prevalent in patients with and without a meniscal tear, and are actually common in those with knee problems in general. Meniscus tears are also common in asymptomatic individuals, with one study finding that 30 percent of uninjured knees had meniscal tears.
Surgery to remove or repair the meniscus has not been shown to lead to better outcomes compared to other interventions. A popular study compared a partial meniscectomy to a placebo or sham surgery and found that surgery provided no more benefit for knee symptoms or function than placebo surgery. It even led to an increased risk of developing radiographic knee osteoarthritis. A brand new Cochrane review concluded that arthroscopic surgery for degenerative meniscal tears provides little to no clinical benefit for pain, function, and quality of life compared to placebo surgery.
Exercise has been shown to be just as effective in the long term for both younger and older populations with meniscus tears. Clinical practice guidelines favor conservative management in those with degenerative meniscus tears.
We provide a comprehensive rehab program that covers multiple categories aimed at increasing your capacity and tolerance to various stressors. The program includes knee range of motion exercises, hip, knee, and ankle strength exercises, balance and proprioception exercises, and cardiovascular exercise.
Surgical Interventions
We have learned that surgery to remove or repair the meniscus has not been shown to lead to better outcomes compared to other interventions. In fact, a recent Cochrane review concluded that arthroscopic surgery for degenerative meniscal tears provides little to no clinical benefit for pain, function, and quality of life compared to placebo surgery. Therefore, current clinical practice guidelines favor conservative management in those with degenerative meniscus tears.
Instead, we recommend a comprehensive rehab program that covers multiple categories aimed at increasing your capacity and tolerance to various stressors. We will provide multiple exercise options within each category, ultimately giving you two different workouts to follow. These exercises are intended for non-surgical cases. If you had surgery, you should talk to your doctor or physical therapist before starting, as you may have weight-bearing precautions or other considerations to consider.
The first category is knee range of motion. Ideally, you should be able to fully straighten your knee and touch your heel to your butt. At minimum, you should aim to restore extension and flexion that is equal to your uninjured side. For knee extension or straightening, we recommend seated active quad contractions, propping your heel up on an elevated surface, and banded tke. For knee flexion or bending, we recommend using a stationary bike, heel slides, and quadruped rock backs or tall kneeling rock backs.
The second category is hip, knee, and ankle strength. For quadriceps, we recommend a four-step split squat progression and a single-leg knee extension. For hamstrings, we recommend standing knee flexion with an ankle weight, machines, or hamstring sliders.
By following these exercises, you can increase your tolerance to weight-bearing knee flexion in deeper positions and improve your knee symptoms related to a degenerative meniscus tear.
Non-Surgical Interventions
We understand that meniscus tears can cause pain and other mechanical symptoms in the knee joint. However, surgery may not always be the best option for treating this condition. In fact, current scientific literature does not fully support the idea that surgery to repair or remove the meniscus leads to better outcomes compared to other interventions.
Therefore, we recommend a comprehensive rehab program that includes exercise progressions with sets and reps. This program aims to increase your capacity and tolerance to various stressors within each category. We have categorized the exercises into two main categories:
Category One: Knee Range of Motion
The first category focuses on restoring knee range of motion. Ideally, you should be able to fully straighten your knee and touch your heel to your butt. If not, you should aim to restore extension and flexion that is equal to your uninjured side.
Here are three exercises that can help with knee extension:
Seated Active Quad Contractions: Straighten your leg and squeeze your quad for 10 seconds. Repeat this for 10 repetitions, three times a day. If your motion is improving, you can use a towel or strap to pull up on your foot to intensify the stretch.
Heel Prop: Prop your heel up on an elevated surface for 10 to 15 minutes, three times a day. If you need to enhance the stretch, you can add a weight just above your knee. The goal here is low load, long duration.
Banded TKE: Place a band behind the back of your knee, anchor it to an object, and perform the same quad contractions against resistance.
For knee flexion, here are three exercises that can help:
Stationary Bike: Start with the seat at a higher level, and as your range of motion improves, lower the seat to expose the knee to more flexion.
Heel Slides: Use a slider on carpet or a towel on a hard surface. Start by actively sliding your heel towards your butt for 10 to 15 repetitions. As motion improves, progress by using a towel or strap to pull the knee into more flexion. You should do these often, at least three times a day, every day.
Quadruped Rock Backs or Tall Kneeling Rock Backs: Kneel on a pad or pillow for these exercises. You can even experiment with using a towel behind the knee, which can help patients move into more knee flexion with less discomfort.
Category Two: Hip, Knee, and Ankle Strength
The second category focuses on hip, knee, and ankle strength. We recommend a four-step split squat progression that will help increase your tolerance to weight-bearing knee flexion in deeper positions.
Here are the four levels of the split squat progression:
Body Weight Squat: Perform three sets of 20 repetitions, getting your hips to at least parallel. If you need to, start with hand assistance, such as using a TRX or another object.
Heels Elevated Squat: Elevate your heels two to three inches. This will help keep your torso more upright and allow you to go deeper, moving your knee into more flexion. Perform three sets of 20 repetitions, and again, try to get your hips to at least parallel.
Split Squat: Stand in a split stance and lower down while driving the front knee forward as far as you can. Perform three sets of 15 controlled reps on each leg before progressing.
Front Foot Elevated Split Squat: Elevate your front foot on an object two to four inches high and lower it down, driving the front knee forward. Over time, you can increase depth and add weight.
For the hamstrings, we recommend standing knee flexion with an ankle weight, using machines, or performing hamstring sliders. Start with double-leg eccentric sliders for three to four sets of 10 to 15 reps on each leg. Your goal is to move through the full range of motion with the weight at a challenging intensity, but to start, you can shorten the range of motion or even perform with no weight if needed.
In conclusion, exercise has been shown to be just as effective in the long term for treating meniscus tears compared to surgery. Therefore, we recommend a comprehensive rehab program that includes these exercises to help you recover from this condition.
Exercise as a Treatment Option
We have seen that surgery for meniscus tears may not be the best option, and that exercise can be just as effective in the long term for both younger and older populations. Therefore, we present a comprehensive rehab program that covers multiple categories aimed at increasing your capacity and tolerance to various stressors within each category.
Knee Range of Motion
The first category we will cover is knee range of motion. Ideally, you should be able to fully straighten your knee and touch your heel to your butt. At minimum, you should aim to restore extension and flexion that is equal to your uninjured side.
For knee extension or straightening, we recommend three options. The first is seated active quad contractions, where you straighten your leg and squeeze your quad for 10 seconds. Repeat this for 10 repetitions, three times a day. If your motion is improving, you can use a towel or strap to pull up on your foot in order to intensify the stretch.
Another option is propping your heel up on an elevated surface for 10 to 15 minutes, three times a day. If you need to enhance the stretch, you can add a weight just above your knee. The goal here is low load long duration, so while it may feel slightly uncomfortable, it should not be unbearable.
Finally, once you gain more range of motion, strength, and control, add in a banded tke. Place a band behind the back of your knee, anchor it to an object, and perform the same quad contractions against resistance.
For knee flexion or bending, we recommend three options. You can use a stationary bike and start with the seat at a higher level. As range of motion improves, lower the seat to expose the knee to more flexion. Another option is heel slides. You can use a slider on carpet or a towel on a hard surface. Start by actively sliding your heel towards your butt for 10 to 15 repetitions. As motion improves, progress by using a towel or strap to pull the knee into more flexion. You should do these often, so at least three times a day, every day.
Finally, a more advanced option is quadruped rock backs or tall kneeling rock backs. We recommend kneeling on a pad or pillow for these, and you can even experiment with using a towel behind the knee. Anecdotally, we have found this to help patients move into more knee flexion with less discomfort.
Hip, Knee, and Ankle Strength
The second category we will cover is hip, knee, and ankle strength. Let’s start with a four-step split squat progression, which will help increase your tolerance to weight bearing knee flexion in deeper positions.
Level 1 is a bodyweight squat. Your goal is to perform three sets of 20 repetitions, getting your hips to at least parallel. If you need, start with hand assistance such as using a TRX or another object.
Level 2 is a heels elevated squat. Elevate your heels two to three inches. This will help keep your torso more upright and allow you to go deeper, moving your knee into more flexion. Your goal is three sets of 20 repetitions, and again, try to get your hips to at least parallel.
Level 3 is a split squat. Stand in a split stance and lower down while driving the front knee forward as far as you can. Your goal is three sets of 15 controlled reps on each leg before progressing.
Level 4 is a front foot elevated split squat. Elevate your front foot on an object two to four inches high and lower it down, driving the front knee forward. Over time, you can increase depth and add weight.
For the quadriceps, we recommend a single leg knee extension for three to four sets of 10 to 15 reps on each leg. Your goal is to move through the full range of motion with the weight at a challenging intensity, but to start, you can shorten the range of motion or even perform with no weight if needed.
For the hamstrings, the first option will emphasize knee flexion. You can perform standing knee flexion with an ankle weight, use machines, or an exercise we like to use called hamstring sliders. Start with double leg eccentric sliders before progressing to single leg eccentric sliders.
We hope this comprehensive rehab program will help you increase your capacity and tolerance to various stressors, ultimately leading to better knee function and quality of life.
Rehab Program
We will now discuss a comprehensive rehab program for meniscus tears, which includes exercise progressions with sets and reps. The meniscus is a fibrocartilaginous structure located between the femur and tibia bones in the knee joint. There are two menisci in each knee, the medial meniscus on the inner portion and the lateral meniscus on the outer portion. The menisci provide shock absorption, force transmission, and stability to the knee joint.
Meniscus tears can be either traumatic or non-traumatic. Traumatic tears occur due to a specific injury, while non-traumatic tears occur due to age-related changes. Tears can be classified according to location and orientation, such as vertical, longitudinal, radial, horizontal, oblique, or complex. Vertical or oblique tears that twist and fold over within the joint are termed bucket handle tears.
In the past, pain and mechanical symptoms such as clicking, catching, and locking of the knee were thought to be caused by a meniscus tear. Therefore, surgery to repair or remove the meniscus was performed to reduce symptoms. However, current scientific literature does not fully support this theory.
There is not a simple cause and effect relationship between symptoms and tears. For example, a 2018 study found that mechanical symptoms were equally prevalent in patients with and without a meniscal tear and are actually common in those with knee problems in general. Other research has concluded that these symptoms have limited utility as an indicator for the presence of meniscal tears or are not useful clues to the diagnosis.
Meniscus tears are common in asymptomatic individuals. In one study, researchers found that in 230 uninjured knees, 30 percent had meniscal tears. If tears are prevalent in a non-painful population, it questions the efficacy of surgery in reducing symptoms.
Surgery to remove or repair the meniscus has not been shown to lead to better outcomes compared to other interventions. For example, a popular study compared a partial meniscectomy to a placebo or sham surgery over the course of five years. Surgery provided no more benefit for knee symptoms or function than placebo surgery. It even led to an increased risk of developing radiographic knee osteoarthritis. In fact, a brand new Cochrane review concluded that arthroscopic surgery for degenerative meniscal tears provides little to no clinical benefit for pain, function, and quality of life compared to placebo surgery.
Exercise has been shown to be just as effective in the long term for both populations. One study showed exercise led to similar improvements in pain, function, and quality of life after 12 months in a younger population with mostly traumatic tears. Another study showed no clinically relevant difference in function after two years in an older population with degenerative tears.
Therefore, current clinical practice guidelines favor conservative management in those with degenerative meniscus tears. We will now present a comprehensive rehab program that covers multiple categories aimed at increasing your capacity and tolerance to various stressors within each category. We will provide multiple exercise options, ultimately giving you two different workouts to follow.
Before diving into these exercises, there is one caveat we want to mention. These exercises are intended for non-surgical cases. If you had surgery, you will ultimately follow a similar framework, but before starting, talk to your doctor or physical therapist as you may have weight-bearing precautions or other considerations to consider.
Category One: Knee Range of Motion
Ideally, you should be able to fully straighten your knee and touch your heel to your butt. At a minimum, you should aim to restore extension and flexion that is equal to your uninjured side.
For knee extension or straightening, here are three options:
Seated active quad contractions: Straighten your leg and squeeze your quad for 10 seconds. Repeat this for 10 repetitions, three times a day. If your motion is improving, you can use a towel or strap to pull up on your foot to intensify the stretch.
Propping your heel up on an elevated surface: Elevate your heel on a surface for 10 to 15 minutes, three times a day. If you need to enhance the stretch, you can add a weight just above your knee. The goal here is low load, long duration, so while it may feel slightly uncomfortable, it should not be unbearable.
Banded TKE: Place a band behind the back of your knee, anchor it to an object, and perform the same quad contractions against resistance.
For knee flexion or bending, here are three options:
Stationary bike: Start with the seat at a higher level and lower it as range of motion improves to expose the knee to more flexion.
Heel slides: Use a slider on carpet or a towel on a hard surface. Start by actively sliding your heel towards your butt for 10 to 15 repetitions.
Knee Range of Motion Exercises
We will now discuss knee range of motion exercises that are essential for rehabilitating meniscus tears. The meniscus is a vital structure that provides shock absorption, force transmission, and stability to the knee joint. Meniscus tears can be traumatic or non-traumatic and can be classified based on their location and orientation. The presence of pain and mechanical symptoms such as clicking, catching, and locking of the knee were traditionally thought to be caused by a meniscus tear. However, surgery to repair or remove the meniscus has not been shown to lead to better outcomes compared to other interventions.
Therefore, we recommend a comprehensive rehab program that covers multiple categories aimed at increasing your capacity and tolerance to various stressors. In the first category, we will focus on knee range of motion exercises. Ideally, you should be able to fully straighten your knee and touch your heel to your butt. At minimum, you should aim to restore extension and flexion that is equal to your uninjured side.
For knee extension or straightening, we recommend three options. The first is seated active quad contractions, where you straighten your leg and squeeze your quad for 10 seconds, repeat this for 10 repetitions, three times a day. Another option is propping your heel up on an elevated surface for 10 to 15 minutes, three times a day. If you need to enhance the stretch, you can add a weight just above your knee. Finally, once you gain more range of motion, strength, and control, add in a banded tke. Place a band behind the back of your knee, anchor it to an object, and perform the same quad contractions against resistance.
For knee flexion or bending, we recommend three options. You can use a stationary bike and start with the seat at a higher level. As range of motion improves, lower the seat to expose the knee to more flexion. Another option is heel slides. You can use a slider on carpet or a towel on a hard surface. Start by actively sliding your heel towards your butt for 10 to 15 repetitions. As motion improves, progress by using a towel or strap to pull the knee into more flexion. You should do these often, at least three times a day, every day. Finally, a more advanced option is quadruped rock backs or tall kneeling rock backs. We recommend kneeling on a pad or pillow for these, and you can even experiment with using a towel behind the knee.
These knee range of motion exercises will help increase your knee’s flexibility and strength. It is essential to perform these exercises regularly to help you recover from your injury.
Hip, Knee and Ankle Strength Exercises
We have put together a comprehensive rehab program that covers multiple categories aimed at increasing your capacity and tolerance to various stressors. Within each category, we will provide multiple exercise options ultimately giving you two different workouts to follow.
Before diving into these exercises, we want to mention that these exercises are intended for non-surgical cases. If you had surgery, you will ultimately follow a similar framework but before starting, talk to your doctor or physical therapist as you may have weight-bearing precautions or other considerations to consider.
Category One: Knee Range of Motion
Ideally, you should be able to fully straighten your knee and touch your heel to your butt. At minimum, you should aim to restore extension and flexion that is equal to your uninjured side.
For knee extension or straightening, here are three options:
Seated active quad contractions: Straighten your leg and squeeze your quad for 10 seconds. Repeat this for 10 repetitions, three times a day. If your motion is improving, you can use a towel or strap to pull up on your foot in order to intensify the stretch.
Propping your heel up on an elevated surface for 10 to 15 minutes, three times a day. If you need to enhance the stretch, you can add a weight just above your knee. The goal here is low load, long duration, so while it may feel slightly uncomfortable, it should not be unbearable.
Banded TKE: Place a band behind the back of your knee, anchor to an object, and perform the same quad contractions against resistance.
For knee flexion or bending, here are three options:
Stationary bike: Start with the seat at a higher level. As range of motion improves, lower the seat to expose the knee to more flexion.
Heel slides: Use a slider on carpet or a towel on a hard surface. Start by actively sliding your heel towards your butt for 10 to 15 repetitions. As motion improves, progress by using a towel or strap to pull the knee into more flexion. You should do these often, so at least three times a day every day.
Quadruped rock backs or tall kneeling rock backs: Kneel on a pad or pillow for these and experiment with using a towel behind the knee. Anecdotally, we have found this to help patients move into more knee flexion with less discomfort.
Category Two: Hip, Knee and Ankle Strength
Let’s start with a four-step split squat progression which will help increase your tolerance to weight-bearing knee flexion in deeper positions.
Level 1: Body weight squat – Your goal is to perform 3 sets of 20 repetitions, getting your hips to at least parallel. If you need, start with hand assistance such as using a TRX or another object.
Level 2: Heels elevated squat – Elevate your heels two to three inches. This will help keep your torso more upright and allow you to go deeper, moving your knee into more flexion. Your goal is 3 sets of 20 repetitions, and again try to get your hips to at least parallel.
Level 3: Split squat – Stand in a split stance and lower down while driving the front knee forward as far as you can. Your goal is three sets of 15 controlled reps on each leg before progressing.
Level 4: Front foot elevated split squat – Elevate your front foot on an object two to four inches high and lower it down, driving the front knee forward. Over time, you can increase depth and add weight.
For the hamstrings, the first option will emphasize knee flexion. You can perform standing knee flexion with an ankle weight, use machines, or an exercise we like to use, hamstring sliders. Start with double leg eccentric sliders.
We have put together a comprehensive rehab program that covers multiple categories aimed at increasing your capacity and tolerance to various stressors. In this section, we will focus on knee range of motion and hip, knee, and ankle strength.
Knee Range of Motion
Ideally, you should be able to fully straighten your knee and touch your heel to your butt. In order to restore extension and flexion equal to your uninjured side, we recommend the following exercises:
Seated active quad contractions: straighten your leg and squeeze your quad for 10 seconds. Repeat for 10 repetitions, three times a day. You can use a towel or strap to pull up on your foot in order to intensify the stretch.
Propping your heel up on an elevated surface for 10 to 15 minutes, three times a day. You can add a weight just above your knee to enhance the stretch.
Banded tke: place a band behind the back of your knee and perform the same quad contractions against resistance.
For knee flexion or bending, we recommend the following exercises:
Stationary bike: start with the seat at a higher level and as range of motion improves, lower the seat to expose the knee to more flexion.
Heel slides: actively slide your heel towards your butt for 10 to 15 repetitions. As motion improves, progress by using a towel or strap to pull the knee into more flexion. Do these at least three times a day every day.
Quadruped rock backs or tall kneeling rock backs: kneel on a pad or pillow and use a towel behind the knee. This will help you move into more knee flexion with less discomfort.
Hip, Knee, and Ankle Strength
We recommend the following exercises to increase your tolerance to weight bearing knee flexion in deeper positions:
Four step split squat progression:
Level 1: Body weight squat – perform 3 sets of 20 repetitions getting your hips to at least parallel.
Level 2: Heels elevated squat – elevate your heels two to three inches to allow you to go deeper. Your goal is 3 sets of 20 repetitions and again try to get your hips to at least parallel.
Level 3: Split squat – stand in a split stance and lower down while driving the front knee forward as far as you can. Your goal is three sets of 15 controlled reps on each leg before progressing.
Level 4: Front foot elevated split squat – elevate your front foot on an object two to four inches high and lower it down driving the front knee forward. Over time, you can increase depth and add weight.
Single leg knee extension: perform for three to four sets of 10 to 15 reps on each leg. Your goal is to move through the full range of motion with the weight at a challenging intensity.
Hamstring sliders: start with double leg eccentric sliders and progress to single leg. Your goal is to move through the full range of motion with the weight at a challenging intensity.
By following these exercises, you can increase your capacity and tolerance to various stressors and ultimately improve your overall knee function.
