Each year over 350,000 meniscus surgeries are performed in the United States (more specifically, these surgeries are called arthroscopic partial meniscectomies).1 This seems like a high number and we can’t help but ask: is every single one of these surgeries completely necessary?
Let’s answer this question first by addressing what a meniscus is, the symptoms/causes of a torn meniscus, what the research says about surgery, and how to heal the meniscus naturally.
What is a meniscus?
The knee joint is made up of the large thigh bone (femur) meeting with the shin bone (tibia). The meniscus is connective tissue that sits between these two bones and acts a shock absorber for the knee.
The meniscus is roughly shaped like the letter “C” and one is situated on the inside of the knee (medial meniscus) and another is situated on the outside of the knee (lateral meniscus).
Symptoms and Causes of Torn Meniscus
A meniscus is typically torn with a sudden twisting movement of the knee as often seen with contact sports. More complex tears are called bucket handle tears and they actually block movement in the knee (i.e. you physically can’t bend your knee past a certain point).
A meniscus can also undergo degenerative tearing in which smaller tears appear without any sudden injury as the human body ages.
What are the signs of a torn meniscus? It is important to note here that proper diagnosis is not always simple and straightforward.
Therefore, it is imperative to see a healthcare professional for accurate diagnosis.
Typically, a meniscus tear will present with pain when the knee is fully straightened and swelling of the knee is usually present.
Often, joint locking or clicking will also be present along with feeling like the knee is unstable or is going to buckle.
What the Research Says
Often in the general public and in the medical community, once a proper diagnosis of a meniscus tear is made, the accepted next step is surgery. Is that truly the next best step? The current research tells us a different story.
A study from 2018 from the Journal of the American Medical Association showed that people undergoing a course of physical therapy and people undergoing surgical arthroscopy had the same outcomes after 24 months.2
The authors actually suggested that for patients without bucket handle tears, physical therapy may be superior to surgery because of the lack of side effects of physical therapy when compared to surgery.
A systematic review (which looks at many different studies and summarizes their results) found that in adults over 40 years old with degenerative tears, there is no strong evidence to support the use of surgery over physical therapy.3
They also couldn’t say strongly whether one treatment was better than the other. Another study agreed with the systematic review in that people over 40 with degenerative tears undergoing surgery or physical therapy showed no difference after 2 years.4
None of these studies seem to show physical therapy as superior to surgery. Why consider PT? It is important to note that not every person and every tear is the same so we cannot say that every person shoulder either undergo surgery or should avoid surgery.
What we can say is that often times the results from a course of PT and surgery ultimately are the same, so if you can completely avoid surgery and have the same results, why not do it?
How to Heal the Meniscus Naturally
It is important to remember that healing the meniscus is going to take time, probably months, so it is important to not stop treatment too early. The strong recommendation for healing a torn meniscus would be to undergo a course of physical therapy with a PT who is experienced in treating these type of injuries, so let’s go over the basic principles.
1. Active Rest
The first step is to back off any sudden cutting movements (like with basketball or soccer), but still maintain movement in the knee. You should still try to go for walks, swim in the pool, and remain generally as active as possible. The last thing you want with this injury is become very sedentary and avoid walking on or bending the knee; that kind of approach usually ends with more stiffness, pain, and a slower recovery time.
2. Range of Motion
Another large part to healing the meniscus naturally is regaining or maintaining the range of motion in the injured knee. This is best done with exercises in which you are either sitting or lying down and gently bending and straightening the knee as far as comfortable. These type of exercises ensure that the knee doesn’t become stiff, and allow for improved blood flow to aid in the healing of the meniscus.
3. Strength training
0In addition to regaining range of motion, improving strength in the entire leg is very important in healing a meniscus tear.
Often times when experiencing a lot of pain, muscles around the knee don’t fire as they should which can ultimately lead to weakness. Not using the leg as you normally would can also lead to weakness.
Strength exercises should focus on the quadriceps, hamstrings, and muscles surrounding the hips. All of these muscles work together to help stabilize the knee which will help to ensure a meniscus tear does not occur again. Simple strength exercises could include stair climbing, leg presses, and possibly lunges (if not painful).
4. Balance training
Normally in a healthy joint, the brain is able to sense where the joint is at any given time; this is called proprioception. Often after a meniscus injury, proprioception in the knee and leg is inaccurate. This can lead to further injuries and instability in the knee if it is not addressed. Simple ways to begin to address this are with balance exercises. Starter balance exercises include: standing on one leg, calf raises on one leg, and tossing a ball while standing on one leg.
5. Physical Therapy
Physical therapy includes the four areas above and more. The goal of physical therapy is to restore pain-free movement in your knee. A physical therapist may provide you with hands-on techniques to improve the mobility in the knee joint. But, more importantly, they will assess your knee and provide you with a structure rehabilitation program to help you get back to get back to your normal activities. Physical therapy can help to heal the meniscus naturally; however, insurance companies may limit your access to a physical therapist.
A post-rehab program is a continuation of your rehab after you finish working with a physical therapist. Similar to physical therapy, a post-rehab program is a structured program t – ideally developed by a physical therapist. However, a post-rehab program focuses on more complex activities and return to playing sports.
In many cases, physical therapy ends before a person feels 100%. A post-rehab program can help you get back to running a 10K, hiking, squatting at the gym, playing soccer, and other activities that require higher demands from the knee.
7. Proper Nutrition
An overlooked aspect of rehab is nutrition. Hydration and adequate intake of nutrients with facilitate the natural healing process of the body. The body is in a constant state of repair; therefore, it needs a consistent supply of nutrients through a balanced diet of nutrient-dense and minimally processed foods.
A diet that meets those characteristics will also be promote optimal levels of inflammation in the body. Those dealing with meniscus tears usually have an inflammatory response when the knee gets irritated. To minimize the effects of excessive inflammation, it will advantageous to include foods such as wild salmon, turmeric, and fruits/vegetables often in your diet.
8. Professional Guidance
If you continue to struggle with a meniscus tear, it’s best to obtain guidance from a professional. Health care providers such as primary care doctors and physical therapists can assess your knee to determine whether rehab is the best option. If rehab is the best option, then you should find a physical therapist who can help you with a structured program including exercises and personalized recommendations to maximize the current and long-term health of your knee.
Why is rehab important to recover from meniscus tears?
We have outlined basic principles for healing a torn meniscus naturally, but as previously mentioned, it is best to be diagnosed by an experienced physical therapist and to follow the exercise program they prescribe.
Just remember, surgery is not always necessary and following a regimented exercise program may allow your meniscus to heal on its own.
If you need help getting started with rehab, then download our Free Meniscus Tear Quick Start Guidebook for 5 simple exercises to get begin rehab.
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