Meniscal Tears: What They Are, What To Do, AND What NOT To Do
There are many types of knee pain. We’ve all heard of ACL tears, MCL sprains, and knee arthritis, but one of the most common is a Meniscal Tear.
We, all, hear of people who have had arthroscopic surgery to correct the injury. Sometimes the orthopedic surgeon will repair the tear (which involves 6 weeks on crutches and extensive 8-12 weeks of physical therapy afterwards) or sometimes the surgeon will just take out the tear (which is quicker, but can still require 6-10 weeks of PT). The thing most people don’t know is that the surgery can, actually, increase the speed at which you develop arthritis…
…But, not doing anything about it will also increase the speed of arthritis development.
…SO, this article is very important, as I will explain to you what the meniscus does and the options with take care of a tear without surgery.
Let’s start by learning a little about the meniscus itself…
Anatomy Of The Knee Meniscus
The meniscus is found between the bottom part of the thigh bone (femur) and the top part of the lower leg bone (tibia).
The meniscus is a separate but attached to the edges of the Tibia (“the shin bone”) structure on the inside of the knee. It functions as a shock absorber during daily activities like walking or sports that are required during running or jumping.
The meniscus also helps improve the stability of the knee by filling the space in the knee and allowing the joint to slide nicely in the lines that it belongs.
Therefore, when the meniscus is torn, it often causes symptoms of the knee giving way.
What Causes A Meniscus Tear?
The most common cause of a meniscus tear is repeated “twisting” of the knee over a long period of time.
This can happen from from pivoting on the knee, such as when making a cutting motion to change directions when running, from overpronating (flattening feet too much) when walking, or from just weak lags that limit your ability to control the leg.
Meniscal tears can also be caused from a traumatic blow to the knee after a car accident or after a football tackle.
Are There Tests For Meniscus Tear?
MRI for Meniscus Tears
The gold standard test for a meniscus tear is an MRI to see an “internal” picture of the knee.
However, there are some very good (and WAY less expensive) clinical tests for meniscus tears.
Clinical Tests For Meniscus Tears
The Thessaly test, the McMurray’s test, and Apley’s Compression test are three tests done clinically. They are all tests that involve twisting the tibia with some compression of the joint in varied degrees of knee flexion (bending) that have good specificity—meaning that if the test is positive (cause pain or popping), there is a high probability that there is a tear. However, small tears may not be seen with these tests.
Will I Need Surgery For A Meniscus Tear?
The good news is that most of the time, you do NOT need surgery for a meniscus tear.
Clinical studies show that many people with meniscus tears on their MRI can recover just as well without surgery as with surgery.
The outer parts of the meniscus have a better blood supply than the deeper part, so sometimes tears in the deeper part of the meniscus may require surgery.
However, as we'll discuss below, doing exercises that improve blood flow to the meniscus and control the tracking of the knee perfectly are a good way to help the meniscus to heal without surgery.
Exercises To Avoid With A Meniscus Tear
Before discussing what exercise are good for a meniscus tear, we should first cover what exercises to avoid with a meniscus tear.
Exercises to Avoid with a Meniscus Tear include:
1. High-impact Exercises
2. Exercises that involve twisting
3. Deep squatting
4. Resisted Hamstring exercises
High-impact Exercises
As mentioned above, the meniscus acts as a shock absorber, so it has diminished capacity to dissipate forces when it is torn.
Activities that result in increased downward forces on the meniscus will compress the thigh and lower leg bones together. As a result, high-impact activity will increase the inflammation and can worsen a meniscus tear.
Running and jumping are prime examples of high-impact exercises to avoid with a meniscus tear.
Twisting Exercises
Twisting is a major cause of meniscal tears. Therefore, exercises that involve twisting such as golfing, tennis, swinging a baseball bat, or sports that require cutting and directional changes should be avoided in the early stages after a meniscus tear.
Deep Squatting
Deep squatting will aggravate the meniscal tear because the meniscus gets impinged at the back of the knee in a deep squat position. Heavy squatting also puts more pressure on the knee meniscus.
Squatting isn't necessarily a bad exercise if you have a meniscus tear, you just need to limit how heavy and how deep you squat, and how well you do this exercise and control the tracking of the knee.
Resisted Hamstring Exercises
One of the hamstring muscles called the semi-membranosis attaches to the back of the meniscus. It's normal job is to pull the meniscus backward as you bend your knee to keep the meniscus in line with the joint.
However, if you already have a meniscus tear, doing heavy resisted hamstring exercises like leg curls on a leg curl machine can put extra tension on the meniscus.
What Meniscus Tear Exercises Are Good To Do?
Cardiovascular Exercise With Meniscus Tears?
The meniscus has the ability to repair itself, but it requires sufficient blood flow to the area to heal. As a result, activities that increases blood flow, such as cardiovascular exercises, can help the meniscus to heal as long as they are not high-impact cardiovascular exercises.
Good cardiovascular exercises to do with a meniscus tear include walking, swimming, and riding a stationary bike.
Running is typically NOT recommended due to the high-impact forces/stresses that occurs at the knee, especially within the meniscus.
Range Of Motion And Stretching Exercises For Meniscus Tear
Gentle range of motion exercises and stretches can help if you have a meniscus tear. A gentle hamstring stretch helps you to fully straighten your knee when walking.
Bending the knee gently while seated or laying down are good ways to help the meniscus to glide forward and backward with the knee as it bends and straightens.
What Else Can Help Meniscus Tears?
Meniscus Tear Knee Brace
A meniscus tear can cause your knee to feel unstable.
Whether your knee is actually clinically unstable, or if it just feels unstable, wearing a hinged knee brace for a meniscus tear can be helpful to give you more confidence and peace of mind to do your daily activities without fear of your knee giving out.
Physical Therapy For Meniscus Tear
Although bracing and exercise can help meniscus tears, neither one address the root cause of the meniscus tear, such as poor movement patterns during daily activities or sports, hip and ankle instability, and/or strength and flexibility deficits.
Even if the pain from a meniscus tear goes away, if you keep doing the activity that caused the meniscus tear in the first place, the pain from a meniscal tear can come back.
As the meniscus gets more and more worn down, it can put you at greater risk for arthritis.
Need Help For A Meniscus Tear?
If you'd like to find the root cause of your meniscus tear and how to get the pain to go away for good, tap the button below to request an appointment with one of our Specialists.
Not Ready for a Full Assessment? Click here to Download our FREE Knee Pain Guide!
Other Free Resources If you want to read more of our informative blogs, click the link below: Click Here To Read More Of Our Physical Therapy Blog Articles Click Here To Read –The 4 Tell-Tale Signs that an Injury Will Stop You from Running Click Here To Read – 4 Tips to Avoid Back Pain When Traveling We also have free, downloadable reports for people with Back Pain, Knee Pain, Neck Pain, Foot and Ankle Pain, or Shoulder Pain Want videos on demand? Check Out Our YouTube Channel (Remember to hit subscribe so you don’t miss out on our new videos!)