If you think that meniscus tear treatment can only be done by surgery, you’ll might want to read this. Meniscus tear treatment without surgery is very well possible in most cases.
The meniscus tear recovery time without surgery is about 6 weeks and the meniscus tear recovery time after surgery is somewhere between 1 and 3 mounths. Also, a recent study shows that after 1 year there is no significant diference between surgery and physical therapy.
In this article I’ll tell you exactly how you can do your own meniscus tear treatment without surgery. All you need are the 3 exercises I will describe.
I’ll also explain to you how to treat your meniscus tear without surgery.
Also, I will tell you everything that you need and want to know about the meniscus and his recovery.
I will also go through the surgery process in case the treatment doesn’t work for you because of the size and location of the tear.
But despite of what your orthopedic surgeon might tell you, you should always try to recover your meniscus injury without surgery. Surgery will always be your last resort.
So here you will find everything you need to know about meniscus tear treatment.
What is a meniscus and what does it do?
To understand how the meniscus tear treatment without surgery works, you need to know what a meniscus is and what his function in the knee is.
The meniscus is a c-shaped cartilage disc in the knee. The knee contains 2 menisci: the lateral meniscus and the medial meniscus.
As you can see in the picture, the shape of these menisci is different. This is because of the different shape of the top of your tibia or shinbone. Your medial meniscus is bigger than your lateral meniscus.
The function of the meniscus is to increase the stability of your knee. Naturally, your tibia and femur don’t really fit together.
This is because your tibia is flat where your femur is more round shaped. The function of your meniscus is to eliminate these shape differences. The bottom of your femur fits perfectly in the holes that are formed by your menisci.
The second function of your menisci is shock absorption. Shock absorption in the knee is very important to protect the underlying cartilage in the knee. Forces affecting your knee during running or climbing stairs are very big. Without your menisci your cartilage would be damaged very easily, leading to a higher risk of Osteoarthritis. We will discuss this later when we cover the different surgery options.
Another difference between the medial meniscus and the lateral meniscus is that the medial meniscus is attached to the medial collateral ligament. This hold your medial meniscus firmly into place. This is the reason that a torn lateral meniscus is more common than a torn medial meniscus.
What are the causes of a meniscus tear?
There are 3 common meniscus tear causes that we’ll explain now.
Usually it happens when playing sports where you have to turn or twist quickly. When you turn but your foot stays put on the ground, forces on your meniscus get really high. Especially when your knee is also bend, you can easily tear your meniscus.
Also when you bump your knee, you can damage your meniscus. Bumping your knee almost always happens when your knee is slightly bend. When your knee is bend, your meniscus becomes more prominent in your knee, especially your medial meniscus.
You can apply indirect pressure on your meniscus when your knee is bend. So when you bend your knee it’s easier to damage your meniscus.
Another common cause of a meniscus tear is lifting heavy weights. When you lift heavy weights, pressure on your meniscus gets really high, up to five times the actual weight your lifting. When your meniscus is already worn out because of your age or a previous tear, this weight can cause new damage.
Being overweight may also cause a meniscus tear. Due to the extra weight on your knees, your meniscus gets worn out faster. This may case a meniscus tear over time.
The last common cause of a meniscus tear is when you bend your knee suddenly and extremely. This often happens when you fall on the ground because of a misstep. Because of the extreme bending of your knee, your meniscus gets compressed between your tibia and femur. This can damage your meniscus.
The incidence of a medial meniscus tear is greater than of a lateral meniscus tear. This is because the medial meniscus is attached to the medial collateral ligament, where the lateral meniscus can move freely. Because the medial meniscus is can’t move freely, it can’t be pushed away by the forces that are applied. Therefore compression increases causing a tear in the end. This is the main reason why a medial meniscus tear happens more often than a lateral meniscus tear.
What are torn meniscus symptoms?
The torn meniscus symptoms depend on the location and the size of the tear. We can divide a torn meniscus into 3 different types, each with their own symptoms.
With a minor tear you have slight pain and swelling. You can walk without much pain and are only slightly limited in your daily life. A minor tear is often caused by bumping your knee. This slightly damages your meniscus on the outside, where recovery is generally very good.
A moderate tear can cause pain at the side or center of your knee. Often swelling of your knee occurs in the first 2-3 days after injury. This type of injury is often caused during heavy lifting. Walking is painful but possible. Also bending your knee can be limited and your knee can feel stiff in the morning or after sitting for a long time. Also twisting your knee can cause a sudden stinging/ sharp pain in your knee. This type of damage usually recovers within 4-6 weeks with exercises.
When you experience a severe tear a piece of your meniscus can actually let loose. Now this part of the meniscus can move freely inside the joint space. This can cause you knee to pop or lock. When your knee locks you may not be able to bend it for a period of time. You can also experience some instability of your knee. This is because your femur and tibia don’t fit together anymore. A bucket Handle tear is one of the most common forms of a severe meniscus tear.
Usually swelling kicks in right after injury and your knee might become blue after 1-2 days. This is because of a popped blood vessel inside the meniscus or the surrounding tissue. Walking is usually very difficult after a severe meniscus tear. Recovery can take up to 3 months and might require surgery.
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How can I perform a meniscus tear test myself?
The following movement can be used as a meniscus tear test:
• Bend your knee into a 90 degrees angle.
• Now rotate your lower leg inside and outside.
If the rotation hurts inside your knee this can be considered a positive meniscus tear test. Internal rotation puts pressure on your lateral meniscus and external rotation puts pressure on your medial meniscus
You can also change the meniscus tear test a little bit so it will give more pressure on your meniscus. You can do this by also extending your knee after the internal or external rotation.
The second meniscus tear test is simply by putting direct pressure on your joint space when you knee is bend in a 90 degrees angle. If your meniscus is damaged, putting direct pressure will hurt. This is also an indication for a positive meniscus tear test.
What is the difference between a torn meniscus and the patellofemoral pain syndrome?
A torn meniscus is often confused with the patellofemoral pain syndrome and vice versa. Fortunately you can tell the difference quit easily.
The pain of a meniscus tear is mostly located at the side of the knee where the pain of the patellofemoral pain syndrome is more located on top of the kneecap. Also pain from a meniscus tear is felt at one specific place where the pain caused by the patellofemoral pain syndrome is more diffused over the entire knee.
Secondly, with a meniscus tear rotation of your lower leg is painful, where with the patellofemoral pain syndrome this doesn’t hurt. You can test this yourself by bending your knee in 90 degrees. Now rotate your foot to the outside. If this aggravates pain in your knee you can be quite certain you have meniscus problems.
Also, the pain of the patellofemoral pain syndrome is difficult to put your finger on and doesn’t have a clear moment of genesis.
The easiest way of checking if you have a patellofemoral pain syndrome is by performing the following test:
Sit on the ground with your leg straight. Now bend your painful knee.
Extend your knee again and place your thumb on the inside or medial side of your patella. Push your patella to the outside or lateral side and bend your knee again. If this is less painful you’ll probably have a patellofemoral pain syndrome. If it doesn’t change anything you’re more likely to have a meniscus tear.
What can and can’t I do with a meniscus tear?
When you suspect to have a meniscus tear there are several things that you shouldn’t do during your recovery period.
The things that your shouldn’t do are activity’s that require extreme bending of the knee or puts a lot of pressure on your knee. This includes squats, lunges or rowing exercises. Also activities like soccer or running puts too much force on your damaged meniscus.
Things that you can and should do are swimming and cycling. However, it depends on the severity of the tear if this is possible for you. A general rule of thumb is that the activity itself may cause little pain, but this pain has to disappear within an hour after ending the activity.
Also you can perform strength training exercises for your upper leg muscles as long as it doesn’t require putting weight on your knee or bending your knee. We will discuss some exercises that will help your meniscus tear treatment without surgery later.
How do I know if my meniscus tear can recover without surgery?
If meniscus tear treatment without surgery is possible for you depends on the location and severeness of the meniscus tear. Of the 3 kinds of meniscus tears we discussed earlier, the minor and moderate tear recover very well without surgery. A severe tear on the other hand might require surgery but this doesn’t always have to be the case.
In general, the cause of the meniscus tear can be a prediction for the need of surgery.
A bump of the knee almost always recovers without surgery within a few weeks. Also a meniscus tear caused by heavy lifting recovers very well. In general you can state that the bigger your pain and dysfunction is right after the meniscus tear injury, the more likely you will need surgery. Fortunately sometimes even a severe meniscus tear can heal with exercises.
Wikipedia states that the menisci are nourished by small blood vessels but have a large area in the center with no direct blood supply. That means that a tear in the center of the meniscus almost doesn’t heal at all by itself.
So if you know what caused the tear of the meniscus and if its more on the inside or outside, you can determine the likeliness of recovery without surgery.
But remember this:
No matter the cause or the severity of your meniscus tear you should always try to treat it with the following exercise program. Only if this doesn’t reduce your pain within 6 weeks, you should consider surgery.
Remember to start the exercise program slowly and increase the number of repetitions and pressure depending on the amount of pain you’re experiencing.
What does a meniscus tear treatment without surgery looks like?
The first thing you can do to relieve your pain is to massage the back of your knee. What happens when you feel pain in your knee due to the meniscus tear is that the muscles on the back of your knee tens up. This tension increases the pain you’re experiencing.
By massaging these muscles your pain will reduce and it will be easier for you to walk. This will help your recovery and makes it easier to perform the following exercises.
Our meniscus tear treatment without surgery consists of 3 exercise. These exercises will help to increase the strength of your upper leg muscles and increase bloodflow to your knee. The meniscus needs nutritions in order to be able to repair itself. These nutritions are delivered by your blood.
Research shows that a 12 month training program of the muscles in your upper leg is as effective as surgery for the recovery of a meniscus tear.
Meniscus tear exercise 1:
the purpose of this first meniscus tear exercise is to increase the strength of your quadriceps muscles. This exercise is specially designed to train your quadriceps without putting pressure on your knee or bending your knee. That’s because the pressure on your knee will increase the damage of your meniscus. Therefore this is a better exercise that squads.
As your perform the exercise you will notice that it is harder to perform it with your injured leg than it is with your healthy leg. This is caused by the injury directly.
Start off with 3 sets of 10 repetitions and perform this 2 times a day. Then slowly in time, try to increase the repetitions towards 15 and eventually 20. When you can increase the repetitions you will notice that your pain decreases.
Perform the meniscus tear exercise as showed below:
Meniscus tear exercise 2:
The second meniscus tear exercise is designed to increase the mobility of your knee. When your meniscus repairs, you need to restore the mobility of your leg completely in order to return to full function.
With the following exercise you can increase the mobility of your knee without the risk of reinjure.
When you perform the exercise you may feel a little discomfort in your knee. However it shouldn’t hurt too much. Slowly try to increase the flexion over time.
Perform the meniscus tear exercise as showed below:
Meniscus tear exercise 3:
The third meniscus tear exercise is designed to increase the stability of your knee.
After damaging your meniscus the stability of your knee is often also decreased. This is because the shape of the meniscus plays a big role in your knee stability. So in order to restore this stability you need to train your knee.
What happens is that the muscles around your knee learn to react faster. This way your muscles will compensate for the loss of stability caused by the meniscus tear.
Try to perform this exercise as often as possible.
How is a meniscus tear surgery performed?
Unfortunately, sometimes a meniscus tear doesn’t heal without surgery. As we stated before this is often caused by the severity and location of the tear.
In that case surgery is your only final option.
Fortunately surgery of a meniscus tear has a very high success rate with little risk of complications.
In general there are two options for surgery.
The first option is to cut away the loose part of the meniscus. The second option is to stitch the meniscus back together.
Whether the surgeon chooses for the first or second option depends on a few things:
- Size of the tear
- Location of the tear
- Desired recover time
As we stated before, the size and location of the tear is very important for his healing ability. So when the tear is located in the outer ring of the meniscus, where blood vessels are present, the surgeon will choose for stitching. Also, when the tear is not to big stitching will be preferable.
There is one simple reason why stitching is preferred over cutting in meniscus treatment.
Research shows that after cutting of the meniscus the risk of developing osteoarthritis in the future is much higher than it is after stitching. The recovery in the end is better than after cutting. The only downside is that the recovery time takes a little longer because the meniscus still has to heal.
The only time where cutting is preferred over stitching is when stitching won’t see results due to location or size of the meniscus tear. Also when recovery time has to be short like in professional athletes cutting is preferred. This is because recovery time of this method is shorter because there is nothing that has to be health.
Arthroscopic surgery is used to repair the meniscus. In this procedure the surgeon makes 3 little holes in the knee.
One hole will be used to fill the knee with water. This increases the space inside the knee to work with for the surgeon. Also this will decrease the chances for infections during or after the procedure.
The second hole is used to insert a light source and the camera.
The third hole is used for the surgical instruments.
Even during the procedure the surgeon can change his repair method if desired.
When surgery is finished the holes in your knee will be closed by stiches. These stiches will be removed after about 2 weeks.
A meniscus tear surgery is usually a one day procedure. You will enter the hospital in the morning and leave in the afternoon, if everything went well. The procedure is done under local anesthesia.
How do I recover from meniscus tear surgery and how long does it take?
The recovery time after meniscus tear surgery depends on a number of things.
- Physical condition
- Stitch or cutting of the meniscus
- Size of the meniscus tear
The first few days
The first few days you will be walking with crutches because you’re not allowed full weight bearing yet. When your meniscus tear is cut this usually takes about 3-7 days. However this highly depends on your situation. Some people don’t walk with crutches at all and some for 2 weeks. When your meniscus is stitched, it’s advised to walk with crutches for about 2 weeks. Ask your surgeon about this.
After a few days you may also remove the bandage supporting your knee.
Right after your meniscus tear surgery you can also start exercising. The exercise program is basically the same as the meniscus tear treatment without surgery discussed earlier.
You may increase the resistance of your training and your activities based on the amount of pain and disability that you experience.
Usually you can start your sport activities after about 6 weeks after surgery. When your meniscus tear is stitched this will be after about 4-6 months due to the longer recovery period.
About 90% of all patients recover entirely after a meniscus tear surgery.
A meniscus tear is a very common problem. In general meniscus tear treatment without surgery is very well possible. However sometimes surgery is necessary. Luckily the success rate after surgery is very high.
If you have any question after all this information feel free to e-mail me: [email protected]. We will try to enter the answers into this post to keep improving it.
Don’t forget to share it with your friends so everyone can benefit.
Note: This information can never substitute your doctor. If you are not certain about your condition or the exercises don’t work or make it worse you should see your doctor.