Torn meniscus and other meniscal tears are common sports and fitness injuries that vary in symptoms and severity, including the amount of pain they cause. Why are athletes susceptible to knee pain, runner’s knee and injuries that cause meniscus tears? Because contact sports and certain types of exercise tend to place tremendous stress on the knee joint, the largest and one of the most complex joints in the entire body. The knee must support a high amount of weight everyday, especially when jumping, landing, running or lifting heavy weights.
A meniscal tear is especially common among people with arthritis and older athletes, since the meniscus in the knee weakens with age. Due to degeneration of tissue, cartilage wears thin over time, making it more prone to tears.
Can a medial meniscus tear heal on its own? What about a lateral meniscus tear? Treatment for a torn meniscus depends on a number of factors — like the degree of the tear, location of the injury, how severe someone’s torn meniscus symptoms are, the age of the patient and their activity level. Torn meniscus recovery time can take several months, but the prognosis is usually good if physical therapy, exercising, stretching and other natural treatment approaches can be kept up.
What Is a Torn Meniscus?
A torn meniscus is a common injury, often due to twisting or rotating the knee aggressively, that causes certain tissue in the knee to tear. It’s one of the most frequently occurring cartilage injuries in the knee and is especially common in traumatic and/or sports injuries.
As a “hinge” joint, the structure of the knee allows for movement in only one direction. The two thick pads of cartilage positioned between the tibia (shin bone) and femur (thigh bone) are called the menisci. There are two main menisci that form the structure of the knees, the medial and lateral meniscus, which normally move positions with movement of the knee. An injury can occur by placing an exuberant amount of weight and pressure on the knee while it is partially flexed. This can trap a meniscus between the tibia and femur bones, resulting in a break or tear in the cartilage. (1)
Meniscus Tear Symptoms
The most common torn meniscus symptoms include: (2)
- Knee pain
- Trouble moving the knee or walking (due to the knee locking)
- Swelling and tenderness around the knee
- Limited range of motion of the knee/leg
A major torn meniscus symptom is localized pain in the knee, near the area where the tear has occurred. Sometimes a person will feel an immediate pop or snap during the injury while others may have a slow onset of pain and symptoms. In addition, a person may have pain with movement or knee locking when a piece of the meniscus breaks off and lodges into the joint.
Can you walk around with a torn meniscus? The knee is designed to move up and down (flexion and extension) and rotate slightly. But walking becomes very difficult when the knee locks and loses range of motion. Knee locking happens when it will neither completely bend nor completely straighten because something is caught.
After a day or two, the knee may swell with fluid accumulation surrounding the joint. The knee could later feel stiff but the symptoms may subside and the pain may become intermittent. This is due to the lack of nerve endings in your cartilage. After 4-to-6 weeks, the pain and swelling may subside and daily living activities may become more tolerable. However, once athletic activity starts back, unfortunately the pain and swelling usually does, too.
Meniscus Tear Causes
A torn meniscus happens when there is an injury or trauma to the knee, which can occur suddenly or over time due to degeneration of tissue. Often times, the lateral surface of the leg gets pushed medially resulting in a cartilage tear. This can be both painful and restrictive to the movement of the knee.
- Meniscal tears can occur with the twisting or sudden direction change of the knee. (3) Many times it occurs alongside other injuries such as an ACL (anterior cruciate ligament) or MCL (medial cruciate ligament) tear.
- Usually, an unnatural rotation or twisting of the leg can cause the cartilage of either meniscus to tear partially or fully. Twisting injuries occur when the knee rotates but the foot stays fixed in position. The impact from action sports, such as football, snowboarding and basketball, to the front or side of the knee can cause this type of injury.
- In addition, an extreme bending or over-rotation of the knee can tear a meniscus due to a planting or cutting force on the knee.
- Movements including bending, rotation and fast kicking are associated with lateral meniscal tears.
- Even everyday activities, like getting in and out of the car, standing too quickly or falling/slipping can cause a torn meniscus in someone who’s susceptible. (4)
Torn Meniscus Diagnosis
Doctors normally perform a physical exam to diagnose a torn meniscus. Signs like swelling, tenderness on the joint line of the knee, loss of motion and pain with special twisting maneuvers can all indicate a meniscus tear.
Usually a diagnostic test such as an MRI can also reveal to a doctor the location and severity of a meniscus tear, which helps to determine the treatment approach.
Anatomy of the Meniscus and Knee
What is a meniscus? A basic meniscus definition is “a crescent-shaped fibrous cartilage between the bones at certain joints, especially in the knees.” (5)
The knee is made up of the femur, the tibia and the patella bones. Ligaments hold the bones of the knees together. The articular capsule at the knee joint is thin and in some areas is incomplete, but is strengthened by various ligaments and tendons of associated muscles.
The knee is a hinge joint and is considered to be even more complex than the elbow or ankle joints. The two menisci in each knee help to sit around the joint acting as shock absorbers for any of the impact on the leg and knees. They also provide stability and allow for smooth movement. Menisci serve as protective cushions around the protrusions at the end of the femur bone, preventing it from rubbing the tibia.
- The meniscus is a pad of fibro-cartilage situated between opposing bones within a synovial joint. It is a rubbery flexible piece of cartilage that provides cushioning between the bones of the knee.
- The meniscus functions to improve the fit between the femur (thigh bone) and the tibia (shin bone).
- Menisci are also called articular discs. They help to regulate the flow of synovial fluid which protects the bones from wear and tear. Additionally, menisci help balance out the overall weight distribution of the knees.
- The meniscus has blood supply only at its outer attachments, which can making it very difficult to heal if a serious meniscus tear has occurred.
Medial vs. Lateral Meniscus Tear:
- The medial meniscus is located in a C-shape on the inside of the knee. The lateral meniscus is located on the outer side of the knee in a U-shape.
- Together they help to stabilize the knee and facilitate movement between surfaces of the knee.
- A lateral meniscal tear will radiate to the outside of the knee, while a medial meniscal tear will radiate towards the inside of the knee.
Conventional Torn Meniscus Treatment
Many factors can affect torn meniscus recovery time. These factors include a patient’s age, activity level, type of meniscus tear, symptoms and location of the tear. All of these help to inform doctors as to which type of torn meniscus treatment will be best.
What happens if you leave a torn meniscus untreated? Can a meniscus tear heal without surgery?
The outer portion of the meniscus called the “red zone” has a good blood supply and can sometimes heal on its own if a tear is small. The inner portion of the meniscus is called the “white zone” and does not have a good blood supply, making it very difficult to heal by itself. If left untreated, it can cause further problems such as osteoarthritis and other undesirable joint issues.
Here’s the good news regarding medial meniscus and lateral meniscus tears: once treated, recovery is usually pretty smooth and the knee will usually function normally for years. However, getting to this point can take anywhere from 3 weeks to 3 months, depending on the severity of the injury. If you’re young, active and mostly healthy, you will likely recover well with physical therapy and rest, and may not need any surgery/invasive procedures at all.
A number of different treatments may be recommended to heal a torn meniscus, including:
- Resting and icing the affected area.
- Anti-inflammatory medications to reduce pain and swelling, such as NSAIDs or Ibuprofen.
- Physical therapy to restore functionality and strength.
- Use of a meniscus tear brace.
- Electrical stimulation — Neuromuscular electrical stimulation of muscles in the knee may be used to strengthen the meniscus and surrounding tissue.
- Injections — Corticosteroid injections can be used to relieve pain or inflammation in the soft tissue of the knee. This can be a temporary fix, but may ultimately lead to later meniscus surgery.
- Torn meniscus surgery — A medial or lateral menisectomy can be done by removing part of the meniscus that is torn. Or, if the tear is in the “red zone”, the orthopedic surgeon may choose to repair it instead. Surgery can be done arthroscopically or open. The arthroscopic treatment is a minimally invasive treatment with a much shorter recovery time than an open repair. During torn meniscus surgery, the orthopaedic surgeon inserts a miniature camera instrument through a small incision or portal and can repair the meniscus or complete a menisectomy in a short amount of time. Torn menisci that do not cause the knee to catch or lock are less likely to require surgery. In this case, symptoms like swelling symptoms can be treated with over the counter pain medications.
Doctors might choose to take a “watch and wait” approach for about six weeks when a patient has a torn meniscus, checking to see if swelling and pain decrease. If they don’t, many experts feel that it’s unlikely that the tear will heal without surgery.
There is much research today looking into complications that may occur after removing the meniscus in an affected knee. According to recent study, “lack of vascularity in the human knee meniscus often leads to surgical removal (total or partial meniscectomy) in the case of severe meniscal damage. However, complete recovery is in question after such removal as the meniscus plays an important role in knee stability. Thus, meniscus tissue regeneration strategies are of intense research interest in recent years.” (6)
5 Natural Treatments for a Torn Meniscus
1. “RICE” Intervention ASAP to Manage Swelling
RICE stands for “Rest, Ice (Intervals), Compress, & Elevate.” You’ll want to immediately take time to rest and recover if you’ve suffered from a torn meniscus or another knee injury, starting by lifting up your affected leg above the level of your heart to reduce swelling and icing to control pain. Use cold/ice packs for about 20 minutes, several times a day.
Your doctor might also recommend you wear an elastic compression bandage, use crutches or wear a brace for a period of time in order to limit weight bearing, swelling and movement of the knee.
2. Physical Therapy
Before surgery is performed to repair a meniscus, physical therapy is considered the first line of defense. (7) Physical therapy for about 4–6 weeks (and sometimes longer) is recommended to help strengthen and stretch the muscles that support the knee, which will slowly rebuild functionality and range of motion. (8)
Working with a physical therapist is the best way to learn how to correctly and safely perform meniscus tear exercises and stretches. According to reports from the Mayo Clinic, it is important to complete certain exercises to help the knee heal properly and to avoid chronic pain or an unstable knee.
Physical therapy for a torn meniscus will focus on gently stretching first, and then strengthening the hamstrings and quadriceps to help support the knee and prevent muscle imbalances. Imbalances can cause pressure on the knees as your body overcompensates. Overtime and with repeated repetitive movements, joints can be stretched out of place and misaligned. But studies have found that strengthening weak muscles in the legs will help evenly distribute your weight and create more stability, preventing pain. (9)
During recovery, it’s recommended that someone with a torn meniscus avoid pivoting, twisting and squatting that can aggravate symptoms. One goal initially should be to work on improving range of motion and keeping the quadricep muscles strong in order to help increase knee stability. At first, quadriceps setting exercises should be done with the knee mostly straight, such as with straight-leg raises or “mini-squats” that require bending the knee only to about 15 degrees. (10)
3. Meniscus Tear Exercises
Below are some of the best meniscus tear exercises to practice in order to support recovery:
- Flexion/Extension Exercise — This can be done standing or sitting; simply bend and straighten the knee as far as the pain and range of motion will allow you. Shoot for 3 sets of 10–20 reps.
- Straight Leg raises — Lie on your back with one knee bent upwards while keeping the other leg straight and on the ground.Tighten the muscles on your straight as you contract your quadricep, then slowly lift the leg about six inches off the floor. Keep contracting as you hold for several seconds, then slowly lower and repeat about 10 times.
- Heel slides — Lie on your back with one knee bent upwards while sliding the heel along the ground. The heel should slide as far as possible towards the buttocks repeating 10–20 times on each leg.
- Calf raises — Stand with feet shoulder width apart and hold the wall if needed for balance. Lift heels up as high as possible off the floor and slowly back down. Try for 2–3 sets of 15–20 repetitions.
- Hip abduction — Stand on uninjured leg only and take the injured leg out to the side as far away from the body as possible.
4. Posture Correction and Soft Tissue Therapies
Physiotherapy usually starts with a posture analysis, followed by physiotherapy posture correction treatments. A number of different soft tissue therapies can help to improve flexibility and reduce pain while healing, such as myofascial massage, stretching, rolfing and mobilization.
Many patients can benefit from visiting a chiropractor or rolfing specialist for an assessment, treatment and management of soft tissue injury. Not only can a postural specialist help to reduce pain and dysfunction, but they can uncover contributing problems that cause knee pain such as pronation abnormalities, which affect someone’s gait, weak glutes and hips, a weak core or iliotibial band syndrome. (11)
Laser therapy can also be used as a safe, effective, non-invasive, painless alternative. It can reduce pain, strengthen the muscles around the knee joint and increase the range of motion. (12)
5. Anti-Inflammatory Diet and Supplements
You can help to reduce inflammation and boost your body’s ability to heal by eating a healthy diet and taking certain supplements. Nutrient-dense, anti-inflammatory foods to emphasize include:
- A variety of vegetables and fruits, especially leafy greens, cruciferous veggies, berries, sea vegetables, etc.
- Quality proteins, including wild caught fish, eggs and grass-fed meat
- Nuts and seeds
- Healthy fats such as coconut oil, olive oil, avocado, etc.
- Plenty of water, bone broth and green tea
- Supplements that help protect the health of your joints and connective tissue as you get older, including: turmeric, ginger, berry extracts, bromelain and omega-3 fatty acids
Increasing collagen consumption may help in tissue repair and have anti-aging effects. In fact, 70 percent of each meniscus is made up of a network of type I collagen, which forms connective tissue, repairs wounds and keeps joints strong. (10)
If you experience torn meniscus symptoms, always visit your doctor for an evaluation rather than treating the problem on your own. Plan to take some time to recover and slowly gain back strength.
Start with basic stretches and exercises before you move onto more advanced exercises like those using weights, deeper squats and harder stretches. Never perform exercises or stretches that cause lots of pain, since this can be counterproductive and delay healing.
- A torn meniscus is an injury that causes certain tissue in the knee to tear. A torn meniscus and other meniscus injuries are very common injuries, especially among athletes, older adults and people with arthritis.
- Causes of a meniscus tear include: degeneration of joints; twisting, rotating, over-bending the knee; sudden kicks, jumping and landing; and sometimes everyday activities like getting up and down.
- Torn meniscus treatment options include: resting and icing the affected area (known as “RICE”), anti-inflammatory medications or steroid injections to reduce pain and swelling, physical therapy to restore functionality and strength, use of a meniscus tear brace, electrical stimulation, and in some cases, torn meniscus surgery.
- With proper diagnosis, treatment and rehabilitation, patients often return to their pre-injury abilities. Torn meniscus recovery time depends on how severe the tear was, the person’s age and health, and their level of activity.