How To Heal A Torn Meniscus Naturally

Permanence of menisci injuries depend on where they’re located.

How To Heal A Torn Meniscus Naturally | Exercises And Non-Surgical Remedies

Several studies have shown how non-surgically mending your torn meniscus can lead to equal, if not better outcomes than its more invasive counterpart.(1,2) But, all these studies also use specific types of meniscal tears for their research, making how to heal a torn meniscus naturally dependent on a few things.

• The severity and type of your injury
• Where the tear is located

If all these check out, healing a meniscus naturally comes down to controlling the inflammation, getting stronger and adequately flexible, and improving your balance and mechanics.

I’ll talk you through each of those in detail shortly but I think it’s best if you also knew about a few other important things, such as if your meniscus can actually heal on its own and the time you need to let it heal.

How do you heal a torn meniscus without surgery?

All in all, the goal of treatment, natural or otherwise, is to control both pain and inflammation, get your range of motion back to normal, and help get you stronger muscles.

If you had the injury from a certain sport, an added goal would be to improve certain mechanics that may have contributed to your meniscus injury.

All these are addressed in physical therapy but your therapist will also give you exercises and remedies to do at home, including the following:

PRICE

PRICE is short for:

• Protect – This means shielding your knee from any more injury. For meniscus tears, this generally means walking with crutches.
• Rest – Again, this may also mean walking with crutches. This takes all or some pressure away from your knee, allowing the injury to heal unhampered.
• Ice – Theoretically, ice (i.e. cryotherapy) slows down your body’s inflammatory response to trauma which then reduces swelling and pain.(3)
• Compress – The Annals of Vascular Diseases says that compression therapy is underestimated in terms of managing inflammation. Whether it be through bandages, stockings, or knee sleeves, compression helps your veins return blood from your injury.(4)
• Elevate – Elevating your injured leg essentially has the same benefits as ice and compression which is to regulate blood flow from pooling around your knee joint. This can be done by putting a pillow or two under your knee while you’re lying down.

All these are done during the initial stages of your injury because, in theory, the faster you reduce pain and swelling, the faster you can also get back to your pre-injured state.

Just a few notes though:

• When using crutches, you likely will have to use 2 of them in the beginning. But, once your injury gets suitably better, your doctor or physical therapist will have you graduate to using just 1 and, ultimately, none.
• When using 1 crutch, place it opposite the side of the injury.
• Never ice your injury for more than 20 minutes.
• Ice multiple times a day but only until the swelling goes down – which is about 2 days. After that, switch to using heat so you don’t compromise the healing process.
• Don’t leave your compression bandage/sleeve on overnight.

Pain and anti-inflammatory meds

Like PRICE, pain and anti-inflammatory drugs are treatments done particularly during the early stages of injury. Though, depending on your tolerance and specific case, these may extend towards the later stages.

Nevertheless, you’re essentially looking at 2 kinds here:

• Over-the-counter (OTC) medicine – These include acetaminophen and NSAIDs (non-steroidal anti-inflammatory drugs) like Advil and Tylenol.
• Prescription drugs – These mostly include corticosteroids and possibly other narcotics that reduce pain and swelling more powerfully. However, you’d need your doctor’s approval before you can get any of these.

OTC meds are more commonly used (often before prescription drugs are given) largely because the medical community deems it safer.(5)

Plus, the pain and inflammation from most meniscus injuries are fairly manageable with PRICE, so the need for stronger prescription drugs is uncommon.

Having said that, please use any of these meds sparingly as even NSAIDs and acetaminophen can have serious side effects and may even hamper your recovery when abused.

Strengthen the muscles in and around your knee

If you ask me, this is where physical therapy really shines, as well as in improving your mobility and balance (which we will talk more about later on).

That being said, resistance training has shown capable of strengthening ligaments, tendons, cartilage, and other connective tissues – benefits you want to have to fully recover from your torn meniscus.(6)

However, please remember to progress gradually.

While your knee injury is still recovering, start with isometric exercises.

These are exercises where you contract your muscles without moving the joint. This helps preserve the strength of your muscles while you’re unable to participate in full-on exercise. It also helps stabilize the knee.

Focus on your quads and hamstrings during this stage.

• For your quads, you could place a rolled towel under your knees and attempt to push it down. The towel helps keep your knees in a slightly bent position while preventing movement.
• For your hamstrings, the same position – knees slightly bent with a rolled pillow under your knees – but this time, push your heel down.

Additional notes:

• For both muscles, hold the contraction for 5-10 seconds and repeat 10 times. Do this several times a day.
• When you can fully extend your knees on your own, move on to straight leg raises: While lying down on your back with your uninjured leg bent to about 90 degrees, raise your injured leg about 6-12 inches up, hold for 3-5 seconds, then slowly bring it back down. Relax and repeat a total of 10 times.
• Though not an isometric exercise, you may also do side-lying hip abduction exercises.

When you’ve graduated from using crutches, gradually progress your exercises.

First of all, you can also progress your rehab even while you’re on crutches but the primary goal is to get your range of motion back to full.

But, just for the sake of strength training, I like to use getting off of crutches as a sign that I can push patients (i.e. you) a little harder because the meniscus tear has now healed enough to allow it.

To start, try the following exercises:

• Partial wall squats – Stand against a wall with both feet shoulder-width apart and about a foot in front of the wall. Slowly slide your body down, making sure that you bend your knees only to the point where it’s painless. Hold for 3-5 seconds then slowly slide back up.
• Calf raises – Have a chair/table in front of you so you can touch it with your fingers for added stability. Now, with both feet shoulder-width apart, stand on your tippy-toes. Hold for 3-5 seconds then slowly lower yourself down.
• Prone hamstring curls – Lie down on your belly. Slowly bend your knee as much as you can, hold it for 3-5 seconds, then slowly straighten it back down.
• Glute bridges – Lie down on your back with your hips and knees bent, feet flat on the surface, and hands to your sides for stability. Lift your butt off the bed/ground until your knees, hips, and chest form a straight line. Hold for 3-5 seconds then slowly go back down.
• Clamshells – Lie down on your side with your hips and knees bent in front of you. You may also support your head with your hands. Next, slowly raise your knees. Do not raise beyond the point where your hips and torso are forced to rotate. Hold the position for 3-5 seconds then slowly lower.

The exercises above are fairly basic but they can be challenging for anyone recovering from knee injuries. They also work all of the major muscles of your legs, including your glutes (hips), quads, thighs, and calves.

Repeat them all a total of 10 times; Do 3 sets of those repetitions (or less if it’s still intolerable). You will gradually get stronger and the pain and swelling will fade.

When that happens, here are a few other ways you can progress your exercises:

• Use resistance bands. These inexpensive tools are particularly great for glute bridges and clamshells.
• Use machines. These apply to all of the above exercises. Some examples would include the leg press, leg curl machine, seating/standing calf raise machine, and abduction/adduction machine.
• Use physioballs. Otherwise known as theraballs and stability balls, these bouncy rubber balls are light and can come in many sizes. They can be used to make glute bridges, prone hamstring curls, and squats more challenging.

Improve your flexibility

Strength and flexibility go hand-in-hand. Excelling in just one cannot adequately protect you from injury. And, again, a few good physical therapy sessions can help. But, you could also do a few things on your own. Here are a few examples:

• Supine hamstring stretch w/ a towel – Lie on your back with both legs straight. Use a towel under your foot (injured side) to raise your leg until you feel a stretch at the back of your thighs. Hold for 20 seconds, slowly lower your leg, relax, and repeat a total of 3 times. Remember not to fight back the stretch as this could activate your hamstrings and possibly be painful.
• Prone quads stretch w/ a towel – Lie on your belly with a towel in front of your ankles. Hold on to the ends of the towel with both your hands and use it to gently bend your knees until you feel a stretch in front of your thighs. Hold the stretch for 20 seconds, slowly release, relax, and repeat a total of 3 times.
• Standing calf stretch – Stand facing a wall and leave about a foot’s distance between you and the divider. Place your hands on the wall for support. Step back with your injured leg then slowly lean forward until you feel a stretch on your calf. Remember to always keep your foot flat on the ground. Hold for 20 seconds, slowly lean back into position, relax, and repeat a total of 3 times.
• Stationary bike – This serves multiple purposes: 1) for cardio and 2) for promoting knee mobility. If available, choose recumbent bikes or ones where your legs are in front of you rather than directly below you.

Before we move on, know that there are risks to stretching an injured leg without supervision. You could be stretching too aggressively and too soon for the stage of recovery you’re in, for example.

So, for safety purposes, I think it’s best to have your physical therapist show you how it’s properly done. But, if you don’t, just keep in mind to only do stretches and exercises that you can safely tolerate.

Balance and return-to-sport exercises

All those stretching and strengthening exercises I just mentioned? Yeah, they all lead here. Strong and flexible muscles won’t do much without control – and with control comes balance.

Basically, the goal is to keep your center of gravity in line so you don’t fall and/or suffer injuries.

Now, while it’s great to have a physical therapist and/or a trainer guide you through this, there are a bunch of basic balance exercises you can do on your own, including:

• Stand on one leg – On a flat and stable surface, slightly bend your hips and knees on one side so you’re only standing on one leg. Make sure the knee you’re standing on isn’t rotated to either side. Hold this for 60 seconds or for as long as you can, relax, and repeat with the other leg. If it gets too easy, try this with your eyes closed or on a Bosu ball.
• Perturbation exercises – With the help of a friend, have him/her nudge you in whichever direction they want. Make sure both your feet are planted firmly on the ground and you maintain good posture. The point of the exercise is to train both your ankles and hips to adjust your center of gravity back to midline without having you take a step. If this gets too easy, you may proceed to one-leg perturbations, closed eyes perturbations, Bosu ball perturbations, or a combination of all three.

Can a meniscus tear heal on its own?

Yes, but here’s the thing: A meniscus tear will heal only if the tear is located at the part of the meniscus with blood supply (i.e. the red zone).

Luckily, only 19% of the meniscus tears happen in the part with no circulation (i.e. the white zone), so most tears can heal naturally to some degree.(7)

Degenerative meniscus tears also can’t heal on their own.

For the types of tears that won’t naturally heal, ask your doctor to provide medical advice.

What Is the Recovery Time for a Meniscus Tear Without Surgery?

It could be as fast as 4 weeks for minor tears but it could also take up to 12 weeks (3 months) for more severe cases.

However, an underrated part of recovery is your adherence. So, if you want to get back to your usual activities faster, I highly suggest you be diligent with your stretches and exercises and be careful not to cause further injuries.

FAQ:

Will a knee brace help with a meniscus tear?

Yes, knee braces can help with meniscal tears. They add more stability and help limit excessive movement which, in turn, may help relieve pain.

What is the best exercise for a torn meniscus?

There isn’t one specific exercise for injured menisci but programs should be aimed at improving strength, flexibility, balance, and control.

Is a torn meniscus a permanent injury?

Permanence of menisci injuries depend on where they’re located.

– Single-trauma injuries to the outer third (red zone) can heal because it has sufficient blood supply.
– The inner third (white zone), however, will not because of the lack of circulation.
– The middle third (red-white) zone can heal but it might not fully recover or take a while longer.

Damage to the inner and middle thirds of the meniscus may require surgery to reduce joint pain and swelling. Surgical options include repair or removal of all or part of the cartilage (i.e. total and partial meniscectomy).

Degenerative meniscus tears also won’t heal naturally and may develop into arthritis with age. If you’re unsure, I highly recommend seeking a professional’s medical advice.

Conclusion

Meniscus tears are one of the most common knee injuries in sports and while they may sideline you for a little bit, effective treatment options via surgery and natural means are available.

If you and your doctor opt for the latter, the good news is the generally shorter recovery time. Focus on improving your strength, flexibility, and control. And, while you’re at it, maybe ask a trainer how you can improve your technique.

Resources

1. Graaf, Victor A. van de, et al. “Effect of Early Surgery vs Physical Therapy on Knee Function Among Patients With Nonobstructive Meniscal Tears.” JAMA, vol. 320, no. 13, 2018, p. 1328. Crossref, doi:10.1001/jama.2018.13308
2. Katz, Jeffrey N et al. “Surgery versus physical therapy for a meniscal tear and osteoarthritis.” The New England journal of medicine vol. 368,18 (2013): 1675-84. doi:10.1056/NEJMoa1301408
3. Vieira Ramos, Gracielle et al. “Cryotherapy Reduces Inflammatory Response Without Altering Muscle Regeneration Process and Extracellular Matrix Remodeling of Rat Muscle.” Scientific reports vol. 6 18525. 4 Jan. 2016, doi:10.1038/srep18525
4. Partsch, Hugo. “Compression therapy: clinical and experimental evidence.” Annals of vascular diseases vol. 5,4 (2012): 416-22. doi:10.3400/avd.ra.12.00068
5. Dhalla, Irfan A et al. “Opioids versus nonsteroidal anti-inflammatory drugs in noncancer pain.” Canadian family physician Medecin de famille canadien vol. 58,1 (2012): 30. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3264005/
6. Fleck, S J, and J E Falkel. “Value of resistance training for the reduction of sports injuries.” Sports medicine (Auckland, N.Z.) vol. 3,1 (1986): 61-8. doi:10.2165/00007256-198603010-00006
7. Cinque, Mark E et al. “Clinical Outcomes of Inside-Out Meniscal Repair According to Anatomic Zone of the Meniscal Tear.” Orthopaedic journal of sports medicine vol. 7,7 2325967119860806. 25 Jul. 2019, doi:10.1177/2325967119860806

Torn Meniscus Symptoms, Causes & Natural Treatments

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 a thletes 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, t he 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, m enisci 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, t he 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)

Drinking bone broth is a good way to consume collagen and other beneficial compounds like glucosamine, chondroitin and hyaluronic acid, which are supportive of connective tissue/joint health.

Precautions

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.

Final Thoughts

• 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: r esting and icing the affected area (known as “RICE”), a nti-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. T orn meniscus recovery time depends on how severe the tear was, the person’s age and health, and their level of activity.

How To Heal A Torn Meniscus Naturally

If you have, or suspect you have a torn meniscus, and you’re wondering how to heal a torn meniscus naturally, you’ve landed on the right post.

You may be wondering: Do I need surgery? Can you heal a torn meniscus naturally? The short answer is: It depends.

What Is a Meniscus?

The meniscus is a fibrocartilage structure that sits on top of the tibia (lower leg bone). There is one on the medial (inside) aspect of the knee, one on the lateral (outside) aspect of the knee. It is shaped like a C and provides some cushion and support for the knee joint as it acts as a shock absorber.

How Can You Tear Your Meniscus?

A meniscus can be torn with particular injuries typically with sports, twisting, deep knee bending, rotating, or high-intensity type activities, which can sometimes cause some pain and dysfunction. Also, it can just gradually tear or wear out through degeneration throughout the years as we age, which may or may not cause any symptoms whatsoever. Most people believe that if they see a torn meniscus on MRI this automatically means that they may need to have surgery to fix the issue, but this is usually not the case. In fact, if you just get MRIs of people over age 35, most people would likely have a meniscal tear, and most of those folks will not have any symptoms of knee pain whatsoever (1).

Meniscal Surgery Outcomes and Complications

Again, many people believe that meniscal surgery is needed if a meniscal tear is found on MRI and you have some knee pain. However, what is the evidence that having a meniscal surgery would help, and what are the types of meniscal surgeries? About ninety-six percent of the meniscal surgeries that are performed currently are meniscectomies, where the part of the meniscus that is torn or injured is cut and removed.

This is despite many times this being called a meniscal “repair.” Another type of surgery, which is rarer, which is a true meniscal repair is where parts of the meniscus are sewn back together to try to get that meniscus to heal up rather than removing a piece of tissue. Most of the research on arthroscopic surgery, (going in with a scope) for partial meniscectomy shows that the surgery does not work. There was a 2013 study showing that it could not beat physical therapy (2).

There is another study that showed that there was no difference from a fake surgery where you just went in with a scope and performed no procedure (3). Another study showed that surgery was no better than placebo therapy even when the patient had locking and mechanical-type symptoms with a meniscal tear (4). There is even further evidence that suggests that meniscal surgery does not work and can even be harmful to the knee, as removing parts of the meniscus alters the biomechanics of the knee, puts more stress and wear on the cartilage, progressing arthritis at a much faster rate, and, more commonly, leads to a knee replacement (5,6).

There is another study that showed patients that had meniscal surgery were 2.5 times more likely compared to the knee without surgery, even if it had a meniscus tear, to require knee replacement (7,8). Are there any patients that should get this type of surgery? There may be a handful of folks that do have some true mechanical clicking from a specific flap or bucket-handle tear of the meniscus that are not getting better with physical therapy or conservative measures but that is few and far between whereas right now meniscectomy is the most common elective orthopedic surgery despite having multiple research papers showing that it does not work and makes you worse. A true meniscal repair sounds like a much better idea and but is less commonly performed. It usually only can be performed on folks without arthritis, younger people, and only with specific types of tears.

Types of Meniscal tears

Meniscal tears come in a variety of different types, which can affect potential treatments, symptoms or relevance.

1. One type of tear is a radial tear, which is just a left to right tear across the meniscus (see Figure 2 – top row, middle). These are the most common types. Most commonly they are in what we call the white zone of the meniscus where it does not get much blood supply. Thus they are hard to heal naturally, so if you see a surgeon they will likely try to cut this part out despite the evidence saying that a meniscectomy does not work.

1. The next type of tear is a horizontal tear, which is basically an up and down or front to back tear in the meniscus (see Figure 2 – top row, left). Many times these tears are in a portion of the meniscus that does get blood supply so they could potentially heal on its own. If they do not heal naturally then surgical repair can sometimes be tried to help.
2. The next type of tear is a complex tear where you have a combination of different tears where it can be torn in multiple areas of the knee (see Figure 2 – bottom row, middle). Oftentimes when the surgeon sees these, they would attempt a meniscectomy again because most of the time these are difficult for them to try to repair.
3. Next type of tear is an intrasubstance tear. Usually these are just degenerative tears in the midportion of the meniscus. Typically, surgeons will not even try to operate on these. After age 30, these are very common findings of a meniscal tear on MRI, which is of little consequence.
4. Another type of tear is a bucket-handle tear. This is a tear where the meniscus is torn and flipped over like a bucket-handle (see Figure 2 – bottom row, left). These sometimes can cause some catching or alter the motion of the knee. If that is the case then those would be the rare type of tear that actually would need surgery.
5. The next type of tear is a flap tear where a small piece of meniscus can be torn and flipped over (see Figure 2 – bottom row, right). Sometimes this can cause some catching of the knee, sometimes it does not hurt. If there is no catching in the knee, then it would not warrant any surgery to remove that part of the meniscus. If it is causing some catching or altering motion of the knee that might be a rare case where surgery may be indicated.
6. Lastly, another rare type of tear is a tear in the root of the meniscus, which was the back part of the meniscus that anchors it onto the tibia. Depending on the nature of this tear, this one can be something that may need some surgical repair to hold it down, but again meniscectomy would not be a good choice for this as this can increasingly make the meniscus more unstable.
7. The meniscus also can be what is called extruded, where it sticks out the joint either from natural tearing or from after a meniscectomy. When a meniscus extrudes after surgery it is more abrupt and tends to progress arthritis much faster, whereas if it happens naturally, it is more of a gradual change that your body can many times adapt to.

Natural Remedies For a Torn Meniscus

If you have knee pain and have been told you have a suspected meniscal tear either from an exam or from MRI, much of the time this can heal on its own with 4-6 weeks of rest, doing some physical therapy that would focus on some range of motion and strengthening exercises and correcting any biomechanical problems that may stem from the core, back, hips or the ankles. Nutritional support such as just working on a healthy diet, reducing inflammation in the body, taking some turmeric, fish oil, glucosamine, and chondroitin, can help knee pain and inflammation as well.

Treatments For A Meniscal Tear Without Surgery

1. If you go to most pain practices if you fail physical therapy and surgery is not recommended, they may recommend a steroid injection, which can help temporarily reduce inflammation in and around the knee and meniscus, but this is not advised as steroids as we know can cause damage to the joint cartilage, inhibit healing, and has a host of other negative side effects.
2. An injection of something called hyaluronic acid, which is a naturally occuring substance that makes up part of the lubricating fluid of the knee joint, could be used for temporary pain relief. It does not help repair the area but may provide a few months of symptomatic benefit if there is not severe arthritis in the knee.
3. If you actually want to try and get the body to heal that meniscus on its own when rest and physical therapy has not do the job, PRP has excellent evidence that it helps with meniscal injuries as well as mild to moderate arthritis that can be associated with these issues. PRP, when used in the right hands, should be injected precisely with ultrasound guidance into the torn parts of the meniscus, into any ligaments or tendons that may be injured or loose, and into the knee joint itself for optimal results. Many practitioners just inject into the knee, which still can help quite a bit but not as much as if a more thorough approach is taken. There are more than 25 high level studies showing PRP helps with knee pain (Orthopedic Bone Marrow Stem Cell Historical Timeline (netdna-ssl.com)).
4. Bone marrow concentrate that contains the patients stem cells can also be used to promote the body’s healing in more severe meniscal tears or if there are meniscal tears with more moderate to severe arthritis. There are a few randomized control trials that show that this can be helpful for that as well (9-11). Again, you want to have a thorough skilled approach to make sure that image guidance is used, and all of the damaged parts of the meniscus and associated areas of the knee such as tendons, ligaments, and joints are injected as well.

The latter two options are what we focus on at the Centeno-Schultz Clinic, promoting the body’s ability to heal itself with highly specific image-guided procedures that use the body’s own PRP and bone marrow concentrate. These Interventional Orthopedic procedures, performed by board certified specially trained physicians maintain the natural anatomy and structure of the joint, and have more research that is positive than meniscal surgeries. On the other hand, the research on Meniscal surgery shows that except for the rare cases of a flap or bucket-handle tear that can cause mechanical symptoms the surgery is largely ineffective.

Bottom Line

Meniscal tears are common findings in the knee, which many times are of little clinical significance.

If a meniscal tear is associated with pain, depending on the tear, most of these can be handled with nonsurgical treatment measures. When the traditional measures of rest, physical therapy, diet and supplements fail, then PRP and bone marrow concentrate for more severe problems can be a great alternative to help the body heal itself, reducing pain, keeping the natural anatomy, and reducing the risk for future surgeries. Meniscal surgery, despite being the most common orthopedic surgery has little evidence to support it and actually good evidence to suggest that we should eliminate the majority of these types of surgeries. If you or anyone you know has a meniscal tear or knee pain and are interested to see if you are a candidate for our non-surgical treatment for knees, please contact us. We are world experts at helping the body heal itself through regenerative measures for orthopedic problems.

References

(1) Risberg MA. Degenerative meniscus tears should be looked upon as wrinkles with age—and should be treated accordingly. British Journal of Sports Medicine 2014;48:741. http://dx.doi.org/10.1136/bjsports-2014-093568

(2) Katz JN, Brophy RH, Chaisson CE, et al. Surgery versus physical therapy for a meniscal tear and osteoarthritis [published correction appears in N Engl J Med. 2013 Aug 15;369(7):683]. N Engl J Med. 2013;368(18):1675–1684. doi:10.1056/NEJMoa1301408

(3) Sihvonen R, Paavola M, Malmivaara A, Itälä A, Joukainen A, Nurmi H, Kalske J, Järvinen TL; Finnish Degenerative Meniscal Lesion Study (FIDELITY) Group. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med. 2013 Dec 26;369(26):2515-24. doi: 10.1056/NEJMoa1305189.

(4) Sihvonen R, Englund M, Turkiewicz A, Järvinen TL; Finnish Degenerative Meniscal Lesion Study Group. Mechanical Symptoms and Arthroscopic Partial Meniscectomy in Patients With Degenerative Meniscus Tear: A Secondary Analysis of a Randomized Trial. Ann Intern Med. 2016 Apr 5;164(7):449-55. doi: 10.7326/M15-0899.

(5) Netravali NA, Giori NJ, Andriacchi TP. Partial medial meniscectomy and rotational differences at the knee during walking. J Biomech. 2010 Nov 16;43(15):2948-53. doi: 10.1016/j.jbiomech.2010.07.013.

(6) Cohen SB, Short CP, O’Hagan T, Wu HT, Morrison WB, Zoga AC. The effect of meniscal tears on cartilage loss of the knee: findings on serial MRIs. Phys Sportsmed. 2012 Sep;40(3):66-76. doi: 10.3810/psm.2012.09.1983.

(7) Longo UG, Ciuffreda M, Candela V, Rizzello G, D’Andrea V, Mannering N, Berton A, Salvatore G, Denaro V. Knee Osteoarthritis after Arthroscopic Partial Meniscectomy: Prevalence and Progression of Radiographic Changes after 5 to 12 Years Compared with Contralateral Knee. J Knee Surg. 2019 May;32(5):407-413. doi: 10.1055/s-0038-1646926.

(8) Katz JN, Shrestha S, Losina E, Jones MH, Marx RG, Mandl LA, Levy BA, MacFarlane LA, Spindler KP, Silva GS; MeTeOR Investigators, Collins JE. Five-year outcome of operative and non-operative management of meniscal tear in persons greater than 45 years old. Arthritis Rheumatol. 2019 Aug 20. doi: 10.1002/art.41082.

(9) Centeno C, Sheinkop M, Dodson E, Stemper I, Williams C, Hyzy M, Ichim T, Freeman M. A specific protocol of autologous bone marrow concentrate and platelet products versus exercise therapy for symptomatic knee osteoarthritis: a randomized controlled trial with 2 year follow-up. J Transl Med. 2018 Dec 13;16(1):355. doi: 10.1186/s12967-018-1736-8. PMID: 30545387; PMCID: PMC6293635.

(10) Hernigou P, Bouthors C, Bastard C, Flouzat Lachaniette CH, Rouard H, Dubory A. Subchondral bone or intra-articular injection of bone marrow concentrate mesenchymal stem cells in bilateral knee osteoarthritis: what better postpone knee arthroplasty at fifteen years? A randomized study. Int Orthop. 2020 Jul 2. doi: 10.1007/s00264-020-04687-7. Epub ahead of print. PMID: 32617651.

(11) Hernigou P, Delambre J, Quiennec S, Poignard A. Human bone marrow mesenchymal stem cell injection in subchondral lesions of knee osteoarthritis: a prospective randomized study versus contralateral arthroplasty at a mean fifteen year follow-up. Int Orthop. 2020 Apr 23. doi: 10.1007/s00264-020-04571-4. Epub ahead of print. PMID: 32322943.

John Pitts, M.D.

Dr. Pitts is originally from Chicago, IL but is a medical graduate of Vanderbilt School of Medicine in Nashville, TN. After Vanderbilt, he completed a residency in Physical Medicine and Rehabilitation (PM&R) at Emory University in Atlanta, GA. The focus of PM&R is the restoration of function and quality of life. In residency, he gained much experience in musculoskeletal medicine, rehabilitation, spine, and sports medicine along with some regenerative medicine. He also gained significant experience in fluoroscopically guided spinal procedures and peripheral injections. However, Dr. Pitts wanted to broaden his skills and treatment options beyond the current typical standards of care.

Related Posts

• 6 Meniscus Tear Types And How To Treat Them Properly
• How to Avoid Knee Replacement: A Quickstart Guide
• How to Read a Knee MRI for Meniscal Tear
• 7 Most Common Symptoms of a Loose Knee Replacement
• How to Read Knee MRI

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