In this video, I'm going to answer the 12 top most asked questions about knee pain from
a torn meniscus.
Let's get right into it.
Number one, can a meniscus tear heal on its own?
Absolutely, yes.
This is the most asked question I get all the time because people automatically think
that you need to have a surgery if you have a torn meniscus.
But the reality is you can allow your meniscus to flare down.
If it's hurting you right now, it's probably flared up.
You may have found out that you have a meniscus tear, if you had an MRI or you had some testing
done by a specialist, but it can heal.
Now curing a meniscus is questionable, it can heal, you might still have a tear, but
it might be painless, and you can get back to being active again, despite having a tear
that's still there, as the MRI may have shown you.
Question number two, what are three signs of a meniscus tear in the knee?
The top three signs are number one swelling right around the knee joint like right where
your knee bends, it could be on the front on the sides, the inside of the outside or
the back of the knee because the meniscus takes up all that space within your knee joint.
Number two is popping or clicking.
Especially when you go get more active.
The most common time people get this is when they first get up after being sitting down
for a while or after they've woken up in the morning, they get up out of bed and their
knee joint starts to click and pop.
And it's usually repetitive in high frequency because everybody gets their knee joints are
pop every now and then.
That doesn't necessarily mean that you have a meniscus tear.
But if it's a frequent thing, like multiple times a day, especially if it's like every
hour, or every time you go move, it's a reproducible pop and it's kind of popping in the same way.
It's not a different kind of pop, then that's what I'm talking about.
And then the worst sign you can get is joint locking.
And what that means is you're doing your thing you're going through your day and all of a
sudden your knee just stiffens up, and you can't really bend it or straighten it, it
stays stuck in a slightly bent position.
People often when they get this, they they're holding their leg, they can't fully straight
it out like this are fully bended.
They're, they're in this position, and it's painful, they're kind of stuck complaining
about pain, and it takes them a few moments.
Sometimes it can take several minutes, and then it kind of frees up and begins to move.
Again.
That's a classic sign of a severe meniscus problem.
Question number three, what is the best treatment for a meniscus tear?
it really depends on what stage you're at in your meniscus tear.
If it's flared up right now, meaning there's swelling, there's constant popping and clicking
and maybe even you're getting the joint locked in like I just mentioned, then you probably
need to rest it and let it flared down.
So that means get off your feet stop walking around so much stop doing exercises.
A lot of people go look for exercises to do for their meniscus.
But the meniscus just is too raw right now it's too injured, it's too irritated to even
take good exercise that would help it.
But right now you can't do it.
After the meniscus flares down.
And you feel like you can tolerate bearing weight more, you can be on your feet a little
bit longer, then it's time to begin to do the right exercises.
And those exercises need to be focused on the root of the problem which is taking pressure
off that meniscus very often we have muscle imbalances, and these muscle imbalances end
up causing certain muscles to get way too strong.
And when those muscles are very strong, they compress the knee joint and begin to push
on that meniscus.
This is the number one reason why people get degenerative meniscus tears, meaning there
wasn't an accident, they just had a meniscus tear all of a sudden after they started having
some pain and swelling.
The root problem of that is that muscle imbalance, which let me just take a quick side note here
before I go into the rest of it.
I have got tons of videos on this channel that are designed at helping fix the root
problem.
You can find those videos linked in the description below in a playlist called knee meniscus help
go check that out after you're done watching this video.
Question number four, can you walk on a meniscus tear?
It really depends on how flared up you are.
If you're really flared up right now it hurts you every time you put weight through your
leg and you can't really bend it or straighten it very easily.
That it's probably not a good idea to be walking on your meniscus tear.
Think of it this way.
If you had a massive cut on the bottom of your foot, would you be putting pressure on
it?
I mean fresh like you just cut it you stepped on a big piece of glass or something really
sharp.
You had a bandage it up, you stopped the bleeding.
It's under control, but it needs to heal now, you would not walk on that foot for a while
until that wound is healed enough for you to begin to put pressure on it.
And you would baby it until you know that you can put more and more pressure on it without
reopening the wound.
Think of it the same way with a meniscus tear.
If your meniscus is all flared up right now, you don't want to be putting pressure on it.
You want to give it some space, give it some time, offload it, let it heal, and then you
can begin to do exercises for it.
Now, it's important that you do those follow up exercises so that you can take walking
on your torn meniscus better in the future.
You want to be in a painless situation in the controlled state, then walking might actually
be a good thing as long as you're working out of those muscle imbalances.
Question number five, will a knee brace help my torn meniscus?
The jury's still out on this one.
As far as the research we don't really know for sure, in clinical practice.
From my perspective, as a specialist physical therapist, I never recommend braces to patients
that have a meniscus tear.
The only thing I tell our patients with meniscus tears is if you feel like you've benefited
from having a knee brace on, then go ahead and put it on.
But you don't need it to get better unless you have a ligament problem in addition to
the meniscus tear, a knee brace is only for sure necessary if you have an ACL LCL MCL
PCL injury, because those are the main structures that provide stability to the joints.
And you won't get better unless you have a knee brace in those situations.
But for a knee meniscus injury, you don't need to have a brace on there's other things
you need to be doing to make sure you get your motion back.
You need to control the pressures and your knee joints.
But we have patients all the time that say, you know what I put on this neoprene sleeve,
I got my copper brace, and they feel a little bit better.
And I tell them go for it.
It's fine.
If you feel better with it great.
But you don't need to have it on if you're questioning on whether or not to get one.
It's up to you.
Question number six, how long does it take for a torn meniscus to heal without surgery?
And the figures I got in physical therapy school were about three months, I just Googled
this just to find out what Google has to say about it.
And it said six to eight weeks, which is about a month and a half to two months.
And in clinical practice.
Now that I've dealt with people with meniscus injuries for a long time, and I've helped
them avoid surgeries, it takes as long as it takes, which is usually in the ballpark
of six plus months.
On the short end, you're looking at about three months.
But think of this if it's improving week to week, and the 60 weeks, like Google says has
gone by, but you're not 100%.
But you are making improvements.
Why not keep going you're probably going to keep getting better and better.
And you're going to avoid surgery.
If you just continue to do what you're doing.
There isn't necessarily a cut off time for you unless for some reason, you need to go
have a surgery that most people don't have a deadline.
They say you know what I'm dealing with it, I've adjusted my life so that I don't have
to get up and walk around as much I kind of deal with the discomfort.
I figured out things that helped me feel better in the meantime.
And I can tell that I'm improving day to day, week to week.
So it's going to keep going.
If you run in to a health care professional, if you go see your doctor, your therapist,
whoever it is, and they're giving you a deadline on getting surgery, I would step out of that
office nicely and probably not return.
Because your need just takes as long as it takes.
Everyone heals at different rates, tissues heal at different rates.
The meniscus itself is made from cartilage, and it's one of the slowest healing tissues
in the body.
And about surgery, we're finding out in some of the latest research that's coming out of
England, that surgery actually makes you worse in the long run.
In the short run, they found that people that get a meniscus surgery actually do about the
same as people that just go through conservative treatment, which is physical therapy.
But what they found is that after several years, the people that had the meniscus surgery
are way more likely to get knee osteoarthritis which sets them up to get a knee replacement
later on.
So my vote is skip the surgery, figure out how to fix those muscle imbalances.
Give yourself as much time as you need to recover your knee and you need to make sure
that you're making consistent progress, you might have some steps back that you take high
no pun intended.
But if you're making big strides forward overall, in the course of weeks and months, keep going
your knees going to keep getting better.
Question number seven, what percentage of meniscus tears require surgery?
It's less than 10%.
And really only if you had it in the acute traumatic meniscus tear, meaning you were
involved in some accident whether it was like a motor vehicle accident, a bicycle accident,
motorcycle accident, or some sports accident, some trauma that really sent you to the hospital,
you injured your knee badly.
It was a notable time that you got hurt like you can pinpoint if this happened to me, then
my knee got swollen or got hurt.
That would be a higher risk for needing surgery.
But if you had a degenerative meniscus tear, meaning it gradually came on, there was no
accident ever involved.
Maybe you tweaked your knees subtly here and there but there was nothing obvious where
you had to go get emergency care had to go to the doctor, then you're much less likely
to need surgery if you're in that situation.
Number eight does a meniscus tear hurt all the time?
No, absolutely not.
We know that you can have a meniscus tear visible on an MRI, and not be in pain.
This is great news.
Because if you went to the doctor and you had an MRI, and they told you, you have a
meniscus tear, it's very possible that that meniscus tear is not the source of your pain.
You could have had that meniscus tear way back before you started having knee pain,
there's something else or maybe that's a piece of what's causing your knee pain today.
But you need to know that once your knee gets better if you were to have another MRI afterwards,
which nobody ever does, because you're better.
Your meniscus tear is probably going to still be there on that MRI, even though your meniscus
is still technically torn.
So no, a torn meniscus does not hurt all the time.
Question number nine, does a meniscus tear get worse over time?
If you don't fix that underlying root muscle imbalance?
Yes, absolutely gets worse over time because that muscle imbalance controls the pressures
through the knee joints.
And if you don't adjust the pressures, decrease the pressures at the knee joint, you're going
to be pressurizing your meniscus and further injuring it over time.
That's why it is critical to make sure that you fix a muscle imbalance.
We often see people that go have a meniscus surgery of either repair, they get their tear,
repaired, sewn back together, or a meniscectomy they get the chunk that's torn cut off.
And the years go by or sometimes even just months, and they retire it and the reason
for that is because they never fix the pressures on the knee joints on the meniscus.
They just got the repair and surgeons aren't trained to find this stuff.
There's they're trained to surgically repair things.
They're looking for things that are torn things that they can cut out or repair and reattach.
So it's not the surgeons responsibility to fixes it comes down to a specialist physical
therapist that's a trained in knowing how to find these muscle imbalances and correct
them.
So if you're dealing with a meniscus tear, and you're worried about it getting worse
over time and possibly ending up in a surgeon's office for your meniscus tear, you need to
go fix those muscle imbalances.
Big time go check out our playlist.
And I want to let you know about a program that we've got that's focused on fixing the
root problem.
It's called the 28-Day Knee Health And Wellness Boost Program.
This is a program designed at fixing the core muscle imbalances that affect many, many problems
including meniscus tears, knee arthritis problems and other knee injuries.
Go check it out in the description below.
Question number 10.
How can I tell if my meniscus tear is severe?
The number one sign that you have a severe meniscus tear is when you get joint locking.
Like I mentioned earlier that that joint gets stuck and you can't bend it or you spend it
this way or straighten it out that way.
It is just stuck and it's painful.
People can't put weight on the leg, they're usually hobbling around on one leg trying
to find a place to sit.
And then once they kind of wiggle their knee and their foot loose the knee comes loose
and it feels better.
That acute joint locking is a sign that the meniscus tear has a flap somehow that's getting
in the way of the function of the knee and it's getting pinched once you get into a certain
position.
Now it doesn't mean that you need surgery, it just means you need to get your knee meniscus
under control.
So you need to fix those muscle imbalances so that you can reduce the joint locking,
we often get patients in here that have joint locking, and we get that joint lock in under
control.
It may still happen even though they're avoiding surgery, but it's much more predictable and
manageable once they get the right strength around their hips and knees a close second
in being able to tell that your meniscus tears severe is frequent popping or clicking inside
the knee joints.
Now this usually sets up the joint locking.
But if you have a lot of clicking and popping when you get up and moving, it's a repeatable
click and pop.
And it's getting worse over time like you feel like it's just worsening and worsening
and especially if it's becoming painful.
You're on your way to getting joint locking.
So you need to fix those imbalances so that you can get the poppy and clicking under control.
I personally have a torn meniscus in my right knee, and I get occasional popping and clicking.
But it happens once every couple of weeks.
It was for a time happening daily.
I've since then figured out how to control it.
And I go run I got a three-mile run later today.
I ran six seven miles last week total and I've been upping my running and I've had no
knee problems whatsoever and my joint clicking has actually reduced over time, but that's
because I've got my muscles in balance and I'm very aware of using the right muscles
when I go run.
Number eleven is heat or cold better for a torn meniscus?
The jury's still out on this research has never been able to figure out if hot or cold
is better for certain aches or pains.
It used to be thought that cold was better for an acute injury like something that just
happened recently.
And then he is better for a chronic injury but that's been thrown out the window.
In recent research, I think it really just depends on your personal preference.
So your best shot is to try cold out, see if that helps out your knee pain, try heat
out, see if that helps out your knee pain.
You can also try contrasting the two.
I've seen people do that where they put heat on for 15 minutes and then switch to cold
and switch back and forth a few times.
And some people get relief from that.
And some people like none of that, even though they tried it and they just go on with nothing.
That's me.
Actually, I don't if I have an ache or pain, I just deal with the pain.
I don't I find it messy to use ice cubes.
Occasionally, we'll take out a cold pack.
I really never use hot packs because I'm just hot nature.
I start to sweat metal I get uncomfortable.
I don't like that sensation.
But everybody's different.
I have friends and family members that will love he have some they love ice, and some
that love none.
So it's up to you, you decide.
Question number 12.
This is a big one.
How do I know if my meniscus tear needs surgery?
I wouldn't ask yourself this question until you've tried a few things out.
And you can tell if you're making progress or not.
If you have a meniscus tear, don't reflexively go towards surgery.
We know that from the best current research and from clinical practice, I can tell you
here if you end up in a clinic like mine, there's lots we're going to do to make sure
that your knees getting better.
But if you go to physical therapy clinic locally to you, you should be doing exercises that
are focused on getting your glutes stronger, not your quads, the quad muscles are the muscles
that are on the front of your thigh right here.
And those commonly are involved in the muscle imbalance that makes your knee get over pressured,
which over pressures the meniscus inside the knee and continuously feeds on the problem.
And it may not hurt right away when you're doing an exercise.
But it'll build up over time as you gain more strength.
So if you've been to physical therapy, and you've said it didn't work for me, but you
worked on your quads a lot while you're there, you did the wrong kind of therapy likely,
you need to go find a place that is specializing and helping people avoid surgery.
And your therapy should be focused on getting your glutes much stronger.
In some cases, foot muscles need to be addressed as well.
If you're doing this treatment, and you're finding that your joint locking doesn't improve
if you have it, or if you have popping and clicking and that doesn't really improve either
and your overall condition doesn't improve like your ability to do things and your pain
overall doesn't improve despite you getting your glutes tremendously stronger.
Notably stronger like you should be able to tell my glutes are way stronger.
If you have not had that sensation of getting your glutes stronger than you probably haven't
strengthened enough.
But if you've gone through that and you're still getting the locking and the popping
and clicking, then am I considered needing surgery at that point.
If you have done the right things, you've done your due diligence, then surgery might
be a good option for you.
I hope this list was helpful for you.
My name is Dr. David Middaugh physical therapist and I'll pass the manual physical therapy.
Don't forget to subscribe to our channel.
This channel specializes in helping people stay healthy, active and mobile while avoiding
unnecessary surgery injections and pain medications.
I'll see you in the next video.
Bye