How to Heal a Meniscus Tear

The knee is protected by a C-shaped and rubbery disc, the meniscus. This cushions the outer and inner edges of the knee, balancing weight across the knee. An injury or torn in the meniscus can hamper normal performance of the knee and can cause pain, swelling and stiffness. If left untreated, a torn meniscus can lead to knee instability, an inability to move your knee normally and persistent knee pain.^[1] To heal a meniscus tear through medication, self-care, exercise (or a combination of the three), start with Step 1 below.

Steps

Using Self-Care

1. Use PRICE therapy. You can quicken your healing process by using "PRICE" therapy – "Protection," "Rest," "Immobilize," "Compression," and "Elevation."^[2] The P, protection, means it is necessary to avoid further damage to the affected area that can lead to more serious complications. The following measures must be avoided:
   
   
   
   
   
   
   
   
   
   • Heat. Exposure to heat causes dilation of blood vessels that can generate more episodes of bleeding. Thus hot baths, saunas, heat packs or even contact with hot environments must be avoided.
   
   
   • Further movement. Limitations of certain activities must be considered to avoid further injury to the involved area.
   
   
   • Massage. Any pressure placed on the affected area may lead to more damage.
   
   
   
   


2. Rest. Avoidance of activities is usually recommended during the first 24 to 72 hours of injury. Adequate breaks or rest should be promoted to ensure proper healing and prevent further damage to the surrounding muscles and tissues of the affected area.
   
   
   
   
   
   
   
   
   
   • Some exercises may be helpful after the initial 72 hours have passed; those will be discussed below. Ideally, they would be conducted under the supervision of a physical therapist. Apart from these, it's best to stay off it.
   
   
   
   


3. Immobilize your knee. Splint and bandages may be placed on the involved area to stabilize it and prevent unnecessary movements that can further damage the tissues and muscles. Talk to your doctor about what methods of immobilization are best for your case.
   
   
   
   
   
   
   


4. Use compression. During the first 24 to 72 hours after the injury, ice wrapped in a moist towel should be placed over the injured area for 15 to 20 minutes at a time with 2 to 3 hour intervals in between. Follow these guidelines to be sure that you don't cause tissue damage, a result of freezing skin.
   
   
   
   
   
   
   
   
   
   • Exposure to cold temperature causes the blood vessels to narrow thus decreasing flow of blood and swelling in the affected area. Compression also aids in stimulating the flow of lymph fluid, which carries important nutrients to the damaged tissues surrounding the injury.
     
     
     
     • Lymph fluid also removes waste from cells and body tissues which is an important function during the tissue regeneration process.^[3]
     
     
     
     
   
   
   
   


5. Elevate your knee. Continuous elevation of the injured area must be given much importance to ensure proper blood circulation and healing of the involved area. Keeping it elevated will reduce blood flow, thus reducing swelling.
   
   
   
   
   
   
   
   
   
   • When sitting or lying down, prop your knee up with a few pillows. It's best to lay down, but you may also sit – so long as your pelvis is beneath your knee.
   
   
   
   

Using Medical Treatment

1. Take pain medications. Over the counter drugs that are used to relieve pain can be incredibly helpful. However, before you start on medication, know that it's best to discuss treatment with your doctor. He or she will likely know which route is best for you and/or be able to prescribe you a stronger medication.
   
   
   
   
   
   
   
   
   
   • If pain is gets severe and swelling is present, consider taking celebrex; 400 mg on the first dose and 200 mg twice daily as needed for subsequent doses.^[4]
   
   
   • If you're lucky enough to be without swelling and only experiencing mild pain, try 650 to 1000mg of Tylenol every 4 to 6 hours as needed.
     
     
     
     • If you drink alcohol, take precaution. Certain medications react negatively with alcohol. Consult your doctor for advice if this applies to you.
     
     
     
     
   
   
   
   


2. Take NSAIDs. These are oral non-steroidal anti-inflammatory drugs (NSAIDs). However, they should not be taken during the first 48 hours of injury because they reduce inflammation, which is considered one of the body’s compensatory mechanisms. In other words, intake of this drug during this period may interrupt healing.^[5]
   
   
   
   
   
   
   
   
   
   • Examples are Ibuprofen, Aspirin and Naproxen. All of these work by blocking certain body chemicals that ground the progress of inflammation in the involved area.
   
   
   
   


3. Try physical therapy. We'll discuss physical therapy exercises in the next section. For the meantime, know that starting physical therapy can be an incredibly effective way of shortening the healing process. Consult your doctor first before starting therapy; he or she will know what's appropriate for you.
   
   
   
   
   
   
   
   
   
   • Exercises should only be done under the guidance of a therapist so that you will do the exercises correctly and not worsen the situation.
   
   
   
   


4. Consider surgery. This should only be considered if other means fall short. Knee surgery can be performed to patch up and join injured tissues of the meniscus to restore its normal functioning.
   
   
   
   
   
   
   
   
   
   • The surgery is called total meniscectomy, which is a surgery that removes the entire meniscus. Again, your doctor will know if this is a viable option.
   
   
   
   

Using Physical Therapy Exercises

1. Find a licensed physical therapist. Physical therapy involves various exercises that can help you overcome your condition. Starting an exercise regimen with a professional can help you regain strength of the meniscus and preserve its optimal performance.
   
   
   
   
   
   
   
   
   
   • The first five exercises discussed below can be done immediately and be followed by the rest once the pain felt in the knee has minimized.^[6]
   
   
   • These exercises involving movements of the muscles promote better circulation of blood and distribution of oxygen to the affected area. Sufficient supply of oxygen maintains cellular integrity, function and aids in the speedy repair of damaged tissues.^[7]
   
   
   
   


2. Do the passive knee extension. This is often suggested if patients are not capable of extending the knee completely. Here's how to do this exercise:
   
   
   
   
   
   
   
   
   
   • Once in a lying position, put a rolled-up towel beneath the heel of the damaged leg to raise it at least six inches from the floor.
   
   
   • Rest the muscles of the leg for two minutes and allow gravity to gradually straighten the knee.
   
   
   • Repeat the step for three times and execute the exercise for as many repetitions as desired.
   
   
   
   


3. Try the heel slide. Once the pain has started to subside, you can try the heel slide. Here's how:
   
   
   
   
   
   
   
   
   
   • Assuming a sitting position, extend your legs in front of you and gradually slide the heel of the foot on the injured side toward the buttocks.
   
   
   • Return to the starting position and repeat the exercise for up to 15 sets.
   
   
   
   


4. Try the standing calf stretch. In a standing position, place your hands on the wall at eye level. Place the injured leg behind you with your heel grounded on the floor while the other leg is positioned forward with your knee bent. As the back foot is slightly turned inward, slowly lean towards the wall until a stretch is felt in the calf.
   
   
   
   
   
   
   
   
   
   • Keep the position for 15 to 30 seconds and return to the initial pose. This exercise can be repeated several times a day.
   
   
   
   


5. Do hamstring stretches on the wall. Lying on the ground with your buttocks near the doorway, extend the uninjured leg through the doorway. Then, elevate the injured leg and rest it against the wall beside the door frame. Maintain the position until a stretch is felt at the back of the thigh and repeat it three times.
   
   
   
   
   
   
   
   
   
   • Feel free to hold this stretch for as long as feels good. This stretch is especially nice as the doorway takes the pressure off your legs to hold the stretch and the pressure off your arms to hold your leg.
   
   
   
   


6. Try the straight leg raise. Lie flat on the floor with your legs straight in front of you. Bend the knee of the uninjured leg slightly and position the same foot flat on the floor. Stiffen the thigh muscles of the injured leg and raise it about eight inches from the ground. Then gradually place the leg back in its original position. Repeat this exercise for 15 times.
   
   
   
   
   
   
   


7. Do wall squats with a ball. Position your head, shoulders and back against the wall. The feet should be three feet away from the wall. Put a ball behind your back and slowly squat down to a 45 degree angle. Maintain the position for 10 seconds and then return to starting point. Repeat for 10 times.
   
   
   
   
   
   
   
   
   
   • This exercise is also great for your core. Try lifting your arms up to a 90 degree angle when you hit the peak of your squat, lowering as you release.
   
   
   
   


8. Do step-ups. In a standing position, elevate the injured leg at least three to five inches off the ground while the other leg is left flat on the floor. Slowly alternate the position of each leg and do two sets of 15.
   
   
   
   
   
   
   
   
   
   • Once your knee can take it, try working with stackable circuit steps like you find at the gym. Experiment with different heights for a maximum stretch.
   
   
   
   


9. Do knee stabilization work. Cover the ankle of the uninjured leg with elastic tubing then tie it on a door at about ankle height. Facing the door, bend the injured knee slightly and keep the muscles tight. Hold the position while moving the uninjured leg straight back behind you. Perform 2 sets of 15.
   
   
   
   
   
   
   
   
   
   • Alternatively, try resisted terminal knee extension. Using elastic tubing, make a loop and tie it on a door at knee height. Step the injured leg on the loop and bend it at about 45 degrees while the other leg is raised off the floor. Gradually straighten your leg and maintain stiffness in your thigh muscles. Repeat this exercise for 15 times.
   
   
   
   

Understanding Your Condition

1. Know the symptoms. A torn meniscus is the most common knee injury.^[8] If you think this issue is afflicting you, here's what to look for:
   
   
   
   
   
   
   
   
   
   • A popping sensation in the knees. These are snapping sounds when you do activities involving the knee. If the knee is stationary for a couple of minutes and then you try to bend it, a snapping sound is normal, but if you bend for several times again and snapping sounds are still present, it maybe a symptom of having a knee problem.
   
   
   • Swelling and stiffness. Fluids are present in our joint which helps in its movement. If you have torn meniscus, there is an accumulation of too much fluid making the knees swell. Swelling is accompanied by stiffness. Stiffness is difficulty in moving you knee joints and loss of motion when you are trying to do activities involving the knee.
   
   
   • Pain. Swelling and stiffness are also accompanied by pain. It is present especially when putting pressure on the knees or when moving them. You might be unable to bend your knee because of so many pain. Your knee may look like it is locked and cannot be moved.
   
   
   
   


2. Know what small tears feel like. In this situation, a tolerable sensation of pain may be felt during the incident of injury. Pain can be related to the slight swelling, in addition to the injury to the involved tissues that occurs progressively over time.
   
   
   
   
   
   
   
   
   
   • This sharp pain may be relieved after two to three weeks with limitations from strenuous activities. Certain movements such as squatting, bending, lifting and twisting may trigger recurrence of these symptoms.
   
   
   
   


3. Know what a moderate tear is like. Individuals affected by a moderate tear may suffer from sharp pains that occur either at the side or at the center portion of the knee, especially when squatting or twisting. Inflammation may get worse over two to three days and can make the knee stiff. Walking can still be possible but bending may be restricted.
   
   
   
   
   
   
   
   
   
   • Symptoms usually subside in one to two weeks but can persist with prolonged use of the knee. Soreness can be experienced for several years if the tear is left unmanaged.
   
   
   
   


4. Know what a larger tear feels like. This type is accompanied by a greater level of pain and the abrupt appearance of swelling and stiffness. The pain may be sharp, pulsating and excruciating. Presence of inflammation may be visible over two to three days. Some parts of the worn out meniscus may even move into the joint space.
   
   
   
   
   
   
   
   
   
   • These symptoms may lead to instability of the knee or trouble in walking properly and straightening the knee. Needless to say, medical treatment must be sought.
   
   
   
   


5. Know how you'll get diagnosed. Medical records of patients are taken to gauge the connection of present symptoms to past injuries that might damage or injure the knee. Health practitioners will then perform several examinations and tests to evaluate the functioning of the knee such as:
   
   
   
   
   
   
   
   
   
   • Knee evaluation. Each knee is checked from signs of tenderness, knee instability, inappropriate range of motion, soreness at a particular area and incapacity to put pressure on the affected leg.
   
   
   • X-ray. This is performed to assess the knee bones for presence of inflammation.
   
   
   • Magnetic Resonance Imaging (MRI). This is commonly ordered by orthopedists to make a decisive diagnosis for the condition. It provides a clearer view of the site and severity of the meniscus tear together with its surrounding ligaments, tendons and cartilages.
   
   
   • Arthroscopy. This is done by an orthopedist to inspect the interior side of the knee joint by inserting an instrument called an arthroscope through a tiny incision. This apparatus contains a camera with light to directly view and even treat the meniscus tear.
   
   
   
   


6. If these are painful, know your doctor may numb your knee. Some patients might find it painful to undergo certain examinations. In cases like this, doctors may recommend withdrawal of fluid from the knee joint or injection of a local anaesthesia to act as a numbing medicine. It should not add to your pain.^[9]
   
   
   
   • These actions can alleviate pain and can help in the pursuance of the examination. However, if it fails, assessment may be delayed until inflammation or pain subsides.
   
   
   
   

Tips

• Too much twisting or pivoting can put you at risk in tearing your meniscus. Contact sports or activities that involve vigorous use of your knees should be avoided.


• Bones weaken as a part of the aging process. Knee problems are normal and common as you age.

Sources & Citations

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