One of the most annoying, nagging injuries a person can get is a torn meniscus. The knees are some of the most used and abused joints in the body, which results in meniscal tears being quite commonplace in various healthcare settings. This injury can cause kids to be inactive, athletes to miss out on training and competition, and the average Joe to go through daily discomfort. Contrary to popular belief, a torn meniscus isn’t an immediate sentence to surgery. There is a wide spectrum of severity in which meniscus injuries occur. I absolutely agree that some require surgery, but let’s talk about why you should seek conservative care for your torn meniscus.
Anatomy of the Meniscus
The meniscus is a thin piece of cartilage found in your knee. It is composed of two C shaped bands that encases the joint between your upper and lower leg. It is not even close to being the only fibrous soft tissue that plays a major role in knee anatomy, but it is one of the most important. The meniscus acts as a cushion between the femur and the tibia and without it, there would surely be many more cases of knee osteoarthritis at much, much younger ages.
Common Mechanisms of Injury
There are many ways that a person can hurt him or herself. When it comes to the meniscus, there is almost always some sort of twisting motion of the knee that wrenches on the meniscus, resulting in a tear. This often happens when football players are hit while their foot remains planted. This can be a nasty injury that damages other ligaments such as the MCL, ACL, and even the PCL. Not all meniscus injuries are so gruesome. Some individuals injure the meniscus while stepping off of a tall step or even slipping on ice. Acute injury of the meniscus can happen in countless ways, but the commonality between them all is a twisting action on the knee. The meniscus can also tear gradually in endurance runners with uneven strength of the leg muscles. This isn’t as common, but I mention it to stress the importance of proper biomechanics during exercise.
How Do I Know if My Meniscus is Torn?
The short answer to this question is to go get an MRI. I don’t necessarily recommend that prior to conservative treatment for a few reasons. The first is that oftentimes, the presence or absence of a tear doesn’t necessarily affect your ability to live a normal, pain-free life with proper treatment. The second reason is due to a thing we call catastrophization. This is where the presence of some sort of irregular finding on imaging leads to worse clinical outcomes for the patient due to the change in perceived ability to heal. I want everybody to get better as quickly as possible. Not knowing there is a clinically insignificant tear might be better for the patient.
The longer answer to this question is to obtain a thorough examination from a licensed healthcare professional. During consultation and examination, it is important to know that all information regarding how you hurt your knee, when it hurts, the quality of the pain, and any other information you feel might be important to bring up are all important. The more information that you can provide, the better. Detailed history with orthopedic tests such as Thessaly, Mcmurray, and Apley’s compression test as well as functional muscle testing are all necessary for a definitive diagnosis.
What to do about it?
With injury, there are muscular compensations that occur. Your body naturally inhibits injured muscles from contracting to avoid re-injury. Optimal treatment for a non-surgical meniscal tear would involve restoration of the normal strength of those muscles that are conditionally inhibited. In my practice, I utilize applied kinesiology to identify these weaknesses as well as their compensations. Various reflexes are utilized to identify where the problem is and where to perform various manual therapies to restore muscle strength. Minor tears can seem non-existent if proper biomechanics are restored. Some of the most common muscles that are afflicted are the popliteus, anterior tibialis, and vastus lateralis. Doing some muscle work on those muscles yourself just might help.
I urge you to do your homework and to speak to the proper professionals before undergoing surgery. Unless there is a significant tear, not only is surgery not necessary, but it can also lead to more harm than good in the long run. Oftentimes, the fix for a torn meniscus is to do a partial meniscectomy. This involves removal of the torn flap of meniscus that is causing issues. Remember when I mentioned that the meniscus is a cushion between the femur and tibia? Following this operation, osteoarthritis can develop more easily later in life.
Conclusion
Many injuries can seem like they’re going to cause a lifetime of pain. None more commonly than the meniscus. It seems like everybody knows some ex-athlete that “could’ve gone pro” if it wasn’t for his bum knee. A meniscus isn’t a death sentence to a healthy life or an athletic career. Seek proper treatment and you will stack the cards in your favor.
