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Meniscus tear treatment plan

Meniscus tears treatment plan

Learn how the Exakt Health App can optimize your recovery.

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Research-based treatment plan

The research shows that most people with meniscus tears can fully recover through following a graded strength training program.

If you Google it, you’ll find lots of advice about what exercises to do and quite a few different opinions on how to do them. So how do you know what is right for you? What exercises should you be doing, how many repetitions and how often? 

The Exakt Health App provides these answers

  • The app guides you safely from when you first injure your knee to full return to sport.
  • The meniscus tear treatment plan contains evidence-based exercises with clear guidance on reps, sets and frequency.
  • The app adapts the program according to your feedback and specific needs.
  • It implements a walk/run program for a safe return to running.
  • We’ve also included a maintenance program to prevent re-injury.
Get your individual treatment plan
The Meniscus tears treatment plan in the Exakt Health app provides you with daily workouts and information that will help speed up your recovery.
The meniscus tears injury overview screen teaches you about your injury.

The App teaches you about meniscus injury

Understanding what caused your meniscus tear, how it heals and when to see a doctor helps you better plan your recovery and prevent re-injury

You have two menisci in your knee, the medial (inner knee) meniscus and the lateral (outer knee) meniscus. These c-shaped cartilage discs help to absorb some of the shock and protect your knee joint when you are walking and running. They also increase the congruency of the joint surfaces so that the bones “sit” better on top of each other.
 
A meniscus tear usually happens when you do a twisting motion with your foot planted or a deep squat type movement. It can be a subtle twist such as a miss-step while running or walking. The medial meniscus is by far the most common one to injure.
 
The symptoms that you experience can vary a lot depending on the severity of the tear.
For minor tears:
  • you may not even notice it when you tear it e.g. you just miss-step and feel twinge but then nothing. Only later that day you notice your knee is a bit swollen and sore;
  • you may not have much swelling and only notice a bit of puffiness or your joint may feel a bit stiff;
  • you usually have nearly full range of motion. Just the last 10 to 20 degrees of fully extending or flexing your knee causing pain;
  • twisting on your legs with feet planted can cause some pain;
  • you can usually walk with a near normal gait pattern, but walking on uneven ground may cause pain;
  • kneeling down may hurt.
For severe tears:
  • it can be very painful if you sustain a large tear and you will likely have to stop your activity and rest it;
  • your knee will likely swell a lot;
  • very restricted range of motion and you cannot fully straighten and bend your knee;
  • putting your weight on your knee when walking will be painful and difficult;
  • you may experience clicking inside the joint and your knee may lock from time to time.
Most minor to moderate meniscus tears can be treated at home using a conservative exercise-based treatment plan as outlined in the app.
 
You should consider seeing a medical practitioner if you have any concerns about your injury, particularly if:
  • your knee feels unstable or gives way when you stand or walk. This can indicate an injury to a major ligaments inside your knee and needs to be investigated.
  • your knee locks from time to time. This can indicate a bucket handle tear that may require surgical repair.
  • you’re not able to straighten your knee fully after 3 to 4 weeks of gentle exercise.
  • you have a lot of swelling and bruising with very limited range of motion.
  • any part of your leg (thigh, calf or foot) is very swollen, red, hot to touch, or throbs with pain. This can indicate that you have a blood clot and it should be investigated as soon as possible.
  • you have strong pain at night that keeps you awake or interrupts your sleep.
  • you feel pins and needles or tingling in your leg. This can indicate a nerve injury and our treatment plan may not be right for you.
  • your symptoms are getting worse.
  • your injury is not healing as expected.
There are 2 main reasons why you may tear a meniscus:
  • Trauma. A sudden strong force that usually involves a rotation movement of the knee. E.g. footballer’s foot remains planted in the ground while they turn around or if you miss-step while running.
  • Wear and tear. With age, the menisci become a bit weaker and can tear spontaneously with very simple activities e.g. squatting to the floor or walking up a hill.

Treatment

Most minor and moderate tears can recover with a conservative treatment plan that consists of the following steps:
  • First, allow the acute injury to settle down following the PRICE regime.
  • Then, do gentle range of motion and muscle activation exercises.
  • As you recover, progressively strengthen the muscles that control the knee helping to stabilize the joints
  • Include exercises for your core and hip muscles, balance and proprioception to improve the general leg control and decrease the load on your knee.
  • With increased strength and control, you can ease back into your sports.
Our treatment plan will guide you through this process. The average recovery times are:
  • Minor meniscus strains: 4 to 6 weeks
  • Moderate strains usually: 6 to 12 weeks
  • More severe strains, that don’t require surgery: 12 to 24 weeks

Prevention

  • Strength training 2x week
  • Include balance exercises – this develops your control and reduces your chance of making awkward movements that can strain your knee.

The Meniscus Tear treatment plan consists of 6 stages

In order to regain full strength the workout intensities have to increase as your injury heals. The app ensures that you progress at the correct time by setting you clear targets for each stage.

Allow your injury to settle and slowly regain range of motion in your knee. Avoid walking long distances, deep squatting/kneeling, twisting around with planted feet, hopping and running. Do gentle exercising as suggested to maintain as much strength in the supporting muscles as possible.

Your acute injury is starting to settle. It’s time to start gentle exercises to improve the strength and control in your core, legs and knee. Limit your walking to what you can do pain free and avoid deep squatting/kneeling, twisting, jumping and running. Proceed to the next stage when you can walk slowly for 30 minutes and do the assigned strength exercises without an increase in pain.

During this stage you will build the strength and control needed to safely start light running activities. Continue to avoid deep squatting, kneeling, jumping, and running. Proceed to the next stage when you can walk at a brisk pace for 30 minutes and do the assigned strength exercises without an increase in pain.

You’re now ready to start a return to running program. Your strength workouts will increase in intensity but their frequency will reduce as your running volume increases to allow enough recovery. Avoid high intensity running e.g. fast running or hill sessions. Progress to the next stage when you can jog 20 minutes at an easy pace and complete the strength workouts without increasing your symptoms.

The focus is now on regaining your previous running endurance. The strength workouts will maintain the strength that you’ve built in the previous stages. Avoid running on very uneven terrain and high intensity running e.g. tempo, sprint or hill sessions. You can progress to the next stage when you’re able to run your normal weekly running volume at your regular easy running pace pain free.

You can now start to train with increasing speed and intensity. You should continue with your weekly strength routine to support your running activities and reduce re-injury risk.

The meniscus tear treatment plan has 6 stages and the workouts increase in intensity as you grow stronger..
The Exact Health App contains treatment plans for common running injuries.

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References

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  5. Howell R, Kumar NS, Patel N, Tom J. Degenerative meniscus: Pathogenesis, diagnosis, and treatment options. World J Orthop. 2014;5(5):597-602. Published 2014 Nov 18. doi:10.5312/wjo.v5.i5.597
  6. Beaufils P, Pujol N. Management of traumatic meniscal tear and degenerative meniscal lesions. Save the meniscus. Orthop Traumatol Surg Res. 2017 Dec;103(8S):S237-S244. doi: 10.1016/j.otsr.2017.08.003. Epub 2017 Sep 2. PMID: 28873348.
  7. The Meniscus in Normal and Osteoarthritic Tissues: Facing the Structure Property Challenges and Current Treatment Trends Caroline A. Murphy, Atul K. Garg, Joana Silva-Correia, Rui L. Reis, Joaquim M. Oliveira, Maurice N. Collins. Annual Review of Biomedical Engineering 2019 21:1, 495-521
  8. Fukuta S, Kuge A, Korai F. Clinical significance of meniscal abnormalities on magnetic resonance imaging in an older population. Knee. 2009 Jun;16(3):187-90. doi: 10.1016/j.knee.2008.11.006. PMID: 19179080.
  9. Lento PH, Akuthota V. Meniscal injuries: A critical review. J Back Musculoskelet Rehabil. 2000 Jan 1;15(2):55-62. doi: 10.3233/bmr-2000-152-302. PMID: 22388443.

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