Do I Need Physical Therapy for a Meniscus Tear?

If you just found out that the pain and swelling in your knee is a torn meniscus, you probably have a decision to make about how to treat it. What’s best for you depends on what the tear’s like, your age, and how soon you want to get back to your normal activities.

You have two menisci -- that’s the plural for meniscus -- in each knee. They’re made of cartilage, a tough, rubbery substance. They’re basically shock absorbers that keep your thighbone in the upper leg from pounding on the shinbone in the lower leg.

If you tear one, your doctor probably will suggest that you rest, apply ice, and take pain relievers at first. From there, you might need physical therapy (PT), surgery, or both.

Can I Do PT Instead of Surgery?

PT is often part of what doctors call “conservative treatment” to avoid surgery, at least early on. People who are middle-aged or have osteoarthritis often tear the meniscus simply because it’s worn down. For them, PT may be as effective as surgery.

Even if you’re younger, fit, and athletic, a conservative approach is often a good place to start. It can work well, depending on the direction of the tear, how long it is, and where it’s located. But if the tear causes your knee to lock up, you’ll likely need surgery.

Part of your decision may be about how limited you are by the injury. If you’re an elite athlete or you can’t work because of it, you may not have time to see if a conservative approach works.

Even if you have surgery, you’ll need PT afterward. Your doctor may send you to a physical therapist, but at the very least you’ll get PT exercises to do at home. This will help bring your knee back to full health.

What Will It Be Like?

Whether you do PT as part of a conservative treatment or to heal after surgery, the goal is the same -- to get back your range of motion, strength, and control.

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The PT process usually goes something like this:

  1. You start with exercises that focus on range of motion, like flexing and extending your knee as much as you can without pain.
  2. You move on to stretches that keep your leg muscles loose.
  3. You begin basic exercises, like straight leg raises and toe raises.
  4. If you can do all that without pain, you move onto more advanced exercises, like toe raises with weights, squats, and harder stretches.

Those are the general stages, but they can blur into each other based on your needs and ability.

For example, you may start stretches and basic exercises sooner rather than later.

Keep in mind, this isn’t the time to tell yourself, “No pain, no gain.” Your focus is to heal, so you don’t want to start more advanced exercises until you can do the basic ones without hurting.

How Long Will I Need to Do PT?

It depends on your age, the type of tear, how you heal, and type of surgery, if you had it.

As part of a conservative treatment, you’ll probably try PT for around 4 to 6 weeks, on a regular schedule. Also, you must regularly exercise at home the way you are taught.

If it doesn’t work, then it may be time for surgery.

If you have surgery to remove part of the meniscus, it may take 3 to 6 weeks before you get back to normal activities. If you have surgery to repair your meniscus, it may take more like 3 months.

WebMD Medical Reference Reviewed by Neha Pathak, MD on February 03, 2017

Sources

SOURCES:

American Academy of Orthopaedic Surgeons, OrthInfo: “Meniscus Tears,” “Knee Arthroscopy Exercise Guide.”

Mayo Clinic: “Torn Meniscus.”

University of Southern Maine: “Conservative Treatment for Meniscus Rehabilitation.”

University of Wisconsin Sports Medicine: “Rehabilitation Guidelines for Meniscal Repair.”

Harvard Medical School, Harvard Health Publications: “Physical therapy works as well as surgery for some with torn knee cartilage.”

Medscape: “Meniscus Injuries Treatment and Management.”

Brigham and Women’s Hospital, Department of Rehabilitation Services: “Standard of Care: Meniscal Tears.”

UCLA Health: “Meniscus Tear.”

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