Avoid these 8 things if you have a knee meniscal tear and become pain free!
So you think you have a meniscal tear. That’s bad right? Not necessarily….
There are many strategies and approaches you can adopt to lessen or resolve your symptoms conservatively without needing surgery or joint injections.
Please have a read of this article which will help you develop a solid management plan to conservatively manage your meniscal tear.
You should also read this article which reveals the 8 things you should be avoiding whilst your knee recovers.
The 8 things to avoid:
- Doing too much
- Twisting your knee
- Running
- Being immobile
- Breaststroke
- Deep Squats
- Sitting cross legged
- Locking your knee straight
1. Doing too much
During the initial stages of meniscus injury it’s really important to lessen the load on the knee to enable it adequate time to recover. The meniscus is designed to shock absorb and it lines the contours of the tibial plateau. It’s engaged the most when we are on our feet. If you can lessen the amount of time that you have to walk or stand whilst in pain then you should. Some meniscal tears are not painful with standing or walking initially, but pain develops after a period of time. You need to be mindful when this starts to happen. Walking on when pain is starting to build is not helpful to your recovery. I advise my patients to pace their activities if at all possible. Embrace exercise and movement but acknowledge that you need to reduce the demand on the knee – temporarily in order for healing to occur.2. Twisting your knee
Your meniscal tear will improve over time if you reduce the activities which aggravate your pain.
One of the major ways to irritate a meniscal tear is to twist or rotate on the injured knee.
Your rule of thumb here is to let pain initially guide your activity. For the golfers amongst you playing golf may not be within your pain tolerance and should be avoided initially and yet for others the golf swing may not present any difficulty at all and can be safely continued.
We also need to be aware of our post-activity pain as this can be a very useful guide to check if the activity you’ve undertaken is safe for you to do. Again let pain be your guide. Here’s a great example:
You go on 45 minute dog walk over uneven terrain. The knee feels good during the activity and is a little achey afterwards but otherwise you’ve coped well. However, when you wake the next day the knee is swollen, tender, sore and you’re struggling to bend and straighten it. If those symptoms ease with 30 minutes of waking and moving around then you would be safe to continue to walk the dog but try changing some of the variables such as reducing the walk time or changing the walk location to more even terrain.
If your symptoms do not settle within 30 mins and in fact takes several hours to settle and resolve then I would say that your dog walk was far too much and needs to be modified significantly or even be avoided for now.
3. Running
During the initial stages of a meniscal tear you’ll likely be unable to run. It will just be too uncomfortable. But as you progress through your rehabilitation and your pain starts to ease you may be tempted to run.
Here’s your guide to when its safe to run again:
- You have full range of motion in your knee.
- You have restored strength in your lower limbs. Try the squat test for this. Can you complete the following: 20 body weight squats, 20 step downs, 10 single leg squats and balance on the affected leg for > 60 seconds without falling over and finally 20 heel raises? If the answer is yes without pain or instability then you have the green light to start re-introducing running into your workouts again.
- You can walk at a brisk pace for 30 minutes without pain or instability.
4. Being Immobile
So we’ve already covered not overdoing it in section 1 but a very important aspect of managing your meniscal injury is doing enough of the right things in order to facilitate recovery.
Rest of course is an important component but I like to call it active rest.
Putting your feet up on the sofa and doing nothing at all may help your pain in the short term but will ultimately not help you with your recovery. It can lead to weakening of the muscles and stiffening of the joint. The exercises to help recovery will also help with swelling, stiffness and pain. Your knee will thank you for walking and moving as pain allows.
5. Breaststroke
Swimming or movement in water can be a really great aid to recovery but a resolving meniscal tear will not enjoy the twisting that is a big component of the breaststroke kick and it should be avoided.
I like to advise my patients to do the following exercises in water if you have regular access to a pool or if you enjoy swimming:
- Straight Leg Raise 20 Reps
- Hip Extension 20 Reps
- Knee Flexion 20 Reps
- Heel Raises 20 Reps
- Standing March 1-3 Mins
- Walking Lengths 2 mins
This circuit could be completed 1-5 times depending on your stage of recovery.
6. Deep Squatting
Remember to read my article talking you through the safe way to conservatively manage your meniscal tear. You can read it here
It will guide you through how I managed my meniscus tear and you’ll find some great information you can apply straight away.
But you should note that performing deep squats, specifically as a repetitive exercise is not something you should be incorporating into your workout regime. Well not initially anyway. It places too much load on the injured meniscus and can lead to pain, swelling and in extreme cases, increased damage.
You should re-introduce partial squatting first when you are able to perform this movement comfortably and without pain and deeper squats should only be attempted when you have restored your full active range of motion in the knee.
7. Sitting cross legged
By now I hope that you’ve seen the common theme here!
Twisting your knee is to be avoided. Sitting cross legged, although initially may be comfortable will place unwanted load on the joint and could lead to irritation and further inflammation of the meniscus.
The same thing goes for sitting on your legs. You know that position you like to get comfortable in when you sit on the sofa? Yes, don’t do that!
8. Locking your knee straight
In many cases the pain you experience if you attempt this will stop you from doing it. Your body is trying it’s best to tell you something here and you need to be sensible and listen to the message. Sitting with your legs fully straightened for prolonged periods of time may place extra unwanted load on the meniscus and should be avoided if possible.
One of your major goals in your conservative management of your meniscus injury is to restore any loss of range of motion so practising gentle mobility work is important and should be differentiated form holding your knee in a fully locked position for prolonged periods of time.
Conclusion
I hope you’ve found this list useful. You’ll certainly have noticed the central themes that will help you make judgements on situations that arise as you recover. It has equipped you with the knowledge of what to avoid and hopefully how to apply it to all aspects of your life as you recover.
If you are looking for specific one to one help with your meniscus injury you can find me here https://www.mtphysioclinic.co.uk
Good luck with your recovery!
