T Nation

Meniscus Tear


Anyone out there have some advice regarding surgery to repair a torn meniscus. My MRI revealed a torn lateral meniscus and a tear of the posterior horn of the medial meniscus. I have a scheduled date for a scope, but I have been getting contradictory advice. Of course the Ortho wants to get in there. I trust the guy and feel confident with him, but I am getting other advice to do therapy in lieu of surgery. I had this for about ten months.

I waited for it to heal and when the pain eased up, returned to lower body work, only to have the pain and discomfort again. I have been told that therapy can "fix" it, but also believe that unless it is repaired, it will come back following therapy and returning to weight training. Background; 48 yrs, 6-2, 235, in pretty decent shape, gym rat my whole life, done just about every kind of W/O around.


If you tried to return to activity after "allowing it to heal", and the pain still returned, I'd say it would probably be in your best interest to go with the surgery. I am a full believer in going the rehab route as much as possible and to avoid surgery when possible. But given your age, the extent of the tear, and the fact that with time off it still returned to a painful situation, I'd recommend surgery, especially if the doctor is recommending it.

Out of curiousity, who is it that is telling you to not do surgery and go with the rehab/therapy approach?


Its a Chiropractor who specializes in A.R.T., with high level athletes. But, funny thing I have another chiro, A.R.T. guy, a personal friend that is always against surgery and he recommends that I get scoped. His opinion is that based upon the level of my activity, ie, heavy lifting, running, etc, (yes at my age). He flat out told me that there is a very good chance that as soon as I resume my regular routine an unrepaired cartilage most likely wil cause problems. He added that if you cease your regular routines and baby it and can deal with the pain forego surgery. He advised not to allow the whole thing to be removed, because of arthritis in the future. You sound like you are a medical professional. True??? And, thanks for the input.


Well, got it done two weeks ago, April 31st. Repaired Lateral and Medial menisci and shaved down some, what he described as pre-arthritic degeneration of the cartilage on the femor. I think that was where most of the initial pain came from. I was told to do whatever I can tolerate, within reason. Iced the crap out of it as advised by other guys who had similar done, for the first four-five days. Day five started some basic movements on my own consisting of leg raises, R.O.M. stuff, partial body weight and supported squats. After upper body WO did adductor and abductor and glute machine. Started formal PT 5-14, added recumbant bike and stim to menu. Not as bad as the horror stories I read to this point, though sleeping comfortably was and to a degree still is a bitch.


I would suggest in a week or two you might want to get checked to make sure the meniscus is tracking properly by the ART doc. This will be a useful adjunct in your recovery process. In my experience most meniscus tears won't get "fixed" through ART, and rehab, unless it is minor and you manage activity levels very well. You can often "manage" tears through ART and rehab, but that consists of periodic care over time, dealing with flareups, etc. From your brief description, it sounds like you made the best choice, but remember that you will form scar tissue and adhesion due to the surgery, so not dealing with those as a part of your recovery will impede your progress.


I've had 3 meniscus scopes (college football), I think you made the right choice getting it done. Make SURE you're working on getting full ROM in both directions, stretch 3x/day, ice afterward.

Edit: Just because they only shaved part of the meniscus off doesn't mean you wont' get arthritis. I never had any of my meniscus fully removed and I still got it - I'm only 27, could be genetics too possibly? But - taking alot of fish oil has helped quite a bit, no pain most days.


I've had a meniscus scope as well and I absolutely do not regret making the decision to get it done.

Meal Ticket hit it on the money about pretty much everything. Definitely work on the ROM, that is huge. It took me a while to understand how important rehab is but it is absolutely vital. I'm just pushing 21 but I'm getting to be pre-arthritic and it sucks.


Thanks for sharing your experiences with me. I started going to PT about two weeks out, which I thought was a little late. But, they got the ROM progressing, plus strengthening exercises, stim, ice, heat etc.. Been doing the homework they give and added adductor, abductor and glute machines and just started to add acouple light sets of leg curls and extensions. I mean real light. The strectching is tough enough to do on your own and I thoroughly need a PT to push it that extra inch or two to break up the scar tissue. As of three and half weeks out, walking up and down stairs without doing the one step at a time thing. So every day I see a little more progress.


Update in case anyone can pick up something from my experience. PT two-three times per week, starting at week three. Heat, massage, stretch, bodyweight squats (various), recumbent bike, ice, stim. At home stretch 2-3 X per day and ice every time I am sitting down for at least a half hour. Added adductor and abductor and glute machine presses at week 3, 1-2X per wee, depending on tightness from therapy W/O's.
Week 6 since surgery Same basic protocol at PT, but added a few exercises, stiff leg deadlifts, body weight squats with stability bar in arms extended. At home same protocol. In gym on my own doing some light leg curls. They seem to help with ROM, to me. Deadlift from pins, just above the knee, Romanian DL's, 1/4 squats, leg presses. All slow and light, but thet are the only thing that make me feel the muscles flex. I do not do them all in the same workout, but add a couple after upper body to supplement PT. I back off when the knee tightens up a little too much. But, so far, so good.