Training With A Meniscus Tear | Strive Performance Physical Therapy

Training with a meniscus tear is possible when done correctly!

That sharp pain in your knee when you squat or rotate? It’s hard to ignore and constantly on your mind. The internet isn’t doing you any favors to calm your nerves. A quick Google search on the wrong websites will tell you to stop training and prepare for surgery. But is this really the only option? How do I even know it’s truly a meniscus tear and not something else? Why does this one website tell me I can still train, but another tells me to avoid all lower body exercises until I see my doctor? 

Fear not! Here at Strive Performance, we deal with pesky meniscus tears and answer these questions weekly. Let’s break it down!

What is a meniscus?

You have two menisci in each knee, one on the medial (inside) and one on the lateral (outside). They are C-shaped pads of cartilage that act as shock absorbers during activity, help to distribute load across the knee more evenly, act as cushions to protect the underlying joint surface on the tibia (shin bone), and help provide stability in the knee. 

How do I know if I have a meniscus tear? 

The knee is not a very large area anatomically, and determining the cause of knee pain can be quite difficult at times. Meniscus pain has a few classic descriptions and features that a skilled Doctor of Physical Therapy should be able to recognize including:

• Sharp or aching pain with squatting and pivoting

• Sensations of catching or locking in the knee

• Noticeably more discomfort bending the knee vs straightening 

Again, the knee is complex so other knee injuries can have some overlapping symptoms. These descriptors are NOT a 100% guarantee you have a meniscus tear. 

Do meniscus tears heal? 

Depending on location and what type of meniscus tear you have, healing may or may not occur. The meniscus has three “zones” of blood supply, with the “red zone” on the outside receiving the most blood supply. This area tends to heal the best with conservative treatments such as physical therapy. As you get closer to the inside of the meniscus (the “white zone”), the blood supply becomes less and less. 

As for types of tears, there are around half a dozen different classifications. For the simplicity of this article, we’ll only discuss the one that most likely requires surgical intervention. Bucket-handle tears occur when part of the meniscus displaces into the joint, causing painful mechanical blocking/locking. Most other types of tears can be managed conservatively, however these can be quite limiting. 

Can I still train with a meniscus tear? 

Yes, you can still train with a meniscus tear! However, caution is warranted and it is highly recommended to seek professional help from a Doctor of Physical Therapy (especially one at Strive Performance in West Ashley 😉). Some exercises more than likely need to be modified such as squatting, lunging, or anything rotational. Reducing depth is a great place to start, as the meniscus undergoes progressively more stress the deeper you flex your knee. 

Pro tip: You still have an entire upper body and core that can be trained while the lower half needs modification. Keep grinding away at upper-body focused days!

What is the rehab process like? 

At Strive Performance in West Ashley, our Doctors of Physical Therapy are highly skilled when it comes to rehabilitating a torn meniscus. A thorough subjective history is the first step in the evaluation as this can help us determine if your symptoms match a meniscus pathology or lead us to suspect something else. Next, an in-depth movement screen is performed to see where pain arises and how you may be compensating for the pain. 

Once the objective evaluation is complete, we get straight into exercise modifications. If squats hurt for example, can we reduce the weight, range of motion, placement of the load, or foot positioning to still allow for squats in your program? If not, what other exercises can we test and modify so you can still load your legs without irritating the meniscus? Once a few movements/exercises are determined to be tolerable and safe, we provide a detailed home exercise program to initiate the rehab process until we see you again. 

At Strive Performance Physical Therapy, you work one-on-one with a Doctor of Physical Therapy for a full hour. Our therapists are skilled in workout programming, exercise modifications, the principles of rehabilitation and strength and conditioning, and manual therapy. Our gym is packed with equipment to progress you back to 100%, including heavy weights, sleds, squat racks, barbells, medicine balls, etc. 

If you are struggling with suspected meniscus pain or any other type of knee pain, send us a physical therapy inquiry or DM us on Instagram to get started. We look forward to working with you!