Will Walking on a Torn Meniscus Make It Worse?

TORN MENISCUS

Will Walking on a Torn Meniscus Make It Worse?

Can you walk with a torn meniscus? How long after meniscus surgery can you walk? The meniscus is a piece of cartilage between the femur and the tibia within the knee joint that acts as a shock absorber. Your meniscus provides cushioning and stability to the knee as you walk, run and doing exercises. Meniscus can be torn by movements such as twisting movements at the knee joint while the leg is bent. The traumatic action can cause mechanical symptoms such as catching, clicking, or locking if you continue to walk or doing exercises.

Torn meniscus is generally not able to heal on its own due to the limited blood supply in knee cartilage. For some patients, a tear does not get into trouble to cause severe pain and swelling. Others present with knee pain on the inner side of the knee is severe enough that they cannot walk, run, squat or twist. These patients often require surgery involves trimming the torn part of the cartilage in order to reduce the knee pain. Surgery does not fix the tear itself. Continuing to walk could potentially worsen the meniscus tear in some situations. Stop walking will decrease the strength of leg muscles, which may increase the difficulty for recovery.

1. Meniscal Tear Fundamentals - What are the symptoms and causes?

How do you tear your meniscus? Torn meniscus is a very common injury in sports which is caused by sudden twisting or other movements in joint. Older adults generally have an increased risk of getting involved in knee injuries such as a torn meniscus because of degenerative tears occur as part of progressive wear in the knee cartilage as people age. Generally speaking, torn meniscus is more common for people over 35. Younger people have less chance of getting torn meniscus because their meniscus is fairly tough and rubbery.

A meniscus is a disk-shaped piece of cartilage that acts as a shock absorber inside the knee joint. You might have heard of doctor or patients discussing about having torn a cartilage, basically a torn cartilage is just a different name for torn meniscus. Running, squatting and contact sports are more likely to cause torn meniscus because the high impact on the knee and they are more likely to cause forceful twisting or rotation of the joint.

Lateral-and -medial-meniscus-anatomy

Types of meniscus tears can be categorised into degenerative tears or traumatic tears. In degenerative tears, degenerative meniscal lesions are commonly found as the indication of an early stage of osteoarthritis for patients over age 35. Traumatic tears are longitudinal vertical tears especially in the red-red and red-white zones which are a proper indication for repair or non-removal. Types of Meniscus Tears can also be summarised into 6 common types.

Can a meniscus tear heal on its own? As can be seen in the following illustration: red and red-white zones are categorised by the amount of meniscal blood supply. The meniscus red zone receives enough amount of blood supply hence a torn meniscus in this zone may heal without surgery whereas the injury occurs in white-white zone usually require surgery to repair.

Meniscal-blood-supply

How to tell if you have a torn meniscus? If the patient has experienced a torn meniscus, the knee will get swollen and painful initially and they may face the difficulty of straightening and bending the leg as well as feeling the knee get locked up or stuck. The symptoms of torn cartilage in knee can include:

    • Experience pain in the knee generally on one side of patient’s knee
    • Facing difficulty of straightening and bending the leg because pieces of torn meniscus may move into the joint space
    • The knee is stuck that cannot be bent (knee joint locking with limited range of motion)
    • Swelling and stiffness in injured knee
    • Injured Knee remains swelling for more than 12 hours
    • You can feel the pain when the joint is in use but the pain goes away when there is no load

2. Will Walking on a Torn Meniscus Make It Worse?

Walking can help keep you knee cartilage lubricated with synovial fluid which plays a vital role to reduce friction between the articular cartilage of synovial joints when you are walking or doing exercises. As we mentioned above, the meniscus is a piece of cartilage that acts as a shock absorber between your thighbone and shinbone. Research shows that cartilage is filled with fluid to made up 75% of the volume of the cartilage tissue which helps to support weight from our body and lubricate joint surfaces.

According to a study of cartilage deflation from a group at Columbia in 1995 which was led by Gerard Ateshian. The research has shown that synovial fluid is slowly leaking out of the porous cartilage in your knee after we siting or standing for long periods. Loss of synovial fluid means less fluid to lubricate our knee cartilage which can cause a gradual decrease of cartilage thickness and increase the friction on cartilage surfaces which can eventually cause degenerative tears and higher tendency of traumatic tears for meniscus. This is also the reason why your knees feel stiff and sore after sitting for a long time.

The important finds from this study revealed that continuous knee movement can prevent the cartilage deflation process and interstitial pressure from walking or exercising could encourage cartilage to reabsorb the synovial fluid leaked when we’re not moving. Hence by maintaining an active life style by walking with a small distance on a daily basis after having torn meniscus is a great way to keep your knee cartilage lubricated.

Physical-therapy-walking

Walking on a torn meniscus will not make it worse. By starting with small amount of time to walk daily along with physical therapy can help you to speed up recovery and regain the control of muscles. Walking is a good way to loosen your knee joint and your therapist can also evaluate the way you walk to observe any issues that may contribute to a torn meniscus.

3. A Diagnosis of Torn Meniscus is Not an Indication for Surgery

In most cases, the injury can heal within months and surgery may not be required. You're probably wondering when to see a doctor if you may have a torn meniscus injury? If you are experiencing joint locking, extreme swelling of the knee, extreme pain when moving the joint and you are unable to put any weight on the knee. Then you should consult doctor immediately.

Sometimes even major tears that are found during MRI may not require surgery. The initial treatment for torn meniscus should be aimed at reducing swelling thus your knee should be treated first with physiotherapy and observe if the symptoms of swelling, pain and joint locking can be relieved over time.

Doctor-consulting-with-patient-Knee-problems

One of the best indicators of the necessity for torn meniscus surgery is to see if the swelling and or pain persists 2 weeks after rehab. If the swelling and or pain return after rehab then most likely a surgery is required. Please note surgery itself can not guaranteed for future traumatic tears and the result of recovery. Hence please consult your doctor if swelling persist after rehab and take time to discuss your situation thoroughly.

Please remember that a diagnosis of torn meniscus is not an indication for surgery. A key indication will be determined by where the tear is located, the pattern of the tear as well as whether the swelling and pain can be relieved after rehab. You can also take this meniscus tear quiz about whether you should have surgery for meniscus tear to help you to have a say in this decision along with your doctor’s recommendation.

4. Torn Meniscus Exercises to Avoid

Meniscus tears are common in contact sports such as football, basketball and volleyball. Doctors will usually remind patients who have torn meniscus that some exercises can put too much pressure on your knees. Any exercises that can cause pain or mechanical symptoms for your knees such as catching, clicking, or locking should be stopped immediately. Patients should avoid putting weight on their knees as much as possible.

woman-feels pain-in-knee

Other than contact sports, the following exercises are more likely to be done improperly which should also be avoided for patients with meniscus tear:

    • Deep squatting
    • Pivoting
    • Jumping
    • Twisting
    • Climbing
    • Lunging

In order to minimize symptoms during exercise, please do not perform any high-impact sports as discussed above or other activities that include repetitive jumping, squatting and twisting.  Learn how to prevent torn meniscus is also the key to reduce your risks of getting accidental meniscus injury.

5. Meniscus Tear: Strengthening Exercises for Rehabilitation

Strengthening the muscles around the joint protect your knees from further injury by reducing pressure on the knee as well as helps rehabilitation for torn meniscus. For most types of meniscus tears, some simply exercises can help to maintain your muscle strength in the quadriceps and hamstrings, hip and calf. It’s crucial to ensure these areas are functional after injury or surgery. Please always consult your doctor before doing any rehab exercises even if you feel no pain when you are doing any exercises.

How long does a torn meniscus take to heal? According to Cleveland Clinic, after torn meniscus surgery, the initial recovery time can be up to 2 weeks for patients to receive frequent physical therapy. The actual recovery time will depend on patient’s condition and recovery process. A patient’s physical therapy program after surgery can be divided into three main phases: 1. Regaining control of the leg muscles and weaning from crutches. 2. Regaining full knee motion and strength 3. Returning to normal activity.

Generally speaking, you should limit movement for up to 2 weeks after surgery to fix your meniscus. Sometimes it will take weeks or months before you can go back to your daily activities after surgery. After uncomplicated meniscectomy or meniscus surgery, some typical times for returning to activities can also be summarised into 3 main phases:

    1.  2 weeks after the meniscus surgery with the help from knee brace - you can do simple weight-bearing exercises such as standing or walking or right after the surgery with a knee brace or crutches.
    2.  4 - 6 weeks after surgery (2 to 14 days for uncomplicated meniscectomy) - you can start walking without crutches and start doing some low-impact exercises depend on your surgery outcome. Your knees will start regaining full range of motion during this period.
    3.  3 - 6 months (4 to 6 weeks for uncomplicated meniscectomy): you  can start doing the exercises that you like and return to sports.

Meniscus tear exercises for rehab can also help patients to regain the control of muscles around knees and return to normal activities. 3 simple exercises are recommended for different phases of recovery. After certain types of meniscus surgery. Patients may only be able to stay on bed initially. When patients are lying down on bed. The first recommended exercise is knee bends which can help patients’ legs to avoid blood clots. Knee bends is a simple exercise that can help to maintain blood circulation after lying down on bed for a long time. Patient can move one knee up toward their chest and back down, repeat for ten times then repeat the same process for other leg. It’s recommended to repeat knee bends at least once every hour.

knee-bends-exercise

When patients are sitting on bed or chair, the second recommended exercise is heel and toe raises. Patients can remain seated with both feet on the floor in front of them and raise both heels and keep it for 3 seconds. Repeat this process for 10 times then repeat the lifts by raising the toes of both feet.

The third recommended exercise is heel lifts which the patients can stand up to increase blood circulation around knee joints after sitting for a long time. The instruction for heel lifts is to hold onto a chair to balance your body. Then raise your heels gradually so you can transfer your weight to tiptoes. Keep this posture for 5 seconds then repeat 10 times.

Walking is also highly recommended for improving blood circulation around knee joints for torn meniscus recovery. During the early stage of recovery, you can start with small amount of time to walk daily then increase your time and speed gradually to help muscles around knee joints recover.

6. Tips for Walking with a Torn Meniscus

Can you walk around with a torn meniscus? If you only have mild pain in your knees after torn meniscus surgery. Walking and other low impact exercises will help to speed up the recovery, doing exercise can lubricate the joints and mobilize joint fluid. During the recovery, you may feel painful, stiff and fatigue with your knees but it will improve over time by maintain an active life style.

If you still experience moderate to severe pain in your knees after torn meniscus surgery. Only do a short walk at a comfortable pace or try to do any exercises that doesn’t put much pressure on the knees such as swimming or cycling. If knee pain remains severe and prevents you to do any short distance walk, you might consult your doctor for medical advices immediately.

5 tips to help people who are walking with a torn meniscus

  1. Choose the right knee braces to help you recover from a torn meniscus:

Knee brace is one of the helpful sports medicines that can contribute to torn meniscus recovery. The main benefit of knee braces is helping patients stay active during recovery process. Make sure less stress is applied on the joint and extra stability are vital for torn meniscus recovery. Wearing joint support knee braces can help patients recover from torn meniscus by providing extra stability and limit twisting motion to prevent future injury. Joint support knee braces for a torn meniscus can also prevent hyperextension for patients in order to stop knees being extended beyond the safe range of motion because hyperextension at the knee is one of the most common reasons for a torn meniscus. Additionally, joint support knee braces are equipped with unique springs which can provide support to the knee as a shock absorber and help with weight-bearing of your body. The extra support provided by the knee braces also help with the up-and-down motion of squatting and provide extra support to the injured knee.

woman-sitting-at-clinic-with-meniscus-tear-knee-brace

Compression knee brace is a different type of knee brace which can add pressure to the affected area for the purpose of encouraging better circulation. Sufficient blood supply is crucial to speed recovery because it provides nutrition to the meniscus from the synovial fluid in your joint capsule. Although limited blood supply is found in meniscus, recent research indicates around 20% outer portion of the meniscus has its own blood supply. Wearing a compression knee brace can help patients to reduce stiffness and soreness as well as speed recover due to the increase blood circulation.

  1. Warm up before exercise

It’s recommended to worm up before walking or doing any rehab exercises for torn meniscus after surgery. Just like warming up your car in winter, the cylinders in car engine should be lubricated by engine oil before you start driving your car to avoid shorter life on engine components. Same as your knee joints, start exercising without warm up is dangerous for your knees because your joints may feel stiff or sore after sitting down for a long time. You should to warm up exercise to get your joint fluid moving to avoid potential injuries.

  1. Choose a soft walking surface

Choosing a soft walking surface is crucial because your knees will suffer more from the high impact from the hard surface. Although walking is a safe exercise for torn meniscus patients and it’s far less impact than other high impact exercise such as running, they can still get jarring with each step walking on hard surface. Its recommended for patients to walk on soft surface e.g. a cinder track, asphalt or natural surface trail, they are easier on the joints especially during recovery.

  1. Take the opportunity to walk during low-pain times of day

Some patients may experience a lot of pain or stiffness in the evening and torn meniscus pain worse at night while others suffered pain in different times during the day. If you find the pain is mostly occurred during certain time then you should try to schedule your walks within those times. You are more likely to enjoy the walk during the time when you are facing less pain during the day and help you to maintain an active life style and be consistent with your exercise pattern.

  1. Cold Packs After exercising

During the early stage after tearing your meniscus, you might experience swelling or inflammation around knees. The focus should be on reducing the swelling and regaining the muscle strength. Hence after walking or exercising to try to regain the muscle strength, it’s recommended to apply cold packs around knees to reduce swelling and inflammation. Icing can also reduce pain and swelling if done for 15 minutes after the exercise.

Person-Sitting-And-Applying-Ice-Gel-Pack-On-Knee

The Takeaway - Should I Walk with a Torn Meniscus?

Torn meniscus can be a challenge for walking but it’s important to strengthen your muscle in the front and back of the thigh, calf and hip. Although most torn meniscus cannot heal due to the limited blood supply in our knee cartilage. But by doing suitable exercises can help to reduce stiffness and inflammation. Our knee joints mainly consist of cartilage and bone. Since cartilage does not have enough blood supply to nourish it and joint fluid plays a vital role for the nutrition in cartilage. You may experience that knees are sore and stiff after you wake up in morning. The reason is that movements are essential to produce joint fluid to nourish your knee cartilage.

Hence, walking or any low-impact exercises are important to help you build muscle, maintain your joints functional during torn meniscus rehabilitation. Additionally, certain weight-bearing exercises such as walking can also help to increase blood circulation in your legs and knees. Research has shown that even slowly increases the amount of time you walk each day can reveal the benefits during torn meniscus recovery.

female-walking

Lastly, 3 key takeaways to help torn meniscus recovery or knee injuries.

  1. Maintain sound blood circulation around joints are vital for torn meniscus recovery
  2. There are many ways to improve blood circulation in your knee joints, no matter what your activity level – even if you are still lying in bed during the early stage of recovery.
  3. Any amount of walking is the top recommendation for improving blood circulation especially in joints. You can start small, taking short walks indoor, even just a few minutes each day will help to boost your recovery progress.

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