The Truth About Meniscus Tears (What I Wish I Knew in College)

About the Author: Hannah Breal, PT, DPT is the co-owner of Made 2 Move Physical Therapy in Charleston and Charlotte. She helps athletes and active adults rebuild strength, mobility, and confidence so they can move pain-free for life.

Made 2 Move Physical Therapy – Charleston | Daniel Island | Mount Pleasant | Charlotte

I dealt with some knee pain in college and was told I had a meniscus tear. Not gonna lie... I was pretty freaked out.

Every time I felt pain walking, running, or squatting - I thought I was making the tear worse.

I was terrified that I'd eventually need surgery to fix it. or worse... that I'd have to stop working out.

It wasn't until I became a physical therapist myself that I learned what a meniscus tear really means.

The Questions Every Meniscus Tear Patient Asks

Most of our patients with meniscus tears come in with the same questions:

• Do I need surgery to fix this?

• If I have pain, does that mean I'm making it worse?

• Am I going to have pain forever?

• Are there movements I need to avoid forever?

  
  

If you've been told you have a meniscus tear (or even if you suspect one), I get it. It's scary!

Here's what you need to know (and what I wish I knew back in college!)

1. Not All Meniscus Tears Require Surgery

Wild, right?? Most meniscus tears can totally heal on their own, without surgery.

What the Research Says

A 2020 study found no added benefit across 5 years from a partial meniscectomy (meniscus removal) compared to placebo surgery. The surgery actually led to an increased risk of arthritis, which is a whoooole other topic.

A 2022 review showed little to no benefit of arthroscopic surgery for degenerative meniscus tears for pain, function, or quality of life.

When it comes to younger patients (18 – 40) with traumatic tears, the research is a little less clear, but a study in 2022 did show that early surgery didn't have better outcomes than specific exercise treatment.

For degenerative meniscus tears (meaning there was no trauma or accident that led to it), best practice guidelines are NOT in favor of surgery.

What That Means for You

Skimmed over that and wanna know what that means for you?

What I always tell my patients: It's your FUNCTION and your SYMPTOMS that matter more than your imaging.

YOUR MRI IS NOT YOUR DIAGNOSIS.

Not all hamstring pain is a hamstring problem.

Meniscus tears on MRI are very common - in this study, 61% of people with meniscus tears had no pain, aching, or stiffness.

If you have knee pain, went to the doctor, got imaging, and it showed a meniscus tear... you most likely don't need surgery.

Try Treating It Without Surgery First

There are some cases that require surgery, and a lot of others that don't.

I'd highly recommend trying to treat without surgery first. A good PT should be able to evaluate and give you personalized recommendations based on your symptoms, function, history, activity level, and goals!

2. Feeling Pain Doesn't Mean You're Making It Worse or Causing Irreparable Damage

You know how your body heals a cut?

It does the same thing inside too!

Even with larger meniscus tears, healing happens.

Pain Does NOT Equal Damage

Most people are worried that their pain means something is really wrong or that if they feel pain, they must be making their injury worse.

But actually... pain does NOT equal damage! In reality, pain is often just a sign of irritation.

In the presence of an injury, our bodies naturally kick off the inflammatory process, which is super useful and required for healing, but that process can make the area more sensitive and even swollen!

That pain we experience is just our body trying to get our attention and make us aware, like "hey, don't go crazy on us right now. we're trying to heal!"

It's like when there's a wreck on the interstate and EMS arrives to the scene. While it can cause traffic, EMS is super helpful. That traffic is a sign that there's something going on that requires attention.

Use Pain as a Guide

NOW, lemme be clear: that doesn't mean you should push through intense pain. We should use pain and symptoms as a guide.

That brings me to my last point for today:

3. You Don't Need to Avoid Certain Movements Forever (and You Shouldn't!)

It's normal to be nervous about running, jumping, lunging, squatting, especially soon after an injury, but those movements are not off-limits forever.

What Getting Back to Full Function Looks Like

What we need to do is slowly progress you back into doing those things.

that often looks like:

• Restoring normal range of motion (get out of movement jail)

• Building strength in the muscles around your knees

• Improving single leg stability

• Progressing into plyometrics (jumping and landing)

  
  

With the right rehab plan, strength, and patience, you can get back to full function.

Coming Up in Part 2

In Part 2 of this series, I'll share some exercises that have worked for our patients to get them back to doing what they love after a meniscus tear, like Anita, who's lifting weights and running around with her grandkids again!

Even though her doctors said she needed a knee replacement and to "never lift weights again" ....

Want to understand your body better, move with confidence, and stay active for life?

I write a weekly letter on pain, movement, and health — sharing how I actually think about injuries, training, and taking care of your body (without the fear-based nonsense).

If this sounds helpful, you can sign up to get the letters here.

Written by Hannah Breal, PT, DPT, Co-Owner of Made 2 Move Physical Therapy, helping Charleston and Charlotte move pain-free for life.