Several studies have shown how non-surgically mending your torn meniscus can lead to equal, if not better outcomes than its more invasive counterpart.(1,2) But, all these studies also use specific types of meniscal tears for their research, making how to heal a torn meniscus naturally dependent on a few things.
- The severity and type of your injury
- Where the tear is located
If all these check out, healing a meniscus naturally comes down to controlling the inflammation, getting stronger and adequately flexible, and improving your balance and mechanics.
I’ll talk you through each of those in detail shortly but I think it’s best if you also knew about a few other important things, such as if your meniscus can actually heal on its own and the time you need to let it heal.
How do you heal a torn meniscus without surgery?
All in all, the goal of treatment, natural or otherwise, is to control both pain and inflammation, get your range of motion back to normal, and help get you stronger muscles.
If you had the injury from a certain sport, an added goal would be to improve certain mechanics that may have contributed to your meniscus injury.
All these are addressed in physical therapy but your therapist will also give you exercises and remedies to do at home, including the following:
PRICE is short for:
- Protect – This means shielding your knee from any more injury. For meniscus tears, this generally means walking with crutches.
- Rest – Again, this may also mean walking with crutches. This takes all or some pressure away from your knee, allowing the injury to heal unhampered.
- Ice – Theoretically, ice (i.e. cryotherapy) slows down your body’s inflammatory response to trauma which then reduces swelling and pain.(3)
- Compress – The Annals of Vascular Diseases says that compression therapy is underestimated in terms of managing inflammation. Whether it be through bandages, stockings, or knee sleeves, compression helps your veins return blood from your injury.(4)
- Elevate – Elevating your injured leg essentially has the same benefits as ice and compression which is to regulate blood flow from pooling around your knee joint. This can be done by putting a pillow or two under your knee while you’re lying down.
All these are done during the initial stages of your injury because, in theory, the faster you reduce pain and swelling, the faster you can also get back to your pre-injured state.
Just a few notes though:
- When using crutches, you likely will have to use 2 of them in the beginning. But, once your injury gets suitably better, your doctor or physical therapist will have you graduate to using just 1 and, ultimately, none.
- When using 1 crutch, place it opposite the side of the injury.
- Never ice your injury for more than 20 minutes.
- Ice multiple times a day but only until the swelling goes down – which is about 2 days. After that, switch to using heat so you don’t compromise the healing process.
- Don’t leave your compression bandage/sleeve on overnight.
Pain and anti-inflammatory meds
Like PRICE, pain and anti-inflammatory drugs are treatments done particularly during the early stages of injury. Though, depending on your tolerance and specific case, these may extend towards the later stages.
Nevertheless, you’re essentially looking at 2 kinds here:
- Over-the-counter (OTC) medicine – These include acetaminophen and NSAIDs (non-steroidal anti-inflammatory drugs) like Advil and Tylenol.
- Prescription drugs – These mostly include corticosteroids and possibly other narcotics that reduce pain and swelling more powerfully. However, you’d need your doctor’s approval before you can get any of these.
OTC meds are more commonly used (often before prescription drugs are given) largely because the medical community deems it safer.(5)
Plus, the pain and inflammation from most meniscus injuries are fairly manageable with PRICE, so the need for stronger prescription drugs is uncommon.
Having said that, please use any of these meds sparingly as even NSAIDs and acetaminophen can have serious side effects and may even hamper your recovery when abused.
Strengthen the muscles in and around your knee
If you ask me, this is where physical therapy really shines, as well as in improving your mobility and balance (which we will talk more about later on).
That being said, resistance training has shown capable of strengthening ligaments, tendons, cartilage, and other connective tissues – benefits you want to have to fully recover from your torn meniscus.(6)
However, please remember to progress gradually.
While your knee injury is still recovering, start with isometric exercises.
These are exercises where you contract your muscles without moving the joint. This helps preserve the strength of your muscles while you’re unable to participate in full-on exercise. It also helps stabilize the knee.
Focus on your quads and hamstrings during this stage.
- For your quads, you could place a rolled towel under your knees and attempt to push it down. The towel helps keep your knees in a slightly bent position while preventing movement.
- For your hamstrings, the same position – knees slightly bent with a rolled pillow under your knees – but this time, push your heel down.
- For both muscles, hold the contraction for 5-10 seconds and repeat 10 times. Do this several times a day.
- When you can fully extend your knees on your own, move on to straight leg raises: While lying down on your back with your uninjured leg bent to about 90 degrees, raise your injured leg about 6-12 inches up, hold for 3-5 seconds, then slowly bring it back down. Relax and repeat a total of 10 times.
- Though not an isometric exercise, you may also do side-lying hip abduction exercises.
When you’ve graduated from using crutches, gradually progress your exercises.
First of all, you can also progress your rehab even while you’re on crutches but the primary goal is to get your range of motion back to full.
But, just for the sake of strength training, I like to use getting off of crutches as a sign that I can push patients (i.e. you) a little harder because the meniscus tear has now healed enough to allow it.
To start, try the following exercises:
- Partial wall squats – Stand against a wall with both feet shoulder-width apart and about a foot in front of the wall. Slowly slide your body down, making sure that you bend your knees only to the point where it’s painless. Hold for 3-5 seconds then slowly slide back up.
- Calf raises – Have a chair/table in front of you so you can touch it with your fingers for added stability. Now, with both feet shoulder-width apart, stand on your tippy-toes. Hold for 3-5 seconds then slowly lower yourself down.
- Prone hamstring curls – Lie down on your belly. Slowly bend your knee as much as you can, hold it for 3-5 seconds, then slowly straighten it back down.
- Glute bridges – Lie down on your back with your hips and knees bent, feet flat on the surface, and hands to your sides for stability. Lift your butt off the bed/ground until your knees, hips, and chest form a straight line. Hold for 3-5 seconds then slowly go back down.
- Clamshells – Lie down on your side with your hips and knees bent in front of you. You may also support your head with your hands. Next, slowly raise your knees. Do not raise beyond the point where your hips and torso are forced to rotate. Hold the position for 3-5 seconds then slowly lower.
The exercises above are fairly basic but they can be challenging for anyone recovering from knee injuries. They also work all of the major muscles of your legs, including your glutes (hips), quads, thighs, and calves.
Repeat them all a total of 10 times; Do 3 sets of those repetitions (or less if it’s still intolerable). You will gradually get stronger and the pain and swelling will fade.
When that happens, here are a few other ways you can progress your exercises:
- Use resistance bands. These inexpensive tools are particularly great for glute bridges and clamshells.
- Use machines. These apply to all of the above exercises. Some examples would include the leg press, leg curl machine, seating/standing calf raise machine, and abduction/adduction machine.
- Use physioballs. Otherwise known as theraballs and stability balls, these bouncy rubber balls are light and can come in many sizes. They can be used to make glute bridges, prone hamstring curls, and squats more challenging.
Improve your flexibility
Strength and flexibility go hand-in-hand. Excelling in just one cannot adequately protect you from injury. And, again, a few good physical therapy sessions can help. But, you could also do a few things on your own. Here are a few examples:
- Supine hamstring stretch w/ a towel – Lie on your back with both legs straight. Use a towel under your foot (injured side) to raise your leg until you feel a stretch at the back of your thighs. Hold for 20 seconds, slowly lower your leg, relax, and repeat a total of 3 times. Remember not to fight back the stretch as this could activate your hamstrings and possibly be painful.
- Prone quads stretch w/ a towel – Lie on your belly with a towel in front of your ankles. Hold on to the ends of the towel with both your hands and use it to gently bend your knees until you feel a stretch in front of your thighs. Hold the stretch for 20 seconds, slowly release, relax, and repeat a total of 3 times.
- Standing calf stretch – Stand facing a wall and leave about a foot’s distance between you and the divider. Place your hands on the wall for support. Step back with your injured leg then slowly lean forward until you feel a stretch on your calf. Remember to always keep your foot flat on the ground. Hold for 20 seconds, slowly lean back into position, relax, and repeat a total of 3 times.
- Stationary bike – This serves multiple purposes: 1) for cardio and 2) for promoting knee mobility. If available, choose recumbent bikes or ones where your legs are in front of you rather than directly below you.
Before we move on, know that there are risks to stretching an injured leg without supervision. You could be stretching too aggressively and too soon for the stage of recovery you’re in, for example.
So, for safety purposes, I think it’s best to have your physical therapist show you how it’s properly done. But, if you don’t, just keep in mind to only do stretches and exercises that you can safely tolerate.
Balance and return-to-sport exercises
All those stretching and strengthening exercises I just mentioned? Yeah, they all lead here. Strong and flexible muscles won’t do much without control – and with control comes balance.
Basically, the goal is to keep your center of gravity in line so you don’t fall and/or suffer injuries.
Now, while it’s great to have a physical therapist and/or a trainer guide you through this, there are a bunch of basic balance exercises you can do on your own, including:
- Stand on one leg – On a flat and stable surface, slightly bend your hips and knees on one side so you’re only standing on one leg. Make sure the knee you’re standing on isn’t rotated to either side. Hold this for 60 seconds or for as long as you can, relax, and repeat with the other leg. If it gets too easy, try this with your eyes closed or on a Bosu ball.
- Perturbation exercises – With the help of a friend, have him/her nudge you in whichever direction they want. Make sure both your feet are planted firmly on the ground and you maintain good posture. The point of the exercise is to train both your ankles and hips to adjust your center of gravity back to midline without having you take a step. If this gets too easy, you may proceed to one-leg perturbations, closed eyes perturbations, Bosu ball perturbations, or a combination of all three.
Can a meniscus tear heal on its own?
Yes, but here’s the thing: A meniscus tear will heal only if the tear is located at the part of the meniscus with blood supply (i.e. the red zone).
Luckily, only 19% of the meniscus tears happen in the part with no circulation (i.e. the white zone), so most tears can heal naturally to some degree.(7)
Degenerative meniscus tears also can’t heal on their own.
For the types of tears that won’t naturally heal, ask your doctor to provide medical advice.
What Is the Recovery Time for a Meniscus Tear Without Surgery?
It could be as fast as 4 weeks for minor tears but it could also take up to 12 weeks (3 months) for more severe cases.
However, an underrated part of recovery is your adherence. So, if you want to get back to your usual activities faster, I highly suggest you be diligent with your stretches and exercises and be careful not to cause further injuries.
Will a knee brace help with a meniscus tear?
Yes, knee braces can help with meniscal tears. They add more stability and help limit excessive movement which, in turn, may help relieve pain.
What is the best exercise for a torn meniscus?
There isn’t one specific exercise for injured menisci but programs should be aimed at improving strength, flexibility, balance, and control.
Is a torn meniscus a permanent injury?
Permanence of menisci injuries depend on where they’re located.
– Single-trauma injuries to the outer third (red zone) can heal because it has sufficient blood supply.
– The inner third (white zone), however, will not because of the lack of circulation.
– The middle third (red-white) zone can heal but it might not fully recover or take a while longer.
Damage to the inner and middle thirds of the meniscus may require surgery to reduce joint pain and swelling. Surgical options include repair or removal of all or part of the cartilage (i.e. total and partial meniscectomy).
Degenerative meniscus tears also won’t heal naturally and may develop into arthritis with age. If you’re unsure, I highly recommend seeking a professional’s medical advice.
Meniscus tears are one of the most common knee injuries in sports and while they may sideline you for a little bit, effective treatment options via surgery and natural means are available.
If you and your doctor opt for the latter, the good news is the generally shorter recovery time. Focus on improving your strength, flexibility, and control. And, while you’re at it, maybe ask a trainer how you can improve your technique.
- Graaf, Victor A. van de, et al. “Effect of Early Surgery vs Physical Therapy on Knee Function Among Patients With Nonobstructive Meniscal Tears.” JAMA, vol. 320, no. 13, 2018, p. 1328. Crossref, doi:10.1001/jama.2018.13308
- Katz, Jeffrey N et al. “Surgery versus physical therapy for a meniscal tear and osteoarthritis.” The New England journal of medicine vol. 368,18 (2013): 1675-84. doi:10.1056/NEJMoa1301408
- Vieira Ramos, Gracielle et al. “Cryotherapy Reduces Inflammatory Response Without Altering Muscle Regeneration Process and Extracellular Matrix Remodeling of Rat Muscle.” Scientific reports vol. 6 18525. 4 Jan. 2016, doi:10.1038/srep18525
- Partsch, Hugo. “Compression therapy: clinical and experimental evidence.” Annals of vascular diseases vol. 5,4 (2012): 416-22. doi:10.3400/avd.ra.12.00068
- Dhalla, Irfan A et al. “Opioids versus nonsteroidal anti-inflammatory drugs in noncancer pain.” Canadian family physician Medecin de famille canadien vol. 58,1 (2012): 30. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3264005/
- Fleck, S J, and J E Falkel. “Value of resistance training for the reduction of sports injuries.” Sports medicine (Auckland, N.Z.) vol. 3,1 (1986): 61-8. doi:10.2165/00007256-198603010-00006
- Cinque, Mark E et al. “Clinical Outcomes of Inside-Out Meniscal Repair According to Anatomic Zone of the Meniscal Tear.” Orthopaedic journal of sports medicine vol. 7,7 2325967119860806. 25 Jul. 2019, doi:10.1177/2325967119860806