Should I or shouldn’t I? That is the eternal question that occurs in so many aspects of life: Should I or shouldn’t I eat that twelfth doughnut? Should I or shouldn’t I buy that oceanfront property in Mariland? Should I or shouldn’t I enter that karaoke competition even though I sing like a cat that fell in a pool?
Some of these questions have easy answers. When your knee is clicking or locking, throbbing with pain, or swelling like a balloon, you might suspect a meniscal tear and make the easy decision to go to the doctor. However, your first thought may be, “Oh, great. Will I have to have surgery now?” Despite these fears, surgery is not necessarily inevitable, even in the case of degenerative meniscal tears.
The meniscus is a horseshoe-shaped cartilaginous pad that cushions the meeting points of the femur and tibia bones. Its rubbery thickness acts like super fancy basketball shoes protecting the joint from impact. Unfortunately, some weight-bearing, twisting movements can tear the pad. Even if you’re not an athlete, normal use can cause degeneration of the tissue and make it more susceptible to injury.
There are four main problems evident in patients with painful tears:
● impaired kneecap movement
● restricted muscle use due to pain
● impaired stability and balance
Symptoms can also include clicking and popping sounds, and locking or catching of the knee joint.
While pain can be a symptom, it is not a requisite symptom; a study has shown 76 percent of people with no knee pain have had a meniscal tear.
While it is more likely for a tear to happen over age forty, wear and tear of the meniscus can start as early as twenty years of age. 25% of twenty year olds show signs of meniscal degeneration.
Through six studies over twelve years, the British Medical Journal concluded that meniscal tear surgery is not necessarily more effective at relieving pain or improving knee function, and even suggests that it’s “Time to stop meniscectomies for degenerative tears.” Similarly, the American Academy of Orthopedic Surgeons says, “We are unable to recommend for or against arthroscopic partial meniscectomy in patients with osteoarthritis of the knee with a torn meniscus.” They only recommend surgery for acute tears.
Physical therapists have many different therapy options to help control knee pain and start you on the path of strengthening the joint. Medical cupping and myofascial release can relieve tension in the fibers and soft tissues. Even something so simple as a taping technique has helped 70 percent to 80 percent of our clients walk with less pain.
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