Are you experiencing knee pain while running? Knee pain is the single largest complaint for us runners, accounting for over 27% of all running injuries.
Knee pain is usually down to conditions such as ITB Syndrome or Runner’s Knee, but today we will be looking at meniscal tears.
There are many reasons why a meniscus tear can occur, usually due to direct trauma, sudden twisting, or like most running injuries, when your training demands exceed your body’s training tolerance.
The severity of a meniscal tear can range from a mild tear with little to no discomfort to a complete rupture of the meniscus with significant pain and loss of function.
Ignoring a meniscus tear can end up leaving you completely side-lined. So, can you run on a torn meniscus?
In this article, we will provide up-to-date science regarding a meniscus tear, discuss the nuance involved in this pathology and look at how to effectively treat this problematic injury.
More specifically, we will cover the following:
- What Is A Torn Meniscus?
- Running With Meniscus Tear: Symptoms & Diagnosis
- The 3 Most Common Causes Of A Meniscus Tear
- Can You Run On A Torn Meniscus?
- How To Effectively Treat A Torn Meniscus
Let’s get into it!
What is a torn meniscus?
If you’re an active athlete or runner or know someone who is, chances are you’ve heard about the meniscus.
Nestled within the knee joint, the meniscus plays a crucial role in providing stability and support. This crescent-shaped fibrocartilage acts as a shock absorber, safeguarding the knee from the rigors of activities like walking, running, and jumping.
The meniscus is usually split into the medial and lateral meniscus. The medial meniscus is larger and more C-shaped, with the lateral meniscus usually being smaller and more O-shaped.There are several types of meniscal tears that can occur, and each can vary in severity. Let’s take a look at the most common ones:
- Vertical Tear: This tear occurs along the long axis of the meniscus, perpendicular to the tibial plateau.
- Horizontal Tear: This tear runs parallel to the tibial plateau and divides the meniscus into upper and lower segments.
- Bucket-Handle Tear: This is the most common type of displaced flap tear, where a portion of the meniscus is displaced into the joint space.
- Vertical Radial Tear: These tears result in two separate pieces of the meniscus or a single piece still attached to the tibia. Repairing these tears is usually not possible, and they may lead to long-term degenerative changes in the knee.
- Complex Tear: These tears involve two or more configurations of tears within the meniscus.
It’s important to note that the specific type of meniscal tear can influence the treatment options available and the expected outcomes.
Consulting with a healthcare professional, such as an orthopedic surgeon, will provide the necessary guidance for the appropriate management of your meniscal tear.
running with meniscus tear: symptoms and diagnosis
It’s interesting to note that not all meniscal tears exhibit noticeable symptoms.
In fact, the field of epidemiology studies on meniscal lesions faces challenges because many of these tears go unrecognized.
Meniscal tears don’t always present with characteristic symptoms, and some may even heal on their own without intervention.
However, here are the most common symptoms you may expect to experience:
- Knee Pain: A sharp or dull pain along the knee joint, which gets worse with prolonged movement, twisting, or squatting.
- Swelling: You may notice swelling or puffiness around the knee joint due to inflammation.
- Knee Instability: It is usual to have a feeling of unsteadiness as if the knee is going to give way – a common experience when walking upstairs or bending over.
- Locking Sensation: You can notice a clicking noise when bending, along with the knee getting stuck in a certain position.
- Limited Range of Motion: When you move, you may have difficulty fully bending or straightening the knee.
- Difficulty Weight Bearing: If the knee is causing you pain, you may have trouble putting weight on the affected leg.
There are plenty of tests to see if you have a meniscus tear, so book yourself an appointment with a healthcare professional to get an accurate diagnosis.
The 3 Most Common Causes of a meniscus tear
#1: Overuse
Overuse is the primary cause of this injury and is a common factor in most running-related injuries. It accounts for up to 80% of all running injuries.
The extent of overuse varies for each individual, depending on the stress endured by the body and subsequent recovery.
It can take a lot of mental fortitude to push hard during a run, particularly when you are just starting out. But sometimes, it is harder to reign in the effort and allow our bodies a manageable environment to adapt to the required load volume.
Our bodies can adapt to do amazing things, but we have to give them the right mixture of stimulus, rest, and nourishment.
Run easy and often. In recent years, studies have shown that, on average, optimal training intensity is achieved when runners perform around 80% of their training sessions at low intensity and 20% with high-intensity work.
You can measure how “intense” your running session is by the rate of perceived exertion (RPE) or by using a heart rate monitor.
If we continue to run at an effort level above the body’s capacity, it will cause excessive muscle stress and inflammation, possibly resulting in over-training and frustration.
#2: Muscle Weakness
Weak muscles surrounding the knee can compromise the level of support, stability, and alignment of the knee joint.
In order to tackle muscle weakness, runners should incorporate a well-thought-out strength and conditioning program that will increase muscle strength and leave your body less susceptible to injury.
Incorporating a strength training program into your routine involves utilizing resistance training exercises to increase the strength of your muscles and connective tissues as a runner.
This can contribute to improved joint stability and a reduced likelihood of experiencing a meniscal tear. Furthermore, engaging in strength training exercises can assist in addressing muscle imbalances.
#3: Impact
A meniscus tear can occur when the femur and tibia undergo sudden and intense twisting motions under load during movements like jumping or collisions in contact sports.
In such cases, if the femur slides too far forward or backward in relation to the tibia, it can exert excessive force on the meniscus, leading to its rupture.
These twisting movements produce significant torque and are often the primary culprits behind meniscus tears.
Now, let’s get down to what you really want to know, is it ok to exercise with a torn meniscus?
Can you run on a torn meniscus?
Many runners run with a meniscus tear; in fact, some studies show that the prevalence of meniscal tears in runners is no higher than the prevalence reported for those who are sedentary.
Nonetheless, the question, “Can you run on a torn meniscus” depends on a number of factors, and as such, the answer is not a straightforward yes or no.
If you are suffering from a symptomatic meniscus tear, the first port of call should be to take a few days off running and try to assess the level of damage.
The most common mistake runners make is jumping back into running too quickly.
Continuing to defiantly run with a meniscus tear may slow the healing process, prolong the course of the injury and cause long-term damage.
The likelihood is that if you’re suffering from a severe meniscus tear or rupture, your body needs to rest.
If the meniscus tear symptoms are mild and don’t deteriorate with exercise, then a substantially reduced volume of running is certainly possible.
How to effectively treat a torn meniscus
What level of rehabilitation you will need to do depends on the severity of the tear.
By working with a healthcare professional, you can be guided as to whether the meniscal tear will be treated surgically or non-surgically. This will usually depend upon the characteristics of the tear and the person being operated on.
How long after meniscus surgery can I run?
After surgery, you will be guided through a program of rehabilitation in order to bring function back to the meniscus.
If surgery is not clinically necessary, then the best way to heal a meniscus tear is to progressively heal and strengthen the tendon through exercise therapy.
Here is an example of a rehab program:
Phase 1: Reducing Pain
If your injury is acute, you can use the RICE method (rest, ice, compression, and elevation) to help treat your pain right away.
This phase is focused on easing our symptoms and reducing the level of inflammation. Modify your activity levels dependent on the severity of the tear.
Rest allows the body to heal. But too much of it can lead to muscle wastage! Find the right balance.
Phase 2: Improve Strength
Is it OK to exercise with a torn meniscus? Yes, but whichever loading level is appropriate for you depends on the stage and severity of your meniscus tear and how experienced you are with resistance training.
Aim to exercise within a range of motion and load volume that is comfortable for you. Avoid activities with heavy loads in positions where there is likely to be meniscus compression.
It can also be useful to try out some crosstraining exercises like swimming or cycling.
They can be a fantastic resource for maintaining cardiovascular fitness without putting too much impact on the knee joint.
Phase 3: Functional Rehabilitation
So, how long after meniscus surgery can I run? Usually, at this stage of rehabilitation, you can start to re-introduce running.
However, running induces a high level of impact. So be sure to re-introduce it gradually.
You can also utilize plyometric exercises to introduce the meniscus back to impact-based exercises. This conditioning can be graded by increasing weight, time under tension, and number of repetitions.
A graded return to running and other usual activities, alongside a strength phase, will often be enough to rehabilitate a meniscus tear.
If you are suffering from knee pain that you suspect is something else, check out the following:
Great article. After tearing mine last year I found Christopher McDougall’s book on running a revelation as part of my rehab. https://amzn.to/3OZSDr2
Good running form is something I knew nothing about. This totally transformed how I run and meant no more knee pain. Was back to 5k runs in about 4 months. And it takes about 5 mins to learn. Hope it helps.