This is one of the latest questions I received from our running community, and it’s a good one!
I’ve written extensively on how to return to running after meniscus surgery…but what about if you aren’t going to get surgery at all?
Let’s start with the big FIRST question…
Can runners recover from a meniscus injury without surgery?
YES!
More and more research is showing that active individuals can restore normal knee function without going under the knife.
This doesn’t mean that ALL runners should pass on surgery. In certain cases, surgery remains the superior option for long-term knee health.
So, what are the decision criteria to cut or not cut?
To avoid meniscus surgery altogether here is what surgeons will look for…
– Less than 30% of the meniscus is torn.
– The tear occurred in the “vascular” area of the meniscus.
– There is no “flap” to the tear (there isn’t a piece lifting into the joint space)
– There is little to no presence of arthritic changes
– Your knee is functioning well after the injury (no swelling or range of motion loss)
Alright, let’s say you pass the “no surgery” test and you want to get back to running (safely)…what does that look like?
You first want to take care of the basics. Restore a full pain-free range of motion, get your quadriceps (thigh muscle) firing strong, and engage your buttocks muscles.
This “activation” phase is often missed by runners. Most of the time, runners get the “no surgery” clearance and head right back on a run. That’s a mistake. You need to solve the reason WHY you tore your meniscus in the first place!
In my clinic, I’ve seen that 90% of runners (not kidding) have difficulty turning on their buttocks and thigh muscles after a meniscus injury. Although it may feel like you’re engaging those big muscles, often you are, just not at the intensity required to match the non-injured side.
After turning on your big running muscles you need to get them stronger. Squats, deadlifts, step-ups, and lunges are the essentials here. Again, many runners lack sufficient strength even before they injure their meniscus.
Once you activate your key muscles and make them sufficiently strong for the demands of running, then you’re ready to ramp up your running. This usually occurs between 6-8 weeks after meniscus injury.
Probably didn’t expect it to take that long, did you? Your muscles need at least 6 weeks to gain strength, so yeah, it does take that long.
Here’s the thing though…you can walk, hike, cycle, swim, and elliptical shortly after the injury without issue. You will progress back into running with a walk-to-run program that progresses over time.
This RELOADS your cartilage and meniscus without overloading those structures.
By following the activation, strength, walk walk-to-run progression you will avoid damaging your knee joint health and avoid further issues to your meniscus.
Addressing the CAUSE of the injury, with or without surgery, is your number one priority. This likely will require you to work with a running specialist physical therapist to sleuth the cause.
For those of you who are fearful of going under the knife and want to heal your meniscus tear naturally (and you pass the criteria for no surgery) then this framework I’ve provided will help you navigate that pathway.
The best news is that with surgery or no surgery, most runners can return to running safely while avoiding arthritis or the progression of degenerative changes. Awesome right!?
This was a great question that I hoped you gained value from.