1. Chronic knee pain and meniscus dysfunction are some of the most common injuries in the active population. But don’t be fooled, surgery is NOT the only option when it comes to making a full recovery.
2. Do you have meniscus dysfunction? Do this QUICK test bringing your heels to your butt. If you have pain, or have limited range of motion you likely have meniscus issues.
3. Understanding that the meniscus is designed to be mobile is the key to treating meniscus dysfunction with conservative treatments such as advanced manual therapy. And yes, the meniscus can be adjusted and manipulated.
4. There’s a reason why you have developed knee pain and dysfunction. Improving your movement patterns and enhancing your function throughout the kinetic chain can alleviate pain, but also BULLETPROOF your knees against future injury.
Fix Your Knee Pain Without Surgery
Do your knees hurt? Have any of you ever been told, you might have a “meniscus problem” or “You’ve got no cartilage in your knee”? Well….I have some news for you—you may not need surgery!
Within the knee there is a cartilage “pancake” called the meniscus. It serves to absorb shock and increase the stability of the knee. It’s very commonly injured and very commonly the source of your knee pain.
What most people don’t get, is that the meniscus is mobile in the joint space. Meaning, it actually slides within the knee independent of your thigh and shin bones as you bend your knee.
Now here’s the problem: because the meniscus moves independently of the surrounding bones that it is in contact with, it can get caught. The meniscus can become fixated on the differing terrains within the knee joint and start to pinch and wear. This can lead to degeneration, tearing, and chronic knee pain.
Are you at risk for meniscus issues that are causing your knee pain? Do this simple test; lay on your back and bend your knee trying to touch your heel to your butt. If you can’t easily touch your heel to your butt than you might be dealing with meniscal issues.
So what can be done to help alleviate your pain and maybe even avoid surgery? That’s what I’m here to cover, and some of these methods might surprise you.
Advanced Manual Therapy Techniques
Dr. Michael Leahy created a treatment called Active Release Technique (ART) that has become the gold standard in non-surgical pain treatment. He found that he was able to actually feel when the meniscus was getting fixated in the knee by pressing on the meniscus through the joint line of the knee while bending and/or twisting the knee. Because of this, he was able to develop techniques to get it moving again.
Simply put, the results in our clinic have been absolutely stunning.
More people should consider a manual therapy like this before they resort to surgery like a knee arthroscopy for your meniscus tear.
Foundational Movement Re-Education
There are several exercises that can really make an immediate impact on reducing poor knee movement, and thus the irritation of the knee or meniscus, by improving the stability and control of your hips and knees. The two that we’re going to highlight today are Side Planks and Kneeling Chops and Lifts.
Side Planks make a huge difference because weakness of the hip abductor muscles (the muscles on the outside of the hips) correlates with knee pain. If your body is not strong enough on the sides, your knee will fall into subtle inappropriate side-to-side motion, which will irritate the meniscus and cause pain. Strengthen that side core!
Lay down on your side, completely perpendicular to the ground. Place your left forearm under your shoulder, then elevate your pelvis off the ground. Keep your feet pointed upwards (dorsiflexed) throughout. Make sure you keep your body as straight as possible, meaning a straight line between your ear and your ankle bone. The most common error is to have too much bend at the hips (sticking your hips backwards). And it should go without saying, don’t forget to breathe!
Perform this exercise daily and certainly before you engage in any physical activity or workouts:
Beginner: Modified for 1 minute hold
Intermediate: Full side plank for 1-minute hold
Advanced: Full side plank with top leg elevated for 30 seconds hold
Kneeling Chops & Lifts
Most people with knee dysfunction are doing two things incorrectly: not using their hips enough and having poor knee posture during their movements (e.g. the knee caving inward during squatting). These exercises go a long way to improve both of these issues—you will learn to keep your knee posture in tact while getting great hip movement forward and backward.
Kneel at 90 degree angles, this is not a ‘hip flexor stretch’ so make sure your front foot isn’t too far forward in the neutral start position. Keep the kneecap over the foot and never allow it to deviate to the midline of the body (especially when reaching down towards the floor). Be sure to shift your hips forward while reaching back, and shift your hips backwards during the reach forward. Switch directions and which hands are performing the reaching. Don’t get frustrated when this feels awkward at first (again, don’t forget to breathe!). Start with wider stances at the beginning of each level, then progress to a more narrow stance in each.
Again, perform this exercise daily and/or before you engage in any physical activity or workouts:
Beginner: 10 reps on both sides, kneeling with a wide stance
Intermediate: 10 reps, on both sides, kneeling with a narrow stance
Advanced: 10 reps, on both sides while standing in a split stance
Exhaust The Conservative Measures Before Knee Surgery
If you improve your strength with these exercises, you can drastically decrease the injurious forces on your knees. Now this is not complete rehabilitation or medical care for knee injuries, but it certainly will be helpful for those of you that are looking to feel less stiffness and discomfort in the knee. It’s a great start. If you’re able to get to the advanced levels you just might be able to avoid making an appointment with your local surgeon!
About The Author
Dr. Scott Hoar is a sports medicine consultant and also a chiropractor. He’s led multiple NFL Combine prep camps and treated athletes from the NFL, NCAA, UFC, NHL and more. Dr. Hoar is a former Certified Strength and Conditioning Specialist (CSCS) and his practice, Mobility 4 Life Chiropractic and Sports Medicine is located in Boynton Beach, FL and Fort Lauderdale, FL. When he’s not treating patients he provides educational workshops for health and fitness professionals. He can be found at Mobility-4Life.com
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