From seven-figure professional athletes to weekend warriors, knees are one of those things that have given every active person trouble at one time or another. Sometimes knee pain can be a sign of something bigger: a meniscal tear. These are especially common in people who play baseball or softball, or other sports where players do a lot of pivoting, cutting, decelerating or twisting the knee. Meniscal tears with arthritis are also very common in those over 40, and can often be the result of wear and tear.
What’s the best option for treatment? While some more minor tears can be healed with the ever popular RICE method (rest, ice, compression and elevation) and anti-inflammatory medication, more serious tears have traditionally required surgery. But a new study has found that physical therapy may be just as good for treating these tears as going under the knife.
A recent study published in the New England Journal of Medicine randomly assigned patients with knee pain from arthritis and meniscal tears to be treated with surgery or physical therapy. Guess what they found? When they were assessed six and 12 months later, both groups showed the same amount of improvement in movement and pain reduction. In other words, physical therapy was just as effective as surgery for people with this type of injury.
So let’s say all those days on the court finally catch up to you and you begin to experience chronic knee pain or even a meniscal tear: do you opt for surgery or PT? These results suggest either would be beneficial. One benefit of choosing the physical therapy route is that it will address factors beyond the immediate problem. PTs take a “whole person” approach when treating these types of injuries, and can provide insight into why you are experiencing excess strain on your knees instead of just a quick fix. For example, is it because of a loss of strength or flexibility in the muscles? A problem with your overall joint alignment and posture? A result of carrying excess weight? Or just general wear and tear?
When these causes behind the immediate problem are identified, your physical therapist will work with you to correct them. Your PT will prescribe a personalized exercise plan to target and address your specific issues—this is not a one-size-fits-all approach. These plans generally include exercises focused on strengthening and increasing flexibility in the quadriceps, hamstrings and gluteal muscles. Depending on the causes of your knee problems, these plans may also include weight management.
Because I know your brain is deeply entrenched in the Phillies, I’ll use a baseball analogy. Physical therapy is like the team that uses fundamentals to light up the scoreboard, but isn’t known for slamming multiple home runs in the first inning. It’s a slower process, focused on correcting the basics versus the immediate problem. Even if you go to physical therapy and chose surgery in the end, you will still have built a foundation of exercises that will help you in your recovery.
Because there is a portion of the population that does experience great relief from surgery, it is ultimately up to you and your doctor to decide your best course of treatment. Just remember—there is more than one option when it comes to treating knee pain.
For more information about Magee’s Orthopedic Rehabilitation Program, please visit our website or call (215) 218-3900 for outpatient services or (215) 587-3118 for inpatient services.
A version of this blog post originally appeared on Philly.com’s Sports Doc blog on April 16, 2013.