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Meniscus tears are one of the most common knee injuries I see, and the reason they’re so frequent comes down to both structure and movement. The meniscus is a C-shaped piece of cartilage in your knee that acts like a shock absorber between the thigh bone and shin bone. Every time you walk, squat, twist, or land from a jump, the meniscus helps distribute load and protect the joint.
The issue is that the meniscus is constantly under stress, especially during rotational movements. Quick pivots, deep squats, or even awkward twists while getting out of a chair can create the shear forces that lead to a tear. For athletes, the risk is even higher because of the speed, cutting, and explosive movements involved in sport. For older adults, natural changes in the tissue over time make the meniscus more vulnerable.
But here’s the key – most people think a meniscus tear automatically means surgery. Research tells us otherwise. Imaging often shows meniscus tears in people who have zero knee pain, and conservative management through physical therapy often achieves outcomes as good or better than surgery.
The real solution is restoring proper movement across the system. If the hips, pelvis, rib cage, and ankles aren’t functioning well, the knee is forced to absorb stress it wasn’t designed for, which overloads the meniscus. By improving how the whole body shares the load, we can help people recover from meniscus tears, protect their knees long-term, and return to the activities they love – without unnecessary procedures.
If you’ve struggled with meniscus tears – or you’ve had one and keep worrying about the next – it’s not because you’re weak or unlucky. The real problem is that most approaches to knee care are incomplete. Traditional care often looks only at the knee itself: reduce swelling, build quad strength, maybe add some balance drills. While those things can help in the short term, they don’t address why the meniscus is being overloaded in the first place.
The knee rarely fails on its own. Meniscus tears happen because other parts of the body aren’t doing their job. If the hips don’t rotate properly, the pelvis isn’t stable, or the ankles are stiff, the knee ends up absorbing forces it wasn’t designed for. When the system breaks down, the meniscus becomes the victim.
That’s also why many people are told surgery is their only option. But even after surgery, if the underlying movement problems aren’t corrected, the same overload continues – and so does the risk of another tear.
The consequence of not addressing the root cause is a cycle of pain, limited activity, and repeated injury. Left unchecked, this often progresses to more advanced joint problems like arthritis.
The good news is that meniscus tears can be managed – and even prevented – by restoring balance to the whole system. When the hips, core, rib cage, feet, and ankles are all moving the way they should, the load is shared, the knee is protected, and confidence in movement returns.
If you’ve been told you have a meniscus tear, especially after years of knee pain, the usual narrative you hear is: “Try physical therapy, and if that doesn’t work, surgery will.” The truth is, I’ve treated countless people who went through meniscus surgery, and six to twelve months later, they still had the same pain. So what’s really going on?
First, the meniscus tear itself often isn’t the true source of pain. Research clearly shows that imaging findings don’t always match someone’s symptoms. People can have bulging discs, arthritic changes, torn rotator cuffs – or torn menisci – without experiencing pain. Just because an MRI shows a tear doesn’t mean you’re destined for a lifetime of discomfort.
Second, conservative management with a well-structured physical therapy plan has been shown to achieve the same, if not better, outcomes than surgery. The key is whether your plan of care addresses more than just the knee. The knee is usually compensating for dysfunction somewhere else – ankle stiffness, hip weakness, rib cage restrictions, or even how the head and neck are aligned. These issues can overload the meniscus, creating pain that seems like it comes from the tear.
By restoring proper mechanics and teaching your body to move as a coordinated system, we can reduce that overload and often eliminate pain – without surgery. This is why we’ve been able to help so many people who’ve already tried multiple physical therapists, orthopedists, chiropractors, stretches, injections, and still struggled.
The reality is, meniscus tears can be managed successfully when you treat the root cause, not just the image on the scan.
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Featured in Forbes and USA TODAY, LPI Physical Therapy’s “Best Physical Therapy Clinic” award-winning approach treats the entire body as an integrated system, not just the knee.