Tears of the meniscus (cartilage in the knee) from degenerative changes are more common in late middle age than in earlier years. The posterior horn of the medial meniscus is especially likely to develop tears as we get older. The medial meniscus is the portion of the cartilage along the inside of the knee joint (closest to the other knee). The posterior horn is located on the back half of the meniscus.
Horizontal meniscal tears (from side to side dividing the posterior horn in two parts) can respond well to conservative care (strengthening program) without the need for surgery. However, treatment choice for this type of meniscal tear is not always easy. These are difficult tears because they can go deep into the joint capsule. Starting with an exercise program as part of a nonoperative approach is a good idea for many patients.
A program designed and supervised by a physical therapist geared toward improving muscle strength, flexibility, and endurance may be advised. Expect to commit at least eight-weeks to the exercise program (including a home exercise portion). The therapist will evaluate your symptoms, motion, posture, strength, alignment, and function. The program will be tailored to your specific needs.
Stretching; isometric, isotonic, and eccentric muscle exercises will be prescribed in a progressive fashion (increasing over time). You can expect pain relief, improved motion and function, and increased activity levels. Most patients report being “very satisfied” with this type of treatment approach. The tear tends to remain stable and no further treatment is required. Only a handful will continue to experience painful symptoms possibly requiring surgical treatment.