Eric Tannenbaum, MD

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Meniscus Tears Treated Without Surgery

For many people over 40 with a wear-related meniscus tear, large trials show that a supervised exercise program works as well as arthroscopic surgery. Strengthening the thigh and hip, and restoring motion, are the foundation.

Prepared by Dr. Eric Tannenbaum, MD · Board-certified orthopedic surgeon, Southern Indiana Orthopedics

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Use this program for

  • Degenerative (wear-related) meniscus tears
  • Meniscus tears without locking
  • Knee pain from meniscus wear in middle-aged and older adults

Before you start

  • Check with Dr. Tannenbaum or your physical therapist that this program fits your condition.
  • Warm up with 5 minutes of easy movement.
  • Move slowly and with control. Quality matters more than speed.
  • Use the pain guide below to decide how hard to push.
0 to 3 out of 10Safe. Keep going.
4 to 5 out of 10Acceptable if it settles by the next morning. Otherwise ease off.
Above 5, or worse the next dayToo much. Reduce the reps, range or weight.

Phase 1: Calm and move

Weeks 0 to 2

Reduce swelling and restore motion.

1Quad set

  1. Sit or lie with the leg straight and a small towel roll under the knee.
  2. Tighten the thigh muscle to press the back of the knee down into the towel.
  3. Hold, then relax.

10 to 15 repetitions, hold 5 to 10 seconds, 2 to 3 times a day

You should see the kneecap move up slightly as the muscle tightens.

2Heel slide

  1. Lie on your back with legs straight.
  2. Slide the heel toward your buttock, bending the knee as far as comfortable.
  3. Hold, then slide back out.

10 to 15 repetitions, hold 5 seconds, 2 times a day

A towel under the heel or a sock on a smooth floor helps it glide.

3Straight leg raise

  1. Lie on your back with the other knee bent.
  2. Tighten the thigh of the straight leg first.
  3. Lift the leg to the height of the other knee, then lower slowly.

3 sets of 10 to 15, once a day

If the knee bends during the lift, do more quad sets first.

Phase 2: Strengthen

Weeks 2 to 8

Build thigh and hip strength.

4Mini squat

  1. Stand holding a counter with feet hip-width apart.
  2. Bend your knees and sit your hips back as if starting to sit in a chair.
  3. Go only as low as comfortable, then stand up.

3 sets of 10 to 15, once a day

Keep your knees over your toes and your weight in your heels.

5Standing hamstring curl

  1. Stand tall holding the back of a chair.
  2. Bend the knee to bring your heel toward your buttock.
  3. Lower slowly.

3 sets of 10 to 15 each side, once a day

Keep the thighs side by side. Add an ankle weight to progress.

6Bridge

  1. Lie on your back with knees bent and feet flat.
  2. Tighten your stomach and squeeze your buttocks.
  3. Lift your hips until your body is in a straight line from shoulders to knees, then lower slowly.

3 sets of 10 to 15, hold 2 to 3 seconds at the top, once a day

Progress to a single-leg bridge when 15 feel easy.

7Step-up

  1. Stand facing a step or stair.
  2. Step up with the sore leg, pushing through the heel, and bring the other foot up.
  3. Step down slowly with the other leg first.

3 sets of 8 to 12 each side, once a day

Keep the knee in line with the second toe. Use a lower step to make it easier.

Phase 3: Function

Weeks 8 and beyond

Restore balance and endurance.

8Single-leg balance

  1. Stand near a counter for safety.
  2. Lift one foot and balance on the other leg, keeping your pelvis level.
  3. Progress by closing your eyes or standing on a pillow.

3 to 5 repetitions, hold 30 seconds each leg, once a day

Keep a slight bend in the standing knee.

9Stationary bike or walking

  1. Ride a stationary bike with the seat high enough that the knee is only slightly bent at the bottom.
  2. Start with low resistance.
  3. Walking on level ground is a good alternative.

10 minutes, building to 20 to 30 minutes, most days

Regular aerobic exercise is one of the most effective treatments for arthritis.

Avoid for now

  • Deep squatting and pivoting while the knee is painful
  • Kneeling for long periods
  • Twisting sports until cleared

When to move ahead

If your knee locks, gives way repeatedly or will not straighten, stop and call our office.

Stop and call our office at (812) 376-9353 if you have

  • Pain that is getting worse week to week, or severe pain at night
  • New numbness, tingling or weakness
  • Significant swelling, redness, warmth or fever
  • A joint that locks, gives way or will not move
The research behind this program
  1. Kise NJ, Risberg MA, Stensrud S, et al. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up. BMJ. 2016;354:i3740.
  2. van de Graaf VA, Noorduyn JCA, Willigenburg NW, et al. Effect of early surgery vs physical therapy on knee function among patients with nonobstructive meniscal tears: the ESCAPE randomized clinical trial. JAMA. 2018;320(13):1328–1337.

Need more help?

Work with our physical therapists

Our physical therapists at the SIO Physical Therapy & MRI building, 745 Schnier Street in Columbus, work alongside Dr. Tannenbaum and can tailor this program to you.

Request an appointmentCall (812) 376-9353

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