Is running bad for a meniscus tear?

Running with a Meniscus Tear: Management Guidelines

Running is generally not recommended for individuals with a meniscus tear as it can exacerbate symptoms and potentially delay healing. 1, 2

Impact of Running on Meniscus Tears

• Running places significant stress on the knee joint and can worsen symptoms of pain, swelling, and functional limitation in patients with meniscus tears 2, 3
• Mechanical loading during running may impede healing, particularly for tears in less vascularized areas of the meniscus 4
• Continuing to run with a meniscus tear may contribute to the development of degenerative knee disease over time 5, 6

Conservative Management Recommendations

• Physical therapy and structured exercise programs should be the first-line approach for most meniscus tears, particularly degenerative tears in patients over 35 years old 2, 7
• Focus on strengthening exercises for quadriceps and hamstrings to improve knee stability and function 7
• NSAIDs (oral or topical) can be effective for pain management 7
• Cryotherapy (ice) should be applied through a wet towel for 10-minute periods to reduce pain and swelling 7

Return to Running Considerations

• Running should only be resumed after:

  • Complete resolution of pain and swelling 2, 3
  • Restoration of full range of motion 1
  • Adequate lower extremity strength and functional capacity 1
  • Clearance from a healthcare provider 2

• When returning to running:

  • Begin with a gradual, progressive program 1
  • Start on level surfaces initially 1
  • Avoid hills in the initial stages as they can increase strain 1
  • Monitor symptoms closely and adjust activity accordingly 7

Surgical vs. Non-Surgical Management

• Surgery should only be considered after failure of comprehensive conservative treatment lasting at least 3 months 2, 7
• Arthroscopic surgery is not recommended as first-line treatment for degenerative meniscus tears 1, 2
• Recovery from arthroscopic procedures typically takes 2-6 weeks, with limitations on weight-bearing in the first week 1, 2
• Running should be avoided during the recovery period following surgery 1, 2

Risk Factors for Poorer Outcomes

• Advanced age (degenerative tears more common in patients over 35) 2, 5
• Pre-existing osteoarthritis or degenerative knee disease 1, 8
• Mechanical symptoms such as locking or catching 2, 7
• History of previous knee injuries 6
• Anatomical factors such as genu varum (bow-leggedness) 6

Common Pitfalls to Avoid

• Rushing back to running before adequate healing has occurred 2, 7
• Assuming all mechanical symptoms require surgical intervention 2, 7
• Neglecting proper rehabilitation and strengthening exercises 7
• Continuing to run through pain, which may lead to compensatory movement patterns and additional injuries 3