  Me, mountain biking on 11/4/2018 It hurts to climb stairs, walk, squat and many other essential weight bearing tasks. You go to the doctor and hear something like, ”Your knee joint is bone on bone." "You have a torn ACL." "Your meniscus has a tear."
These are scary things to be told. I have personally been told the latter two. I didn't have surgery. The meniscus is the cartilage found within the knee joint that acts as a cushion and stabilizer for the knee joint. Many people have degenerative tears within this cartilage, often with no pain. It has been shown in the medical research that as many as 20% of women aged 50-59 who DO NOT HAVE KNEE PAIN, have meniscus tears shown on MRI (1). The significance here is that there is a large portion of the population who have meniscus tears without pain. What about knee osteoarthritis, or "bone on bone" knees? As many as 43% of adults over the age of 40 have knee osteoarthritis that can been seen on MRI, but they DO NOT HAVE KNEE PAIN (2). What does this mean? You can be pain-free even with knee joint degeneration found on imaging. How about ACL tears? I can personally vouch for the fact that an individual can have a bilateral meniscal tears, and a full-thickness ACL rupture and get back to full function and no pain without surgery. In 2014, I tore my ACL and both medial and lateral menisci in my right knee while playing basketball. I underwent a course of skilled physical therapy designed by me and my colleagues, and successfully managed to get back to mountain biking, snowboarding, hiking, ultimate frisbee, wake boarding and other high-impact activities that I enjoy. It is a common misconception in our society that these issues require surgery or expensive injections to eliminate pain and restore function. Many individuals are able to avoid such procedures through a course of skilled physical therapy. It may come as a bigger surprise that medical research has supported this idea for nearly 2 decades, and yet invasive procedures are still routinely done for individuals who have never tried physical therapy. Consider what was said in a very recent, high quality research article in a well-respected medical journal, The Journal of the American Medical Association (JAMA). "Despite recent studies suggesting arthroscopic partial meniscectomy (APM) is not more effective than physical therapy (PT), the procedure is still frequently performed in patients with meniscal tears.(3)" In other words, a plethora of research exists to support the idea that most individuals can avoid surgery for a torn meniscus through physical therapy, yet, for some strange reason, surgery is still routinely utilized. Surgery, even in those who are young and healthy, is sometimes not without its complications. Even with "successful" ACL reconstruction surgeries, I've personally seen individuals rupture their ACL for a second and THRID time after surgical repair. It is my strong conviction through evidence and experience that many individuals can avoid this through skilled physical therapy. If you falsely assume that just because your knee is "strong", PT won't help, consider the fact that we utilize a combined approach; hands-on soft tissue and joint mobilization to address pain and range of motion loss (cupping, dry needling, tool-assisted soft tissue mobilization, taping, etc), combined with functional strengthening and balance that is sport or activity specific for each patient. Get back to doing the things your love and need to do. We’ve helped several folks avoid knee surgery this year. Give us a call at (606) 425-4665 or check out our website to learn more at LivingBetterPT.com
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Josh Harris PT, DPT, Cert. MDTPulaski / Lake Cumberland Area, KY Physical Therapist Archives
February 2019
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