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Does surgery fix the mind or the meniscus? 

The mind is a powerful healing tool when it is given the chance. So powerful that some orthopaedic surgeries are now being called out as nothing more than a placebo. The placebo effect – the idea that your brain can conveniently give your body a fake treatment is a real deal – has been around for thousands of years. However, I bet you never thought that a surgeon would be selling it to you.

So, let’s talk about a scenario
You have a sore knee that isn’t seeming to get better for a few months (or even a year) and you’ve had a gutful. You find yourself desperate to rid yourself of the pain so you turn to good old Dr Google for some advice. Dr Google tells you all about how surgery might be the answer … finally a quick fix! You head off to your GP who sends you off for a scan that confirms you have a degenerative meniscal tear – duh! You then find yourself in the waiting room of an orthopaedic surgeon who suggests… You guessed it… surgery!
– Read more about the persuasive power of a scan here

So, what’s the big deal?
I’ve read multiple high-quality studies saying that knee surgery for degenerative meniscal tears is no more effective than placebo or other non-surgical options – like physio. Degenerative meniscal tears are common and a fairly normal part of aging – in fact, 35% of people over 50 have one. Interestingly, 67% of those cases go symptom-free! Maybe that meniscus tear isn’t the true source of your pain? A degenerative meniscal tear often is accompanied by knee osteoarthritis. The latter is the most common cause of knee pain and if you weren’t aware it can fluctuate and go away with time. Interestingly, 60-90% of people with symptomatic knee osteoarthritis have meniscal tears. Yes, a meniscus tear can increase your risk of developing knee osteoarthritis but are you ready for a paradox… so does the knee surgery that supposedly “fixes” your knee. Studies show that this surgery – an arthroscopy partial meniscectomy – actually makes your arthritis progress more rapidly. Oh, and you’ll be 3x more likely to have a total knee replacement later on in life. Going off to have the surgery will only set you back with your recovery and will lead you straight back to where you should have started – physiotherapy.

So what should you do?
Let’s start with the obvious, shall we… Avoid surgery!
If you have been for a scan then don’t be alarmed by all the medical jargon in the report. Remember that you’re more likely to have a tear without pain than with pain. If you are experiencing knee pain then give these few things a go and take control: 

  • Don’t be afraid of some short term pain relief or anti-inflammatories.
    They are incredibly useful in the treatment of degenerative meniscus tears. Best to run these medications past your GP and always follow the recommendations on the packet.
  • Practice mindfulness!
    It’s simple, effective and it’s free
    Click here to read my top 3 reasons why you should get around mindfulness practice 
  • Stretch it out!
    Your meniscus are basically your knees shock absorbers. Having tight thigh muscles (hamstrings and quads) and calf muscles (gastrocs) has been shown to increase the compressive load on the knee.
  • Start strengthening!
    A strong knee is a pain-free knee! You may not be aware that your meniscus has a small role in passively stabilising the knee. This is why when you have a tear in your meniscus your knee may feel unstable or a bit off. To make up for this deficit you should start strengthening your dynamic stabilisers – aka your muscles. I’ve read a stack of evidence that supports strengthening your glutes (especially your glute medius as it’s a major knee stabiliser), quadriceps and hamstrings muscle groups to reduce your pain scores and increase your function. There would have to be more than 100 ways to perform a squat so find one that is pain-free and get squatting.

What’s the bottom line?
Surgeries used to “fix” degenerative meniscal tears have been proven to be no better than a placebo. Among the hefty price tag, these surgeries are likely to lead to negative outcomes and long rehabilitation timeframes. The good news is that there is strong evidence for physiotherapy to aid your recovery from a meniscus tear. If you have knee pain, want to take control and learn to trust your body again then get in touch with one of the 8th Ave Physio’s.

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