Meniscus Tear Recovery? Newer Techniques May Help!

How long does meniscus tear recovery take without surgery? Can a meniscus tear heal on its own? Can you walk around with a torn meniscus? Does surgery work? Let’s dig in.

Before you can learn about meniscus tear recovery, you need to know about the meniscus. The knee meniscus is a figure-8 shaped structure that sits between the thigh and leg bone in the knee and acts as a shock absorber to protect cartilage. There is one part of the figure 8 on the inside (medial) that attaches to the leg bone in the middle at the meniscal root. There’s another part on the outside (lateral) that also attaches in the middle. In the image here, the medial meniscus is highlighted red and the lateral meniscus is highlighted yellow. Both structures mix in the ACL ligament in the knee, which is why it’s common to see a medial meniscus injury go along with an ACL injury.

What Is a Knee Meniscus Tear?

There are many different types of meniscus tears that may or may not impact meniscus tear recovery. The first thing you need to know is that tears on the outside of the meniscus are more likely to heal based on the better blood supply in the outer 1/3 of the meniscus. This is called the “red-red zone”. Tears in the middle area that have some blood supply will likely only heal in younger people, and this zone is called red-white. Then there’s the inside 1/3 which is called the white-white zone which has no blood supply, so tears are unlikely to heal. 

The image here shows many different types of meniscus tears in red. While your MRI report will likely tell you the type of tear you have, it’s also important to realize that these tear types may not be as important as we once thought, especially in patients 35 and over. As you’ll read below, in that age group, meniscus tears are as common as wrinkles and many people have no idea that they have them, meaning many don’t cause symptoms.

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Can a Meniscus Tear Heal on its Own? Can You Walk Around with a Torn Meniscus? How Long Does Meniscus Tear Recovery Take Without Surgery?

The short answer is that tears toward the outer third tend to heal on their own with time. Other tears may not, but as I describe below, it may not be a big deal whether the tear heals, as you may have had it for years without ever knowing about it. Meniscus tear recovery without surgery can take 6-12 weeks. To maximize meniscus tear recovery, you may want to purchase or get an unloader brace that can take the weight off of that side while the area heals. Remember, that only works if the tear is in the outside third of the meniscus. These braces are widely available on Amazon and can also be obtained via a doctor’s prescription. The braces are differently configured for the medial or lateral compartments, and left and right, so be careful when ordering.

Are Meniscus Tears a Big Deal?

By the time we’re in our mid-thirties, many of us have tears in our meniscus. Most of us don’t know it (9). Why? Because they are as common and wrinkles and about as important, meaning most don’t hurt. For the ones that do hurt, surgery is often considered. Centeno Schultz Clinic, Does it work?

Does Meniscus Surgery Work?

If you fail meniscus tear recovery on your own, the next step is often surgery. The most common surgery performed on the meniscus is an arthroscopic partial meniscectomy (APM). In this surgery, the doctor removes the part of the meniscus that is torn. The New York Times puts the APM procedure into its “useless” category. Why?

A study conducted in 2013 showed us that APM results couldn’t beat a simple physical therapy program (1). Then research later that year demonstrated that APM wasn’t any better than fake or sham surgery (2). Finally, research in 2016 put the final nail in the proverbial coffin of arthroscopic partial meniscectomy when it discovered that the procedure didn’t beat a faked surgery for patients with locking symptoms due to a torn meniscus (3).

There is also research showing that the surgery may harm the knee joint. For example, research shows us that APM alters the normal way a knee moves (4). Other research has shown that the procedure may cause more lost cartilage (5). Finally, knee arthritis is much more common in patients who have had APM when compared to the non-operated knee (6).

In a recent 5-year study in patients who were over 45 years of age, researchers looked at how many patients went on to get a knee replacement (7). Patients either got physical therapy or a partial meniscectomy to treat a meniscus tear. In the end, the meniscus surgery group was about 2 1/2 times more likely to get a knee replacement than those patients who had just had physical therapy!

Are There Newer Meniscus Injection Techniques that Can Help?

Can meniscus tear recovery be helped along without surgery? I can answer that question with the story of a local patient who is a chiropractor, Evan Katz. He injured his meniscus and ACL while exercising and had significant knee pain. He normally would have had APM surgery at that point, but he knew the research showed that it didn’t work despite surgeons still commonly offering the procedure.

What did Evan Katz do? We performed a Percutaneous Meniscus Trephination procedure using high-dose platelets (8). What’s that? We used precise ultrasound guidance to locate the tear and injected his own healing platelets that we had concentrated in the lab. We also performed a Perc-ACLR procedure with x-ray guidance. How did it work? Here’s a text I got from Evan:

The upshot? Meniscus tear recovery can happen naturally, especially if the meniscus is injured in the outer third. In addition, tears are very common as we age and oftentimes about as important as wrinkles. Also, surgery is really not the answer. Finally, newer techniques are available that can help patients avoid surgery.

Regenexx Cayman Clinic

Physicians at the Centeno-Schultz Clinic rotate several times a year down to the Regenexx Cayman Clinic in Georgetown, Grand Cayman. It is an honor to have this privilege and to have the opportunity to provide this level of service to our patients.

Regenexx Cayman Clinic
The Regenexx Cayman Clinic is a remarkable clinic for a number of reasons:

Breathtaking Location Far from Snow and Cold
Seven Mile Beach is an expansive stretch of white sand beach on the western end of Grand Cayman island. Its waters are clear and rich in animals and vegetation. It recently received the honor of “The Caribbean’s Best Beach”. The challenges of subzero temperatures, bone-chilling winds, and sidewalks that need shoveling are absent.

Stem Cell Treatment Options
The Cayman Clinic is unique as it offers the same PRP and stem cell treatments as offered in the United States and more. Treatment options in Cayman Clinic include:

Regenexx SD: Same Day
Bone marrow extraction with same-day processing and re-injection. Regenexx SD is an effective non-surgical alternative for many knees, hip, shoulder and ankle injuries. To review Regenexx SD outcomes and results click here.

Regenexx C: Culture Expanded
Regenexx C is unique as bone marrow is extracted and grown in culture for 2 weeks at a state of the art cell lab located in Grand Cayman. This expansion process results in a much higher number of stem cells that can be used for treatment. This is important to patients who have multiple joints that they want to be treated or who are on required medications which may negatively impact their stem cells. Culture expansion of one’s stem cells is not legal in the United States and therefore not a treatment option for many patients. Regenexx C is only offered in Cayman Island.

Cell Storage
Want to lock in the youth and vitality of your stem cells now? Regenexx Cayman Clinic offers patients the ability to store their expanded stem cells for use at some future time. The stem cells are cryopreserved in a safe, highly monitored and regulated facility. This is a unique opportunity that some nationally recognized athletes have opted for. If and when an injury occurs, the stem cells can be taken out of storage, grown to a higher number and ready tor injection in several days. Cell storage of bone marrow-derived stem cells is not available in the United States. Cryopreservation stores your cells at your current biologic age, so as you get older, you’re getting younger cells, from you.

KPMG
KPMG International Cooperative is a multinational professional services network, and one of the Big Four accounting organizations. It is a top-shelf organization with a commitment to excellence. Most of the staff are active in various athletic endeavors. As such they are susceptible to injuries. I was honored to provide a lecture to this powerhouse company. I outlined how steroid and current orthopedic practices do not serve them and may in fact permanently derail their athletic activities. Surgical treatment of meniscus tears was a case in point. Despite high-level evidence that this surgery is not better than physical therapy, it remains the most popular outpatient surgery both in the United States and Grand Cayman. Participants learned about the Interventional Orthopedics, Regenexx difference and the SANS approach to common orthopedic injuries. KPMG staff are fortunate to have Regenexx Cayman Clinic as it is staffed by board-certified, fellowship-trained physicians who are leaders in the field of Interventional Orthopedics. Treatment options include PRP, Regenexx SD and culture-expanded bone marrow-derived stem treatment which is not a treatment option in the United States and most of Europe.

Hip Pain Causes

There are many causes of hip pain. most people who experience hip pain believe that it comes from the hip. As a pain physician, I encounter a big number of patients who have hip pain and who are told they have either minimally invasive hip surgery, hip resurfacing surgery or total hip surgery. Unforuntately that this not always the case.

The term pain is one most people know through TV or the filmsthe foremost common is a private who presents to the ER with severe arm or jaw pain. They dont have to see a dentist or an orthopedist. they’re having a attackpain is that the phenomenon of pain perceived at a site adjacent to or at a distance from the positioning of an injury’s origin.

The same concept applies to hip pain causes. What does Centeno Schultz Clinic cost? Common causes of pain that refers to the hip include sacroliliac joint dysfunction, bursitis, myofascial pain syndrome and lumbar degenerative disc disease.

All to often a private goes to their physician with complaints of hip pain only to urge an injection of cortisone or an x-ray of the hip. At the Centeno-Schultz Clinic we evaluate all possible sources of hip pain before focusing our attention on the articulatio spheroidea. Regrettably in 2008, Medicare only requires an x-ray of the hip so as for a patient to be a candidate for minimally invasive hip surgery, arthoscopic hip surgery or total hip replacement surgery. An MRI is crucial to guage structures within the hip which include the cartilage, ligaments and bone.

If therapy is required one in all the latest options is that the use of your own stem cells. At Regenexx expanded autologous stem cells are injected into articulatio spheroidea successfully. Patients will attest to their reduced pain and increased function.

Read Centeno Schultz Clinic Reviews.

Knee cartilage surgery

Cartilage may be a dense animal tissue found within the knee where it provides a protective surface. it’s composed of cells called chondrocytes. Unlike other tissues, articular cartilage doesn’t contain blood vessels and thus has poor regenerative qualities. Injury to the articular cartilage of the knee are often the results of trauma, meniscal knee surgery where some or all the mensicus was removed and other sources. Osteoarthrits may be a common condition of cartilage failure that ends up in limited range of motion, possible bone damage and pain.

Until recetnly the sole treatment options included non-surgical treatments and knee cartilage surgery. wanting total knee replacement sugery,the most common knee cartilage surgery was microfracture.

Microfracture is an arthroscopic knee surgerywhere the calcified cartilage is removed and tiny fractures are created within the bone with an surgical pic. There are a series of limiations to the present procedure and it’s been found to be less effective in patients who are older, overweight and have cartilage damage larger the two.5cm. except for the knee surgery pain, the foremost significant drawback is that the must air crutches for 4-6 weeks additionally to daily physiotherapy.

The newest and fewer invasive option for the treatment of damaged knee cartilage is that the use of autologous mesenchymal somatic cella broadcast case report demonstrated successful cartilage growth in human knees using this somatic cell therapy. Unlike knee cartilage sugery,this procedure is performed employing a small needle that’s directed under x-ray into the affected area. Recovery time is significantly different in this after 5-7 days the patient is in a position connected weight on the affected limb without crutches.

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Knee Ligament Surgery

Knee surgery has improved over time. At one point when someone injured their knee it absolutely was not uncommon fo the surgeon to get rid of the “diseased” or damaged structure. However, with what we all know now, knee ligament surgery continues to be far too common.

The cushions within the knee are called meniscus. They pad and absorb the forces exerted by the leg during walking, running and skiing.

The knee is split into two principal sections: the within and therefore the outside. In each of those compartments there’s a meniscus. sort of a disc within the lumbar spine they provide support and structure. When arthroscopic knee surgery is performed often it removes and trims the meniscus. In removing or trimming this vital structure the soundness of the knee if often affected also a pain after knee surgery.

Four Principle Ligaments
There are four principle ligaments:

Anterior Cruciate,
Posterior Cruciate,
Medial Collateral, and
Lateral Collateral Ligament.
The collateral ligaments provide stability. After meniscal knee surgery or arthroscopic knee surgery the medial or lateral collateral ligaments are often weaken and lax which might create to pain after knee surgery.

The medial and lateral colleral ligament may be repaired without knee ligament surgery. the foremost common approach is prolotherapy during which a sclerosing agent is injected to strenghten also as tighten the ligament.

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Autologous Mesenchymal Stem Cell Therapy

The process begins by isolating a person’s own (Autologous) Mesenchymal stem cells (MSCs) from a sample of bone marrow drawn from their hip. The MSCs then divide during a natural growth medium that comes from the identical person’s blood platelets. The result’s to require the relatively small number of MSCs found during a sample bone marrow, say 2 million, and expand them to a population of 20 – 50+ million. With these numbers, substantial tissue growth is formed possible. The MSCs are then injected with atiny low needle, under live x-ray, into areas of bone, cartilage, and ligament/ tendon damage.

Cartilage is regrown in generalized arthritis and/or solitary cartilage defects in knees, shoulders, ankles, hips, and fingers. It may grow to repair partial meniscus tears. Ligaments and tendon injuries, like sprains or partial tears of the ACL, PCL and MCL of the knee, the bodily structure and supporting ligaments of the shoulder, ankle and hand/wrist, moreover as plantar fasciitis, golfer’s and tendonitismay be repaired. Bone is re-grown in chronic non-healing stress fractures or fractures of larger bones that haven’t healed in spite of casting or perhaps surgery. Chrinic conditions like avascular necrosis have also been successfully treated. Finally, some painful disc bulges in lumbar spine (low back) is corrected to alleviate back and leg pain.

People undergoing these treatments are back on their feet the identical day. Those undergoing hip, knee, and ankle injections can begin walking longer distances after the primary week. Their activity levels are gradually increased over the subsequent month, with the expectation that they’ll be back to their pre injury activity level after three months

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Autologous Mesenchymal Stem Cells and Knee Surgery

Countless numbers of individuals suffer from knee pain on a day to day. When this pain is because of cartilage loss causing bone to rub against bone, the condition is termed osteoarthritis. Until recently, treatments for knee pain secondary to osteoarthritis has been limited.

Medications alone, like NSAIDS and narcotics provide temporary, often incomplete relief and might have unwanted side effects like oversedation and stomach ulcers.

Injections of steroid and implant fluid, like Synvisc and Hyalgan, may prove beneficial, but relief is typically temporary.

Prolotherapy, or injection of a dextrose based irritant solution, induces the body’s own healing process, and might offer long run sympotom relief.

There are several surgical options starting from microfracture to total knee replacement are intended to supply more definitive, long run relief from artiritic knee pain. Thse procedures, however often come short of their promised pain relief. Pain after knee surgery is significant and lead to a chronic recovery period. While microfracture’s recovery is a smaller amount than that of knee surgery pain, it’s cartilage growth is commonly minimal and short lived.

Autologous mesenchymal stem cell therapy is an exciting alternative to knee replacement surgery. Unlike any of the procedures mentioned above, this procedure actually regrows cartilage and ends up in reduced knee pain. There are several successful case studies within the literature which attest to the present.

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Tight Hamstrings and Calves: What Are You Missing?

Muscle pain can take your breath away and can be difficult to successfully address because the real cause is often missed.  What are the hamstring and calf muscles?  What causes tight hamstring and calf muscles?  How do you loosen tight hamstrings and calf muscles?   Is there another cause of tight hamstrings and calves that is being overlooked?   What new treatment options exist?  Let’s dig in.

What Causes Tight Hamstring and Calf Muscles?

The hamstrings are a group of muscles in the upper leg.  They are located on the backside of the upper leg and comprised of three muscles:  biceps femoris, semitendinosus, and semimembranosus.  The calf muscles are located on the backside of the lower leg and comprised of two muscles: the gastrocnemius and soleus.  Tight hamstring and calf muscles can be painful, limiting one’s mobility.  They also make lower extremity muscles more vulnerable to injuries.  Tight hamstrings and calves can arise from different sources which include:

Medications

Medications have multiple side effects which can include muscle tightness.  Common examples include:

  • Diuretic (water pills) to treat high blood pressure and congestive heart failure.
  • Beta-blockers are used to treat high blood pressure and irregular heart rhythms
  • Statins used to treat elevated cholesterol (1)
  • Inhalers such as Proventil and Ventolin to treat various breathing conditions.

Muscle and Tendon Injury

No pain no gain is not always true.  Tears in the muscle can cause swelling, reduced blood flow and contraction with resultant muscle tightness and pain.  Injury, inflammation, and or degeneration of a tendon can also cause muscle tightness.  Symptoms with either tendon or muscle tears are typically limited to one leg.

Overuse

Running, strenuous activity, and hard labor can all cause tight hamstrings and calves (2). This can lead to additional injury including muscle strain where the muscle fibers are stretched or partially torn.

Muscle Imbalance

Are you sitting at your desk, office or in class for long periods of time?  This may be causing your hamstring and calf tightness.  Prolonged sitting tightens your hip flexors which in turn can cause your pelvis to tilt forward (3).  Anterior pelvic tilt can cause tightness in the low back which in turn can trigger tight hamstrings.  Avoid sitting for long stretches of time.  Get up and move around on an hourly basis or consider a standing desk.

Dehydration

Dehydration can cause depletion of essential electrolytes which are necessary for the transmission of the electrical signal from your brain to your muscles.  A  weak or intermittent electrical signal can cause hamstring tightness (4).

Poor Posture

Are you constantly looking down at your phone, tablet, laptop, or computer monitor?  Posture dramatically impacts our muscles and joints. Neutral spinal alignment is ideal where the head, chest, and pelvis stack upon one another.  In this posture, there is minimal stress on the muscles and joints. Unfortunately, news feeds, Instagram and Facebook have us all in compromised positions where our heads are forward, shoulders are rounded, the chest is collapsed and pelvis is tilted forward.  Collectively these can cause hamstring and calf tightness. Skeptical?  Next time your hamstrings are tight look in the mirror and examine the position of your head, chest, and low back.  You will be surprised!

Low Back Nerve Injury

Muscles require electrical impulses to function.  The electrical impulses tell the muscles when to contract and when to relax.  This is critical information and is conveyed by the nerves in the low back.  These nerves are called the spinal nerves.   An uninterrupted electrical signal from the brain to the leg results in a smooth and coordinated contraction of the muscle.  A weak or intermittent electrical signal, however, causes muscle dysfunction.   Over time if the electrical signal is weak or intermittent chronic muscle tightness occurs.  Persistent muscle contraction can also cause tendon injury.

What Can Cause a Weak or Intermittent Electrical Signal?

  • Low back disc bulges
  • Low back disc herniations
  • Low back disc slippage
  • Low back stenosis

But I Have No Back Pain?

Patients can have low spinal nerve irritation without having low back pain.  In fact, approximately 50% of our patients with spinal nerve irritation or dysfunction have no back pain.  Low back disc bulges or stenosis can occur with no low back pain or tension.  Often times chronic hamstring and calf tightness is the first warning sign that there is a problem. That nagging hamstring and calf tightness may an indication that there is a problem with the electrical impulses from your brain to the muscles.  In fact, it may be the first signal that you have issues in your low back that warrant attention.  To better understand the connection between spinal nerve irritation and tight hamstrings and calves please click on the video below.

 

How Do You Loosen Tight Calves and Hamstrings?

Treatment Depends Upon the Cause of the Tightness:

  • In many cases, rest after strenuous exercise and work will relieve the tightness.
  • Medications may be causing your hamstring and calve tightness but should not be discontinued without consultation with your physician.
  • Stretching and physical therapy should always be the initial treatment of choice.
  • Muscle imbalance and poor posture can often be addressed with physical therapy.
  • Hydration is key as properly functioning muscles require adequate hydration.

If you still have hamstring and calf tightness despite addressing the issues listed above you may have an irritated spinal nerve.  In fact, your chronically tight hamstring may be a warning sign that you have a problem in your low back that requires attention.  If ignored, like most things in life, it most likely will get worse and the number of injuries will increase.  Remember when your brakes squeaked and they could have been fixed for a nominal price but you opted to ignore them?  You ended up spending serious money with the replacement of the rotators, calipers, and brakes.

A New Treatment for Irritated Spinal Nerves

Precise injections of PRP around the irritated nerve and low back injury can relieve chronically tight hamstrings and calves.  PRP has many growth factors that can increase the blood flow and decrease the inflammation around nerves and injured lumbar discs. Steroid injections should be avoided due to their toxic side effects (5).  To learn more about the treatment options for low back and spinal nerve irritation  please click on the video below:

At the Centeno-Schultz Clinic, we have extensive experience in the treatment of tight hamstrings and calves with both PRP and bone marrow concentrate.  All injections are performed by a fellowship-trained physician using ultrasound or x-ray, or both.  For patients who want to stay at the top of their game, we have a Pro-Active program. This program provides practical advice on understanding the early warning signs such as chronically tight hamstrings and actions to maintain peak performance. To download this free book please click here.

Do Tight Calves Cause Knee pain?

Yes.  The hamstrings play an important role in maintaining proper knee function and health.  If the hamstring fails to function properly due to chronic tightness or if the hamstring decreases in size in comparison to the quadriceps, knee cartilage and the meniscus is at risk for swelling, degeneration, and injury. (6)

In Conclusion

Tight hamstrings and calves are common and can arise from many sources.  Stretching is not always the best solution as it may only provide temporary relief and does not address the underlying problem.  Identifying and treating the underlying problem is best.  Chronically tight hamstrings may feel like a leg problem but is usually a warning sign that there is a back problem.  Ignoring the issue may lead to more severe injuries.  Precise injections of PRP around irritated low back nerves are an effective treatment option for tight hamstrings and calves which have not responded to conservative therapy. What does Centeno Schultz Clinic Cost? Click to see patient feedback.


1.Stroes ES, Thompson PD, Corsini A, et al. Statin-associated muscle symptoms: impact on statin therapy-European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management. Eur Heart J. 2015;36(17):1012-22.DOI: 10.1093/eurheartj/ehv043.

2.Decoster LC, Scanlon RL, Horn KD, Cleland J. Standing and Supine Hamstring Stretching Are Equally Effective. J Athl Train. 2004;39(4):330-4.

3.Takaki S Ms Pt, Kaneoka K PhD Md, Okubo Y PhD Pt, et al. Analysis of muscle activity during active pelvic tilting in sagittal plane. Phys Ther Res. 2016;19(1):50–57. Published 2016 Nov 29. doi:10.1298/ptr.e9900.

4.Freckleton GPizzari T. Risk factors for hamstring muscle strain injury in sport: a systematic review and meta-analysis. 

5.Wernecke C, Braun HJ, Dragoo JL. The Effect of Intra-articular Corticosteroids on Articular Cartilage: A Systematic Review. Orthop J Sports Med. 2015;3(5):2325967115581163. Published 2015 Apr 27. doi:10.1177/2325967115581163.

6.Kumar D, Subburaj K, Lin W, et al. Quadriceps and hamstrings morphology is related to walking mechanics and knee cartilage MRI relaxation times in young adults. J Orthop Sports Phys Ther. 2013;43(12):881-90.DOI: 10.2519/jospt.2013.4486.

7. Read Centeno Schultz Clinic Reviews here. Patients speak out about failed treatments.

Are Umbilical Cord Stem Cells a Thing?

Transcription

Hi, it’s Dr. Centeno, and I’d like to go over whether umbilical cord stem cells are a real thing –or, is this a scam?

So, many clinics are actively advertising that your stem cells are too old, hence you need to use young umbilical cord stem cells because there’s vials of these things that contain millions, live, and highly vital stem cells that they can inject.

There’s just one problem with that idea….

…And that’s reality.

We have at least three studies that have been done that show that show that amniotic and umbilical cord tissue – as being sold out there, and being used by these clinics – doesn’t actually have viable and functional mesenchymal stem cells as they claim.

In addition, we have this study, which is about to be published, which looked at five umbilical cord products.

So, on the left here (see image), you see the see those five umbilical cord products. These are commonly used by that advertise these things (i.e. umbilical & amniotic “stem cells”), and the fact that all of those plates are white means that they are no stem cells to be had in any of those products.

Now, this study by CSU, their Translational Medical Institute – on the right, that’s actually elderly and middle-aged bone marrow. And you see the purple dots there (see image)? Purple dots equals stem cells.

So, no stems cells in umbilical cord products being used by these clinics. [There are] Lots of stem cells in your own elderly bone marrow.

Why is this Happening?

 

By the time these umbilical cord tissues are harvested at a public hospital, they’re

  • Stored,
  • Transported,
  • stored (again),
  • processed,
  • bottled,
  • frozen,
  • shipped,
  • and shock-thawed in the doctor’s hand in the office, no living stem cells remain.

 

Note if a doctor gives you a White Paper produced by the company he uses, and that purports to show that there are lots of viable stem cells. But, regrettably, the tests used to look at viability in these white papers, while appearing scientific, aren’t nearly sophisticated enough to detect if the cells die over the first few days. That’s a process called apoptosis. When university labs test these products, that’s exactly what happens.

So, if you see a clinic advertising umbilical cord “stem cell” therapy, you need to run because that’s a scam.

 

Thanks so much for watching [or reading], and have a great day!

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