A locked knee due to meniscus tear can be terribly painful and difficult to deal with. Trust me, I know. I have some looseness of my left knee from a sports injury that happened almost 25 years ago that has left me with a torn meniscus. Through an active lifestyle and sometimes strenuous physical activity (including running a half-marathon and intense hiking in the Rocky Mountains) it is often not a problem, but last weekend my knee locked up – I could not straighten it past 45º.
It is sadly funny that in spite of my active lifestyle, I felt my meniscus slip and my knee locked not while doing not much of anything at all; I was trying to meditate in a full lotus position. I knew I was in trouble when I tried to straighten my leg and I could only get it to a right angle. I was on the floor on a yoga mat and I could not get my self up onto a couch or a chair even though they were only a foot or two away. I was on my own because I knew that I would be home alone for at least 45 minutes. Fortunately, the knee was not painful and I could bend it all the way – I was surprised that I could sit on my knees on the yoga mat.
While waiting for my wife to come home and help me, I grabbed my computer (it was within arms reach) and tried to find on the internet how to unlock a knee with a torn and displaced meniscus. I found plenty of advice on the necessity to have arthroscopic surgery for a locked knee, but I could not find any advice on what to do to improve my knee before making an appointment with an orthopedic surgeon or going to the emergency department.
So, without Google’s help, I discovered several things that were very helpful to first unlock my knee and then help it feel better quickly before going to the orthopedic doctor.
- Let the lower leg of the affected knee hang while sitting on a tall chair like a bar stool for as long as you comfortably can (30 to 60 minutes at a time worked well for me). Spacing or distraction of the affected joint creates space for the impinging meniscus fragment to return to its normal position.
- Apply cold to the knee joint to prevent inflammation that can occur with a displaced or torn meniscus. 10 to 20 minutes of cold application per hour is adequate. A cold wet compress will be more penetrating and effective than an ice pack. The application of cold will help to reduce inflammation in the joint that can cause pain and restricted range of motion.
- Apply heat to the muscles of the lower leg (calf) and upper leg (thigh) to encourage the muscles to relax and allow spacing in the knee joint, reduce pain from muscle spasm, and increase range of motion. CAUTION: apply heat ONLY to the muscles of the calf and the thigh. DO NOT APPLY HEAT TO THE INJURED KNEE until 72 hours have passed.
- Starting 72 hours after the injury, use contrast hydrotherapy to decrease the pain and improve the range of motion. Contrast hydrotherapy is the application of heat, then cold to an injury. Any form of heat is fine as long as it is safe for you. I used a sauna set to 175ºF for 30 minutes, then submerged the entire affected leg for 3 to 4 minutes in a bathtub filled with cold water. CAUTION: if heat is applied too soon to the injured tissue, it will increase swelling, cause more pain, and slow your recovery. You MUST wait 72 hours after an injury before considering applying heat to the injured tissue.
I am very happy with the improvement I have seen from implementing these steps. I hope they support others as well.
Richard Malik, ND
Naturopathic Doctor in Salisbury, CT
Naturopathic Doctor in Manchester Center, VT
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