Whether it’s from sports, a slip on ice, or a workplace injury, meniscal tears are incredibly common, especially among young adults. If you’ve recently been diagnosed or know someone dealing with one, you’ve probably heard two main options thrown around: surgery or physiotherapy.
In Season 5, Episode 5 of Ask Giri: The Physio Show, we discussed exactly that—pulling insight from a new study known as the DREAM trial, and comparing it with what we’re seeing daily in clinics. As physiotherapists who are deeply involved in both research and rehab, we want to help you (or someone you know) make an informed, confident decision.
The DREAM trial compared two main approaches:
The participants? Young adults with MRI-confirmed traumatic or non-traumatic meniscal tears.
And here’s the key finding: After 12 months, both groups showed similar improvements in function, pain relief, and overall outcomes.
That’s right—surgery didn’t necessarily outperform structured physiotherapy when it came to recovery.
So, what does that mean for you? It means you may not need to rush into surgery, especially if your symptoms are manageable and you’re motivated to stick with a rehab plan.
Now, let’s not throw surgery out the window. Another study from the same research group found that patients under 40 who had mechanical symptoms—like locking or catching—might actually benefit more from early surgical intervention.
So yes, context matters. If you’re experiencing those specific issues, that could change the direction of your treatment.
We’ve worked with countless patients dealing with meniscal tears. Whether it’s sports-related, work-related, or just an awkward fall, our approach is always built around you—your symptoms, goals, and day-to-day needs.
Here’s how we typically walk through it:
Step 1: Understand the Injury
We start with a clear assessment. How did the injury happen? What are your symptoms? Are you dealing with swelling, instability, or clicking? Are your movements limited?
Step 2: Educate and Empower
We make sure you understand what a meniscal tear really is and what healing looks like with or without surgery. Education is half the battle. Once you know how your body works, you can begin working with it, not against it.
Step 3: Start Structured Exercise Therapy
For most people, we begin with a customized program that focuses on:
We keep it practical, progressive, and aligned with your life—whether you’re a student athlete or someone just trying to walk without pain again.
Let’s be real—most of us want to avoid surgery if there’s a safe and effective alternative. And research like the DREAM trial gives us that confidence.
Here’s what we love about starting with physiotherapy:
And the bonus? You’ll likely come out with better body awareness, improved balance, and stronger muscles overall.
Sometimes, despite our best rehab efforts, symptoms persist. In that case, we’ll be honest with you. We’ll talk about referring you to an orthopedic surgeon and walk you through what to expect next.
But even then, your prehab work won’t go to waste—it’ll set you up for a smoother surgical recovery and better long-term outcomes.
At the end of the day, there’s no universal answer when it comes to managing a meniscal tear. What this conversation—and the research—really shows us is that you have more than one good option, and it all comes down to what makes the most sense for your body, your lifestyle, and your goals.
Whether it’s surgery or structured physiotherapy, the goal is always the same: restore function, reduce pain, and get you back to doing what you love. And that journey doesn’t have to be rushed or forced. With the right information, guidance, and support, you can make decisions that serve you in the long run.
We encourage anyone facing this decision to take a breath, ask the right questions, and start with the most conservative and supportive path available. And if you need help figuring that out, we’re here—on the show, in our clinics, and across our community—ready to walk that road with you.
Your recovery is personal. Your plan should be too.
We’ve been sharing practical, real-world physio content for years, covering everything from knee injuries to rehab strategies to movement tips.
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