A few months ago, a client told me that he learned about me because when he posted a question about his knee pain on Reddit, someone recommended that he contact me.  


So I logged onto the platform to check out what other people with knee pain were asking about.  


Here’s one post that caught my attention:


“Two years ago I had surgery for a medial meniscus tear…”

We have two menisci in our knees: a medial meniscus and a lateral meniscus. 


The medial meniscus is highlighted above in teal.  



The meniscus is a specialized type of cartilage that not only protects the underlying bone, but also provides better stability in your knee. (source)



The exact type of surgery isn’t described, but I’m imagining that it was an arthroscopic surgery, where punctures – rather than a large incision – are made to insert the surgical instruments.  



The surgeon likely trimmed off a meniscus tear.

And perhaps cleaned up some rough areas of the meniscus – a procedure known as debridement.


When a meniscus isn’t strong enough to withstand the force of a particular activity, a tear results.  


It’s a relatively common occurrence, happening to both active adults and professional athletes.  



Trimming off a meniscus tear may sound like a solution.


However, it does not improve the remaining meniscus, which is likely still weak.  



In fact, “recent studies have conclusively shown that outcomes after [trimming off a meniscus tear] are no better than the outcomes after a sham/placebo surgery.” (source)



“I recovered fairly well…”

Recommendations following surgery vary, but some amount of rest is included.  


If you’ve had knee pain – even if you haven’t had surgery – you may have noticed that scaling back your activity helps relieve pain.  



But rest alone is only part of a full recovery.  


Rest may make your knees feel better, but it often provides a false sense of confidence.  



When someone’s knee starts to feel better, they typically resume the activities they enjoy.


If this causes their knee pain to return, it indicates the capacity of their knees isn’t high enough for their desired activities.  



Knee capacity is measured by determining Load Tolerance, the amount of force your leg can produce, or the inside of your knees can withstand, both without resulting in pain.  



Sometimes low Load Tolerance can be from extremely weak muscles, but it’s more frequently due to weakness inside the knee.  


Knee joint pain improves by increasing your Load Tolerance.  




The person that posted on Reddit stated they recovered “fairly well.”  


That likely means they didn’t recover completely.



Which is probably why they never returned to “running or intense sports.”  


Maybe their muscles were strong enough to run or play sports, but the inside of their knee wasn’t ready for this level of force.



“No ‘moment of injury’ and the pain is a dull ache”

By applying the right amount of force to your knees, your cartilage not only absorbs the forces, but it also causes the cartilage to adapt, to become more firm and more capable of withstanding forces that would have previously caused injury. (source)



Prior to being strengthened, cartilage is softer and weaker. (source) 


It can be more easily damaged.  



The quality of the knee pain described by the person on Reddit – a “dull ache” – is common among those with weakness inside their knees.  



Frequently there is no trauma or “moment of injury” involved because this achy sensation develops after performing activities involving repetitive forces.


Activities like walking “more steps than usual” or playing “tennis.” 



“So I'm thinking a fairly sudden increase in loading the knee could be the cause?”

The person who posted on Reddit acknowledged that by increasing how much they were walking, and by returning to tennis, the load on their knee increased.  


A relatively weak knee can’t withstand loads (forces) from more demanding activities.  


And that’s why knee pain typically results.



Key Takeaways

  • Knee pain without a sudden injury – like a “dull ache” – is common, and often results from weak cartilage exposed to repetitive stress (like walking more or playing tennis). 

  • Surgery to trim a torn meniscus doesn’t strengthen the tissue, and research shows outcomes are no better than sham surgeries.

  • While rest may reduce knee pain, it often leads to a false sense of recovery, with pain returning once activity resumes.

  • Internal knee strength matters more than just muscle strength.  

  • Improving how much force your knees can absorb without pain – your Load Tolerance – is essential for returning to running, sports, and daily movement without causing knee pain.



Related Articles

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Disclaimer: The information in this blog post is for educational and informational purposes only and is not intended as medical advice. It should not be used to diagnose, treat, or prevent any health issue or disease without consulting with a qualified healthcare professional. The author of this blog and the website do not bear any responsibility for any actions taken based on the information provided in this blog.