Strengthening Exercise for Pain Management in Non-Operative Meniscal Tears: A Narrative Review

Abstract

Background: Meniscal tears are a common cause of knee pain and functional limitation in both athletic and older populations. Recent evidence increasingly supports conservative rehabilitation because exercise-based interventions may provide outcomes comparable to arthroscopic partial meniscectomy in selected patients with non-operative meniscal tears.
Objective: This narrative review aimed to synthesize current evidence regarding the effectiveness of strengthening exercise on pain reduction and functional outcomes in patients with non-operative meniscal tears.
Methods: A narrative review was conducted using PubMed, CINAHL, ScienceDirect, PEDro, and Google Scholar databases for studies published between 2016 and 2026. Literature searching was performed using predefined Boolean strategies and manual reference tracking. Randomized controlled trials, systematic reviews, and meta-analyses evaluating strengthening exercise in non-operative meniscal tears were included. Methodological quality was narratively appraised using the Physiotherapy Evidence Database (PEDro) scale. Primary outcomes included pain intensity and functional status assessed using VAS, KOOS, WOMAC, IKDC, and WOMET.
Results: Seven randomized controlled trials were included. Progressive strengthening exercise consistently improved pain and knee-related function across degenerative and traumatic meniscal tear populations. The ESCAPE trial demonstrated a 45.6% improvement in IKDC scores and a 54.5% reduction in VAS pain after supervised rehabilitation. The OMEX trial reported a 25.1-point improvement in KOOS pain scores (95% CI: 21.2–29.0). Several studies demonstrated outcomes comparable to arthroscopic partial meniscectomy during long-term follow-up.
Conclusion: Strengthening exercise appears to be an effective conservative intervention for reducing pain and improving functional outcomes in patients with non-operative meniscal tears.