Good morning Team

I hope you’re well and managing to stay cool. It’s been another hot week, although let’s see if the temperatures ease off over the next few days. With many schools now breaking up for the summer holidays, it definitely feels like summer is in full swing.

This week’s newsletter focuses on meniscus tears. After I shared a post last week about the health conditions many fitness professionals are managing themselves, one topic came up time and time again. So many instructors mentioned having a meniscus tear or recovering from one, so I thought it would be helpful to explain what it is, how it happens and how we can adapt our exercise and Fitness Pilates practice to support recovery.

I’ve also included an update on the Active IQ Level 4 Pilates Qualification, as I’ve had lots of questions over the past week. If you’re thinking about gaining this qualification before registrations close, you’ll find all the details linked below.

Finally, this week’s new masterclass is Fitness Pilates with the Magic Circle. If you’d like fresh ideas, creative choreography and practical ways to use the Magic Circle in your classes, you’ll find all the information below.

Enjoy this week’s newsletter, and have a fantastic week.

Meniscus Tear

A meniscus tear is one of the most common knee injuries. The meniscus is a C-shaped piece of cartilage inside the knee. You have two menisci in each knee:

• Medial meniscus (inside of the knee)
• Lateral meniscus (outside of the knee)

The menisci help to:

• Absorb shock
• Distribute body weight through the knee joint
• Improve joint stability
• Protect the articular cartilage
• Reduce friction during movement

How does a meniscus tear happen?

Traumatic tears

These are more common in younger or active individuals and usually occur when:

• Twisting the knee while the foot is planted
• Pivoting during sport
• Squatting and twisting
• Sudden changes of direction
• Landing awkwardly
• Falling or receiving a direct impact

Degenerative tears

These are more common from the age of 40 onwards as the meniscus naturally becomes less elastic.

A tear may occur during everyday activities such as:

• Kneeling
• Gardening
• Getting out of a chair
• Squatting
• Climbing stairs

Many clients cannot identify one specific injury.

Symptoms

Common symptoms include:

• Pain along the inside or outside of the knee joint
• Swelling within 24–48 hours
• Clicking or catching sensations
• Locking of the knee
• Difficulty fully straightening or bending the knee
• Pain when twisting
• Pain during squatting
• A feeling that the knee may give way

Types of meniscus tear

Different tear patterns include:

• Small stable tear
• Horizontal tear
• Vertical tear
• Flap tear
• Bucket-handle tear
• Complex tear
• Degenerative tear

Some tears heal well with rehabilitation, while others may require surgery.

How is a meniscus tear diagnosed?

Diagnosis may include:

• Clinical examination
• Orthopaedic assessment
• MRI scan
• Occasionally an X-ray to rule out arthritis

How is it treated?

Treatment depends on:

• Age
• Activity level
• Size and type of tear
• Location of the tear
• Whether the knee locks
• Severity of symptoms

Many people recover successfully without surgery.

Conservative treatment may include:

• Relative rest
• Ice
• Compression
• Elevation
• Physiotherapy
• Progressive strengthening exercises
• Balance training
• Activity modification
• Pain relief if required

When is surgery needed?

Surgery may be recommended if:

• The knee repeatedly locks
• There is a large unstable tear
• A bucket-handle tear is present
• Symptoms continue despite rehabilitation
• A young, active individual has a repairable tear

Surgical options include:

Meniscus repair

The torn cartilage is stitched together.

Recovery:

• Approximately 3–6 months

Partial meniscectomy

The damaged section of cartilage is removed while preserving as much healthy tissue as possible.

Recovery:

• Approximately 4–8 weeks for normal daily activities
• Longer before returning to sport

Fitness Pilates considerations

The aims of exercise are to:

• Reduce pain
• Improve knee stability
• Strengthen the supporting muscles
• Restore confidence in movement
• Improve balance and function
• Reduce unnecessary stress through the knee joint

Suitable Fitness Pilates exercises (when pain-free)

Reformer is wonderful for anyone with meniscus problems.

Supine

• Pelvic tilts
• Neutral spine awareness
• Knee folds
• Heel slides
• Shoulder bridge
• Bridge with adductor squeeze
• Toe taps
• Core stability exercises

Side lying

Excellent choices include:

• Clams
• Side leg lifts
• Hip abduction
• Inner thigh strengthening
• Side kicks
• Small leg circles
• Gluteus medius strengthening

Prone

If comfortable:

• Hip extension
• Swimming preparation
• Glute activation
• Leg lengthening

Four-point kneeling

If kneeling is comfortable:

• Cat stretch
• Bird Dog
• Arm reaches
• Leg reaches
• Thoracic rotation

Extra padding beneath the knees may improve comfort.

Standing

Appropriate exercises include:

• Weight transfers
• Heel raises
• Standing balance exercises
• Hip abduction
• Hip extension
• Sit-to-stand practice
• Mini wall squats within a pain-free range

Exercises to avoid during the painful stage

Avoid:

• Deep squats
• Full kneeling if painful
• Deep lunges
• Twisting on a planted foot
• Jumping
• Hopping
• Rapid changes of direction
• Loaded rotational movements
• Deep single-leg squats

Exercises that may need modifying

Modify as required:

• Roll Down (soften the knees)
• Standing leg work (reduce knee bend)
• Chair (avoid deep knee flexion)
• Side lunges (reduce the range)
• Single-leg balance (hold on for support)
• Standing balance work (use a wall or chair if needed)

Strengthening progression

A sensible progression includes:

1. Glute activation
2. Quadriceps strengthening
3. Hamstring strengthening
4. Hip strengthening
5. Core stability
6. Balance training
7. Functional standing exercises
8. Sit-to-stand practice
9. Gradual squatting
10. Return to higher-level activities

Recovery times

Typical recovery varies according to the type of tear:

• Mild tear: 4–8 weeks
• Moderate tear: 2–3 months
• Meniscus repair surgery: 3–6 months
• Partial meniscectomy: 4–8 weeks for everyday activities, with a longer return to sport

Teaching considerations for Fitness Pilates instructors

When teaching clients with a meniscus tear:

• Work only within a pain-free range.
• Avoid twisting the knee while the foot remains fixed on the floor.
• Limit deep knee flexion during standing exercises.
• Focus on improving glute, hip and core strength to reduce load through the knee.
• Encourage good lower limb alignment throughout movement.
• Progress balance and functional exercises gradually.
• If the knee is swollen, repeatedly locks or gives way, the client should seek assessment from an appropriate healthcare professional before progressing their exercise programme.

For many clients, Fitness Pilates can form an effective part of rehabilitation by improving strength, balance, movement quality and confidence while providing a low-impact form of exercise. Progression should always be individualised according to symptoms and stage of recovery.

Have a fantastic week and whats app me with feedback or questions

I love to hear from you 07976 268672 

Rachel Holmes

Have questions about Level 4 – whats app me 07976 268672 

COURSE UPDATES

Level 3 Pilates Course Dates on ZOOM

• 7 / 8 / 9 August 2026
• 11 / 12 / 13 September 2026
• 9 / 10 / 11 October 2026
• 6 / 7 / 8 November 2026
• 11 / 12 / 13 December 2026

LEVEL 3 REFORMER QUALIFICATION (YMCA)

Face-to-Face (C2GO Studio NG16 4HA)

• 21 July 2026 FULLY BOOKED 
• 21 August 2026 FULLY Booked
• 25 September 2026
• 23 October 2026
• 27 November 2026
• 15 December 2026

Fitness Pilates Reformer Teacher Training Course

• 22nd July Fitness Pilates Reformer
• 30th July Fitness Pilates Reformer ONLINE
• 7th August GLOUCESTER Nuffield

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