Meniscus Tear
What Is A Meniscus Tear?
Because our knees take a lot of strain throughout our lives, they have developed extra cushioning pads called meniscus within them. There are 2 meniscus, and medial and a lateral, and they sit between the two bones that make up the knee joint, effectively acting as supplementary cartilage to absorb shock and protect the bone surfaces. The meniscus’ are made of similar material to cartilage so they are soft, hydrated and shock absorbent. Although they can withstand a reasonable amount of force, they can be torn if the put under too much strain. This happens mostly from a twisting incident in the knee.
How Does A Meniscus Become Torn?
There are 2 types of meniscus tear that we see at The Physiotherapy Place - traumatic or atraumatic.
A traumatic meniscus tear usually happens when the knee is twisted and the foot is planted which is why it is quite a common football injury.
An atraumatic tear happens when the meniscus has degenerated as happens in later life. The structure becomes less hydrated and more brittle so it is prone to tears from overuse.
What Are The Symptoms Of A Torn Meniscus?
A traumatic meniscus tear will often:
make an audible pop sound as it happens
cause knee pain and immediate swelling
if part of the meniscus has dislodged in the joint (bucket-handle tear) then it can be difficult to fully bend or straighten the knee
Symptoms of an atraumatic tear:
might not be as noticeable when it happens
can be a more gradual pain that slowly builds up
stiffness that builds up over time
pain when fully bending or straightening the knee
Can It Heal On Its Own?
After the age of 16, the meniscus will rarely heal on its own. This is because it is largely avascular i.e. it doesn’t have much blood supply so its capacity to repair is minimal. This doesn’t automatically mean that it requires surgery though. Many meniscus injuries will settle down well without surgery and as long as the knee is properly rehabbed the outcomes are great. There are occasions where the knee may require surgery though and this will be apparent upon examination of the knee.
What Is The Best Treatment?
Conservatively the best treatment is initially getting the knee range of motion back and reducing inflammation. Manual therapy and exercise are great for this and when this is achieved then more intensive strengthening can begin.
What Exercise Is Best To Do For A Torn Meniscus?
Because the meniscus is involved in shock absorption, early exercise is focussed on low impact mobility and stretching to take pressure off the knee and encourage healing. When it is ready strengthening exercise can begin, gradually introducing load bearing exercises and moving onto sport-specific exercises before a return to sport is considered.
What Will A Physiotherapist Do?
A physio will diagnose your injury and implement the best treatment plan. Sometimes this might mean onward referral onto an orthopaedic specialist but if not then hands on treatment and exercise can begin straight away. You will be guided through your rehab making sure that you only progress onto the next stage when your knee is ready for it. This will ensure that your knee is in the best shape possible when returning to sport, reducing the chances of re-injuring the meniscus.