You may not even be sure what your meniscus is, but according to the American Academy of Orthopaedic Surgeons, a tear to the meniscus is one of the most frequent knee injuries. Each of your knees has two menisci. These are curved pieces of cartilage that provide cushioning between bones. Your medial meniscus is inside your knee between your femur (upper leg bone) and tibia (lower leg bone.) Your lateral meniscus connects these same two bones on the outside edge. While some tears are due to obvious injury, some develop due to disease, such as arthritis.
10. Damage Caused by Injury
Athletes may sustain an injury to the meniscus if they engage in sports that require a lot of twisting of the knees. Sports that require squatting or pivoting can include volleyball, basketball, and tennis. Contact sports can also lead to tears of the meniscus in collisions on the football field or basketball court. Running on uneven terrain can be jarring to the knee, resulting in damage to the meniscus, and is seen in such sports as cross country running. Athletes are not the only people at risk for injury to the meniscus. Professions that involve a lot of standing, squatting, and knee bending can place strain on the knee joints. Plumbers, floor layers, and roofers are susceptible to this type of strain.
9. Damage Caused by Disease
Sometimes the meniscus suffers damage without any obvious injury. Over time, normal wear and tear, along with the aging process, can result in a meniscus that is less flexible and more susceptible to injury. Degenerative conditions, such as osteoarthritis, can wear away at the cartilage of the meniscus and cause tears as well. These types of tears are more likely to occur in the elderly.
8. Symptoms of a Torn Meniscus Caused by Injury
When the meniscus is torn in a sudden injury, the pain is immediate. When the injury occurs, the individual may feel a popping or snapping sensation in the area as the leg is twisted or violently struck. Pain will occur in the area of the tear. A torn lateral meniscus will result in pain on the outside of the knee. Meanwhile, a torn medial meniscus will cause pain on the inside of the knee. With time, the pain will radiate throughout the knee. Meniscus injury is accompanied by swelling and a buildup of fluid in the joint. If pieces of cartilage break off, they may lodge in the knee, causing it to lock up and become difficult to straighten.
7. Symptoms of a Torn Meniscus Caused by Degenerative Disease
A torn meniscus due to an injury causes immediate pain. However, tears caused by osteoarthritis or other degenerative diseases may result in a slow onset of symptoms that build up over time. With time, as symptoms worsen, the individual may notice knee pain, stiffness, swelling, and a loss of range of motion. Pain may be especially noticeable when twisting or turning the knee. Sometimes the knee may feel as if it is giving out as the individual is walking. Again, there is the risk of a piece of cartilage breaking off of the meniscus and becoming trapped, causing the knee to lock up or pop.
To diagnose a meniscal tear, a physician will take a medical history to understand the onset of symptoms. The doctor will conduct a physical exam to check the range of motion, rotation, and assess whether the knee is locking. The McMurray test involves rotating the knee to test for pain or a “click” that indicates a tear in the lateral meniscus. The Apley’s Compression test is another maneuver that will alert the physician to damage to the meniscus. To rule out other types of knee injury, your doctor may order x-rays or magnetic resonance imaging (MRI) to get a clearer picture of what is happening inside the knee.
Before treating meniscal tears, it is helpful to know the location of the tear. Tears on the outer area of the meniscus have an abundant blood supply and may be able to heal on their own. Tears on the inner area of the meniscus are devoid of blood supply and are not able to heal. Meniscal tears in this area may have to be treated surgically. Tears that do not require surgery can be treated with the RICE protocol. This involves using rest, ice, compression, and elevation to allow the tear to heal. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin may be taken to reduce pain and inflammation.
In cases where surgery is necessary, an arthroscopic procedure may be done. In a partial meniscectomy, the injured portions of the meniscus are trimmed away. If meniscus repair is possible, torn areas of the tissue can be sutured back together. Recovery from meniscus repair generally takes longer than recovery from a partial meniscectomy. Following surgery, physical therapy will be prescribed to return strength, stability, and function to the affected knee.
3. Physical Therapy Following a Meniscus Tear
According to the Cleveland Clinic, physical therapy following arthroscopic surgery for the meniscus has three phases. The first phase involves exercises that help the patient achieve balance and coordination following surgery. The second phase concentrates on helping patients regain knee strength and a full range of motion. Patients may use bicycle exercises during this phase to aid in straightening and flexing the knee. The third phase occurs when the patient is ready to return to their normal activities.
While recovery time varies with each patient and with each injury, most individuals can expect to be able to return to the same activities they enjoyed before the injury. Your physician will take into consideration your age, the cause of the meniscal tear, and whether or not surgery is required. It may take as long as eight weeks for a meniscal tear to heal on its own. Recovery following a partial meniscectomy may take one month. A meniscus repair surgery generally requires a longer recovery time.
It is suggested that a meniscal tear may increase the likelihood of a patient developing osteoarthritis. Of course, osteoarthritis also increases the risk of a meniscal tear. In addition to the possible risk of arthritis, some patients find they have a decreased range of motion following a meniscus tear. Other patients continue to suffer some level of pain following this injury.