Meniscus (Cartilage) Injuries of the knee
Dealing with a Meniscal Injury of the Knee
The meniscus is a rubbery, C-shaped disc that cushions the knee between the femoral condyle and tibial plateau (one medial and one lateral). They are commonly referred to as “cartilages”. Bruising or tearing of a meniscus leads to pain and swelling of the knee as well as possible mechanical symptoms such as clicking, catching or locking if the tear is more significant.
What causes a meniscal tear?
Acute (often sporting) injuries to a meniscus are often caused by twisting or turning quickly, often with the foot planted on the ground and the knee bent. This can also happen when you are lifting something heavy and twisting through your knees.
Meniscal damage can also occur through gradual wear and tear and overuse such as prolonged weight bearing and particularly running.
Symptoms of a Meniscal tear
The severity of symptoms can vary widely with these injuries, depending on the amount of damage caused to the meniscus. Some common signs and symptoms are…
- Sudden, sharp pain at the inner or outer, anterior or posterior aspect of the knee joint at the time of injury;
- An audible sound or “pop” or reports of a “tearing” sensation;
- Swelling is often present, which may occur between a few hours or a couple of days post-injury;
- Pain tends to be worse with weight bearing activities, particularly if any twisting is involved;
- Pain may settle significantly with rest and non-weight bearing;
- Climbing stairs, kneeling and squatting are painful and difficult;
- Tenderness to palpation over the medial or lateral joint line of the affected knee; and
- Weakness, instability, giving way, clicking or locking may be reported.
Management of a Meniscal tear
Any suspected meniscal injury must follow the RICE protocol (Rest, Ice, Elevation, Compression) for the first 48-72 hours. Following that, it depends on the severity of symptoms present and subsequent suspicion of the degree of damage that is present in each case.
Minor tears often respond well to conservative management. Treatment involves a combination of hands on physiotherapy, relative rest in the acute phase, electrotherapy and a structured program of lower limb stretching and strengthening in preparation for a graduated return to work, exercise and/or sport. Bracing is generally not required.
Small to moderate meniscal tears that respond well to treatment can aim to be back to normal activity/sport within around 3 to 6 weeks on average.
Larger tears need to be investigated further. MRI is the scan of choice for meniscal damage, and if the tear is significant, surgery is certainly indicated. Large tears tend not to respond to conservative therapy, in part due to the poor blood supply to the meniscus. Orthopaedic referral is then indicated.
I hope this information helps you or someone you know who may have a knee injury! As always feel free to call us, email, or refer your patients to us here at The Physio Nook for a friendly and effective service.
Paul Woodward
Principal Physiotherapist
The Physio Nook.
The meniscus is a rubbery, C-shaped disc that cushions the knee between the femoral condyle and tibial plateau (one medial and one lateral). They are commonly referred to as “cartilages”. Bruising or tearing of a meniscus leads to pain and swelling of the knee as well as possible mechanical symptoms such as clicking, catching or locking if the tear is more significant.
What causes a meniscal tear?
Acute (often sporting) injuries to a meniscus are often caused by twisting or turning quickly, often with the foot planted on the ground and the knee bent. This can also happen when you are lifting something heavy and twisting through your knees.
Meniscal damage can also occur through gradual wear and tear and overuse such as prolonged weight bearing and particularly running.
Symptoms of a Meniscal tear
The severity of symptoms can vary widely with these injuries, depending on the amount of damage caused to the meniscus. Some common signs and symptoms are…
- Sudden, sharp pain at the inner or outer, anterior or posterior aspect of the knee joint at the time of injury;
- An audible sound or “pop” or reports of a “tearing” sensation;
- Swelling is often present, which may occur between a few hours or a couple of days post-injury;
- Pain tends to be worse with weight bearing activities, particularly if any twisting is involved;
- Pain may settle significantly with rest and non-weight bearing;
- Climbing stairs, kneeling and squatting are painful and difficult;
- Tenderness to palpation over the medial or lateral joint line of the affected knee; and
- Weakness, instability, giving way, clicking or locking may be reported.
Management of a Meniscal tear
Any suspected meniscal injury must follow the RICE protocol (Rest, Ice, Elevation, Compression) for the first 48-72 hours. Following that, it depends on the severity of symptoms present and subsequent suspicion of the degree of damage that is present in each case.
Minor tears often respond well to conservative management. Treatment involves a combination of hands on physiotherapy, relative rest in the acute phase, electrotherapy and a structured program of lower limb stretching and strengthening in preparation for a graduated return to work, exercise and/or sport. Bracing is generally not required.
Small to moderate meniscal tears that respond well to treatment can aim to be back to normal activity/sport within around 3 to 6 weeks on average.
Larger tears need to be investigated further. MRI is the scan of choice for meniscal damage, and if the tear is significant, surgery is certainly indicated. Large tears tend not to respond to conservative therapy, in part due to the poor blood supply to the meniscus. Orthopaedic referral is then indicated.
I hope this information helps you or someone you know who may have a knee injury! As always feel free to call us, email, or refer your patients to us here at The Physio Nook for a friendly and effective service.
Paul Woodward
Principal Physiotherapist
The Physio Nook.