Knee Injury and Meniscus Tear

Like a lot of knee injuries, a meniscus tear can be painful and debilitating. Unfortunately, it's quite common. In fact, a meniscal tear is one of the most frequently occurring cartilage injuries of the knee.

So what is the meniscus? It's a piece of cartilage in your knee that cushions and stabilizes the joint. It protects the bones from wear and tear. But all it takes is a good twist of the knee to tear the meniscus. In some cases, a piece of the shredded cartilage breaks loose and catches in the knee joint, causing it to lock up.

Meniscus tears are common in contact sports like football as well as noncontact sports requiring jumping and cutting such as volleyball and soccer. They can happen when a person changes direction suddenly while running, and often occur at the same time as other knee injuries, like an anterior cruciate ligament (ACL) injury. Meniscus tears are a special risk for older athletes since the meniscus weakens with age. More than 40% of people 65 or older have them.

What Does a Meniscus Tear Feel Like?

Symptoms of a meniscus tear include:

  • Pain in the knee
  • Swelling
  • A popping sensation during the injury
  • Difficulty bending and straightening the leg
  • A tendency for your knee to get "stuck" or lock up

At first, the pain may not be bad. You might even play through the injury. But once the inflammation sets in, your knee will probably hurt quite a bit.

To diagnose a meniscus tear, your doctor will give you a thorough exam. He or she will want to hear details about how you got your injury. X-rays may be necessary, to rule out broken bones and other problems. You may also need an MRI (Magnetic Resonance Imaging) scan, which allows a more detailed evaluation of knee cartilage.

What's the Treatment for a Meniscus Tear?

Treatment for meniscal tears depends on the size and location of the tear. Other factors which influence treatment include age, activity level and related injuries. The outer portion of the meniscus, often referred to as the “red zone,” has a good blood supply and can sometimes heal on its own if the tear is small. In contrast, the inner two thirds of the meniscus, known as the “white zone,” does not have a good blood supply. Tears in this region will not heal on their own as this area lacks blood vessels to bring in healing nutrients.

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Happily, not all meniscal tears require surgery. If your knee is not locking up, is stable, and symptoms resolve, nonsurgical treatment may suffice. To speed the recovery, you can:

  • Rest the knee. Limit activities to include walking if the knee painful. Use crutches to help relieve pain.
  • Ice your knee to reduce pain and swelling. Do it for 15-20 minutes every 3-4 hours for 2-3 days or until the pain and swelling is gone.
  • Compress your knee. Use an elastic bandage or a neoprene type sleeve on your knee to control swelling.
  • Elevate your knee with a pillow under your heel when you're sitting or lying down.
  • Take anti-inflammatory medications. Non-steroidal anti-inflammatory drugs (NSAIDs), like Advil, Aleve, or Motrin, will help with pain and swelling. However, these drugs can have side effects, such as an increased risk of bleeding and ulcers. They should be only used occasionally, unless your doctor specifically says otherwise.
  • Use stretching and strengthening exercises to help reduce stress to your knee. Ask your doctor to recommend a physical therapist for guidance.
  • Avoid impact activities such as running and jumping.

These conservative treatments, however, aren't always enough. If a tear is large, unstable, or causing locking symptoms surgery may be required to either repair or remove unstable edges. The procedure is usually pretty simple, and you can often go home the same day. You may need a brace afterward for protection if a repair is performed.

For 85% to 90% of people who get the surgery for a meniscus tear, the short-term results are good to excellent. But in the long-term, people who have a large meniscal injury that is unrepairable may be at a higher risk of developing knee arthritis.

 

When Will My Knee Feel Better?

Recovery time for your knee depends on a number of factors, including how severe your meniscus tear is. Full recovery from surgery may take 4 to 6 weeks, depending on the type of procedure performed as well as other factors. But keep in mind that people also heal at different rates. In most cases physical therapy is used after surgery to minimize complications and speed recovery.

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If your medical team agrees, you could take up a new activity that won't aggravate your knee pain while you recover. For instance, runners could try swimming.

Whatever you do, don't rush things. Don't try to return to your old level of physical activity until:

  • You can fully bend and straighten your knee without pain.
  • You feel no pain in your knee when you walk, jog, sprint, or jump.
  • Your knee is no longer swollen.
  • Your injured knee is as strong as your uninjured knee.

If you start using your knee before it's healed, you could cause further injury.

How Can I Prevent a Meniscus Tear?

Meniscus tears are tough to prevent since they're usually the result of an accident. But some precautions might lower the risks of a knee injury. You should:

  • Keep your thigh muscles strong with regular exercises.
  • Warm up with light activities before taking part
  • Give your body time to rest between workouts. Fatigued muscles can increase your risk of injury.
  • Make sure your shoes have enough support and fit correctly.
  • Maintain flexibility.
  • Never abruptly increase the intensity of your workout. Make changes slowly.
WebMD Medical Reference Reviewed by David Zelman, MD on November 18, 2015

Sources

SOURCES: 

American Academy of Orthopedic Surgeons: ''Meniscal Tears.'' 

Calmbach, W. American Family Physician, Sept. 1, 2003. 

Davis, M. Expert Guide to Sports Medicine, American College of Physicians Press, 2005. 

Rouzier, P. The Sports Medicine Patient Advisor, second edition, SportsMed Press, 2004.

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