Meniscus Tear Knee Injury

Medically Reviewed by Zilpah Sheikh, MD on May 08, 2024
Written by Kathryn Whitbourne
9 min read

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. Cartilage is connective tissue that protects your joints and bones. 

Meniscus tears often happen in contact sports like football and wrestling, as well as in non-contact sports requiring jumping or pivoting, such as volleyball and soccer. 

 

 

The meniscus is a piece of cartilage in your knee that cushions and stabilizes the joint. It acts as a shock absorber, protecting the bones from wear and tear. Each of your knees has two pieces of this cartilage: 

  • The medial meniscus is on the inside of the knee.
  • The lateral meniscus sits on the outside of the knee. 

Both are shaped like Cs and provide cushioning between your shinbone (tibia) and your thighbone (femur). The two menisci help to keep your knees stable.

A tear can happen when you change direction suddenly while running, or twist your upper leg while your foot is still and your knee is bent. These tears often occur alongside other knee injuries, like an anterior cruciate ligament (ACL) injury. In some cases, a piece of the shredded cartilage breaks loose and catches in the knee joint, causing it to lock up.

But the menisci also weaken with age, so as you grow older, you might get a tear just from making an awkward turn when you get out of a chair. More than 40% of people 70 or older have had a torn meniscus.

Symptoms of a meniscus tear include:

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

What Does a Meniscus Tear Feel Like? 

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. The pain might increase when you squat, lift weight, or get up from a chair. 

If you have a small or moderate tear, the pain could go away but return if you do a twisting motion or continue to overuse your knees without treatment.

If you have a large tear, then swelling will come right away, you'll have a lot of pain, and it'll be hard to walk or straighten your knee.

There are many types of meniscus tears, depending on their shape and their location when seen on a scan done by a magnetic resonance imaging (MRI) machine, which uses powerful magnets and radio waves and can make
detailed pictures of the knee.

Medial meniscus tear

This is a tear in the medial meniscus. The medial meniscus is attached firmly to the inside of the knee joint and ligament, so it's not very mobile.

Lateral meniscus tear

This is a tear in the lateral meniscus. The lateral meniscus is attached to the outside of the knee joint and ligament, but not tightly, so it's more mobile.

Tears are more common in the medial rather than in the lateral meniscus, perhaps because of this lack of mobility. Here are some common types of tears that can happen in either part of the meniscus.

Bucket handle meniscus tear

This is a fragment of a vertical tear from the shinbone to the thighbone, moving along the length of the meniscus. Nearly 10% of meniscus tears fall into this category. Normal knee motion is usually impossible as the torn part of the meniscus causes the knee to lock. 

Radial tear

This is one of the most common types of tears. About 28% of all medial meniscus tears fall into this category. These tears run perpendicular to both the tibia and the long axis of fibers in the meniscus. This means they can put increased pressure on the joint by disrupting the structure that helps distribute weight in the knee.

Posterior horn medial meniscus tear

This is a tear at the spot where the meniscus and bone meet. It most often happens when lifting a heavy object improperly or playing a sport with a twisting motion, like tennis. Older people can get it even while doing something like climbing stairs. Often, symptoms don't happen right away, but they'll show up over time and you may end up with a stress fracture. 

Meniscus degenerative tear

This is a tear due to aging (rather than because of a specific injury) and is often linked to knee osteoarthritis. Most people with this condition have no symptoms. Those who do may have knee pain and feel the knee locking up. Treatment starts off with exercise, pain relievers, and topical treatments. The doctor may also advise you to lose weight.

To diagnose a meniscus tear, your doctor will give you a thorough exam and ask how you got your injury. They'll check your knee to see if there's any tenderness along the joint line where the meniscus is located. That tenderness often indicates a tear. 

The doctor may order some other tests as well. They may ask for an X-ray to rule out broken bones, arthritis, and other problems. They may also order an MRI scan, which allows a more detailed evaluation of knee cartilage and menisci.

Meniscus tear test

A common way to check for this kind of tear is the McMurray test. Your doctor will have you lie down on a table. They'll bend and straighten your knee and rotate it both ways. If you have a tear in your meniscus, you may feel pain or hear a clicking sound in the joint.

Treatment for meniscal tears depends on the size and location of the tear, as well as your age, activity level, and related injuries. 

Happily, not all meniscal tears require surgery. If your knee is not locking up, is stable, and symptoms clear up, nonsurgical treatment may be enough. To speed the recovery, you can use the RICE principles, which are:

Rest the knee. Stop the activity that caused the injury. Limit movement to walking if the knee is 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 are 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.

You can also:

  • Take anti-inflammatory medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), like Advil, Aleve, or Motrin, will help with pain and swelling. But these drugs can have side effects, such as a higher risk of bleeding and ulcers. They should be only used now and then, 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.

Meniscus tear knee brace

Wearing a knee brace can protect your knee from further injury after a meniscus tear. The brace will prevent you from overextending your knee and lessen the stress on your meniscus. The knee brace also compresses your knee, which encourages blood circulation and helps your tear heal faster. Wearing a brace is often paired with doing physical therapy.

Your doctor may also have you wear a knee brace after surgery. 

Your choice of knee brace depends on the kind of meniscus tear you got, plus the types of activities/sports you're doing and how long you need to wear it. But any type you get should provide support and compression.

Meniscus tear surgery

If a tear is large, unstable, or causing locking symptoms, your doctor will perform what's known as arthroscopic surgery. They'll insert a tiny camera through a small cut in the knee. This allows them to see inside the knee. Then they'll insert some surgical instruments through two or three other tiny cuts to trim or repair the tear.

The procedure is usually pretty simple, and you can often go home the same day. If the damaged meniscus tissue is just trimmed (a meniscectomy), the recovery period is short. If the pieces of tissue are repaired (sewn together), the recovery time is longer, as you have to wait for the meniscus to heal. You may need a brace during recovery.

After surgery, you'll have to do rehabilitation exercises either at home or at a physical therapist's office. 

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 getting knee arthritis.

Can a meniscus tear heal on its own?

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.

Recovery time for your knee depends on a number of things, including how severe your meniscus tear is and whether or not you had surgery. But people also heal at different rates. 

Meniscus tear recovery without surgery

If you had a simple tear and no surgery, your healing time could be 4 to 6 weeks, during which you'll be resting the knee and doing physical therapy. 

Meniscus tear recovery after surgery

The rehab time (during which you'll be doing physical therapy) for a meniscectomy is 3 to 6 weeks. For a meniscus repair (also doing physical therapy), it's 3 to 6 months.

Meniscus tear exercises

Physical therapy helps to speed recovery from surgery as well as to heal a minor meniscus tear where you didn't have surgery. Your doctor or physical therapist may suggest some exercises. These exercises could include leg raises, buttock tucks, partial squats, and hamstring stretches. The American Academy of Orthopaedic Surgeons has a full knee conditioning program with instructions for several exercises. Talk to your doctor or physical therapist about which exercises are best for you.

Your therapist might also advise that you walk (2 weeks after surgery) or ride an exercise bike. You may have to avoid running while your meniscus tear heals. If your medical team agrees, you could try swimming instead.

When is it safe to return to exercise?

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.

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. 

  • Keep your thigh muscles strong with regular exercises.
  • Warm up with light activities before you exercise.
  • 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.
  • Stay flexible.
  • Never abruptly increase the intensity of your workout. Make changes slowly.

Meniscus tears are very common knee injuries, particularly for athletes. Often the tears can be treated with rest, ice, compression, and elevation. Wearing a knee brace and physical therapy are also common remedies. If the tear is large, or these treatments don't work, your doctor may recommend surgery to fix the problem. Once your knee heals, you can usually go back to the activities and sports you love.

Can I walk with a torn meniscus?

Yes, you often can. When you first tear your meniscus, you may not feel any pain. But over the next 2 or 3 days, your knees could get stiff and swollen. Don't skip your doctor visit!

What happens if you don't fix a torn meniscus?

Depending on the part of the knee affected and how big the tear was, it may not get better by itself. If it doesn't and you don't treat it, the pain will likely get worse. Your knee might feel like it's locking up or giving out when you stand, and you might be unable to straighten or bend it. This will impact doing daily activities and set you up for getting osteoarthritis.

Can a torn meniscus cause calf pain?

Yes it can, because your calf might be overcompensating for your knee when you walk. You might also have calf pain after meniscus surgery, but this will go away as you heal.