What is a Meniscus?
The Meniscus a set of thick, rubber-like and crescent-shaped cartilage that attaches to the shinbone. The purpose of the menisci is to provide shock absorption and to steady the knee during activities with impact on the knee joint. There are two types of menisci, the medial meniscus, and the lateral meniscus. On the inner side of the knee joint is the medial meniscus, and on the outside is the lateral meniscus.
A torn meniscus vary in severity and type. Meniscus tears can occur in a crescent shape, ripped off the knee or split in half. A minor tear can go unnoticed for years and simply be made worse by a slight trip off a sidewalk.
The lateral meniscus bears approximately 70% of the shock and makes it a vital shock absorber of the knee. Tears of the lateral meniscus are uncommon as the cartilage has more manoeuvrability than the medial meniscus. An untreated lateral meniscus tear could lead to osteoarthritis due to the added strain on the lateral compartment.
What causes a Meniscus to tear?
Physical activity such as running, football, rugby or tennis can cause a lateral meniscus tear. Any physical activity that involves turning or twisting and sudden changes in direction can result in an injury. The tears in the menisci can happen during practice as the same motions are used that lead to damage. Also, kneeling or deep squatting can lead to injury, and the tears can be experienced by athletes such as weightlifters as well.
Age also increases the risk of developing a torn meniscus as the cartilage gradually loses blood supply and resilience. Adding body weight also puts more strain on the meniscus resulting in simple daily activities such as walking increasing the chances of tearing and degeneration.
A meniscus injury will involve pain and tenderness in the knee joint and around the outside of the knee. The knee will experience swelling, and you will feel pain when trying to bend the knee or when you squat down.
Some of the symptoms will include the following:
- Pain immediately after the injury. You may experience a “pop” sensation within the knee when you have over-extended the joint during a turn or twist.
- With a torn lateral meniscus, you will feel the pain on the outer edge of the knee.
- Experiencing pain with movement of the knee. Pain will usually indicate the location of the injury, but the pain will be felt throughout the knee area when you try to move the knee.
- Resting the knee will result in reducing the pain and swelling, but the pain will return when you try to move.
- The accumulation of fluid in the knee that will cause the entire knee to swell.
- Locking of the knee. Should a piece of the meniscus get stuck in the knee joint, this can cause the knee to lock. The locking of the knee means that you will not be able to straighten the leg.
- Gradual start of symptoms. For some, a torn meniscus will have no symptoms but will experience a gradual onset of the symptoms which is more common in the aged or people with osteoarthritis.
Treatment options for a torn meniscus can be surgical or non-surgical, depending on the severity of the injury.
Should the tear be small and on the outside edge of the meniscus, you can follow one or more of the following non-surgical interventions:
- RICE protocol: this protocol involves Rest, Ice, Compression and Elevation and is used for most sports injuries.
- Rest: use crutches or a can to resist putting weight on the knee or take a break from physical and sporting activity.
- Ice: for a few days use an ice pack for 20 minutes several times a day.
- Compression: use a compression bandage to prevent swelling.
- Elevation: place your leg up higher than your heart to reduce swelling and administer anti-inflammatory medication to help with pain and swelling.
For more severe tears, surgery may be needed to repair the torn cartilage. Arthroscopic surgery can repair severed tears like bucket handle tears. The procedure involves stitching the torn cartilage and aims to preserve as much as possible of the cartilage. Surgical success depends on many factors such as the age and physical condition of the patient, as well as the severity of the damage.
The surgical procedure is usually followed by a series of physical therapies to strengthen the knee and improve the balance of the patient. To ensure full recovery, a full commitment to the physical therapy program is a must.
Recovery period and process
Torn menisci are common injuries among people that are physically active. A typical meniscal tear can take up to eight weeks to fully heal, and with the correct treatment and rehabilitation, people can be fully recovered to return to their normal sporting activities.
For patients that underwent surgery to repair the tear, recovery may take up to four months. The recovery time will include physical therapy to aid in rehabilitation.
During the recovery period, it is vital to stay away from activities that will strain the knee in any way. It is always advisable to keep weight off your knee during recovery, and you may need to use crutches or knee supports.
Meniscus tears are easy to diagnose, treat and recover. Always ensure to seek out medical advice when you suspect a ligament or cartilage injury to your knee. Speedy diagnosis and treatment will make a huge difference in the recovery time from the injury. To avoid knee surgery always ensure that you warm up all your joints before any sporting activity. Warming up will lessen the strain on your joints and reduce the potential for injury.