I Have A Torn Meniscus. What Does This Mean?
So you have - or suspect that you have - a torn meniscus. But what does this really mean - and more importantly - how long until you can get back to feeling great and not having a painful knee? Today, our podiatry team is talking about meniscus tears, recovery and what you can do to stop it happening again.
What is a meniscus - and how has it torn?
First thing’s first - if you have a torn meniscus, you’re not alone. Here in Australia, the incidence of this injury is as high as 6 in every 1000 people.
The meniscus itself is a piece of rubbery cartilage that is located between the femur (thigh bone) and tibia (shin bone), where they meet at the knee alongside the patella (kneecap). There are two menisci in each knee joint.
The purpose of the menisci in the knee is to:
- Provide shock absorption and distributing load throughout the joint
- Improve your stability
- Provide nutrition for the articular cartilage
- Limit extreme flexion and extension (which could lead to knee injury and pain)
- Control the movements of the knee joint
There are three main ways that a meniscus can become torn. For those under 30 or that are athletes, it's typically the result of an acute injury - for example playing sport where the knee is in a slightly bent position and the body suddenly twists to change direction. This combination of forces causes the meniscus to deform and tear.
For older adults, a meniscus injury tends to occur over time as part of a degenerative process, resulting from activities that load and twist the knee over years. In this case, as the damage occurs so slowly, it's unlikely you will be able to pinpoint when the problem began. As your meniscus is weakened, the final noticeable injury may occur doing a mundane activity like standing up from sitting.
The final and less common source of meniscus tears occurs alongside other knee injuries such as ligament tears. Approximately 50% of patients with Anterior Cruciate Ligament (ACL) tears also have a meniscus tear.
What does a meniscus tear feel like?
Unless the problem has been developing for years, symptoms will come on suddenly and then get worse. For degenerative injuries, the symptoms will typically come on slowly and worsen. You may feel:
- Pain and tenderness within the knee joint
- Stiffness in the knee
- Pain exacerbated by bending/straightening the knee or when kneeling
- Knee instability and a feeling that the knee could ‘give way’
- A ‘popping’ sound as the injury occurs
How do we treat meniscal injuries here at The Podiatrist?
We can’t emphasise how important it is to have your knee properly assessed to find out the extent of the injury and the type of tear present. This is something we offer at Optimise Health together with our sister clinic, The Physio. Your first appointment will involve a comprehensive assessment before prescribing a tailored treatment plan to prevent further damage and kickstart recovery. Sometimes, we may need to refer to you for an ultrasound, especially if we suspect that other tissues aside from the meniscus have been injured.
When you notice this injury at home, the first thing you want to do is minimise your pain by following the PRICE principles (protection, rest, ice, compression and elevation). This means avoiding any movements that trigger the pain, using compression bandages on the knee if available to help minimise swelling, applying indirect ice to the knee for 20-30 min periods with breaks in between, and keeping the knee elevated as much as possible.
Your treatment will focus on allowing the knee to heal and reducing the likelihood of re-injury in the future. This may include:
- Off-loading the knee using a brace or crutches while it heals
- Custom orthotics to increase stability in the lower limbs and correct any alignment problems at the knees or feet
- Footwear assessment to ensure the shoes are helping and not hindering recovery
- Physical therapy to stretch tight muscles and strengthen weak muscles
- Activity modification to reduce the load on the affected knee until it has healed
- Strapping the knee to temporarily help relieve symptoms and facilitate healing and repair
The meniscus has areas of both good and poor blood supply. If the tear is small and occurs in an area with good blood supply, conservative (non-surgical) treatment is often highly effective. If the pain persists and the knee does not respond to treatment, surgery may be indicated. This may be necessary where the tear has occurred in a poorly vascularised area or for large tears. We can refer you for a consultation with a surgeon if this is the case. The good news is that the surgery is relatively minor and the prognosis for recovery after surgery is great for the majority of patients.
Can you prevent a meniscus tear?
It’s a hard condition to prevent since it often occurs as part of an accident but you can definitely do things to reduce your risk, such as:
- Warming up before physical activity
- Getting enough rest and not trying to do ‘too much, too soon’
- Maintaining your flexibility
- Selecting the correct shoes to support your body to do your activities of choice
We understand how important it is to be able to walk and play without pain so if you’re worried about your knees or you’ve suffered an injury - whether it’s painful or not - we’d love to help. We’ve been helping our community in Toowoomba & Darling Downs for over 20 years. To book an appointment, call us on (07) 4638 3022 or book your appointment online here.