Torn Meniscus

Torn meniscus health facts

  • The meniscus is a disc of cartilage in the knee that absorbs impact and can be torn by trauma, as in a sports injury, and by chronic wear over time.
  • A torn meniscus is one of the most common knee injuries.
  • Older adults are at a higher risk for meniscus tears, as the meniscus weakens with age.
  • Torn meniscus symptoms include a popping sound at the moment of an injury, knee pain, knee swelling and difficulty straightening the knee.
  • Generally, we can manage meniscus tears without surgery, using injury rehabilitation techniques and knee injections.

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What is a torn meniscus?

A meniscus is a c-shaped cartilage disc found in the knees. There are two menisci that act as cushions for the knees, absorbing the impact during physical activities like walking, running or jumping. A torn meniscus occurs when that cartilage disc tears. This is the most common type of knee injury.

There are several different types of meniscus tears. They are related to how the tear appears and where on the meniscus it occurs.

  • Longitudinal tears – when the cartilage tear is roughly parallel to the long axis of the bone.
  • Horizontal tears – when the cartilage tear is roughly perpendicular to the long axis of the bone.
  • Bucket handle tears – a tear in one of the menisci of the knee joint that occurs near the rim and follows the curvature can cause a flap of cartilage shaped like a bucket handle, which hinders the joint’s natural movement.
  • Parrot-beak tears – a cartilage injury that results in a narrow, curved wedge resembling a parrot’s beak.
  • Root tears – cartilage injury that occurs where the meniscus attaches or is “rooted” to the bones.
  • Complex tears – can combine any of the above meniscus tear types.

Meniscus tears are difficult to prevent. People can try to prevent a meniscus tear by warming up before physical activity, regularly exercising leg muscles that support the knees, and maintaining proper form while exercising.

Causes of a torn meniscus

A meniscus tear can occur during a variety of activities. These types of cartilage tears typically occur when the knee is twisted or turned while bent with the foot planted on the ground. This is the kind of stress on the knee that can often occur in sports, such as tennis, football, soccer and basketball, and other activities where quick changes of direction occur.

In addition to athletic pursuits, tears can occur while kneeling, getting in or out of a car, or simply stepping off a curb. The older a person becomes, the more likely he or she is to experience a torn meniscus, as aging and arthritis weaken the cartilage.

Symptoms of torn meniscus

Torn meniscus symptoms include:

  • Pain when rotating or twisting the knee.
  • Diminished range of motion or a locked knee.
  • Knee swelling and stiffness.
  • A popping sensation when an injury occurred causing the meniscus tear.

Meniscus tear symptoms are dependent on the location of the tear, the severity of the injury and the overall health of the individual who was injured. If the tear occurred due to a traumatic event, it is common for other areas of the knee to be injured at the same time.

Diagnosis of a torn meniscus

If the tear was due to an injury, our sports medicine physician will ask about the specific activity and the patient’s situation when the injury occurred. After he examines the knee, an X-ray may be needed to rule out broken bones and other issues. Depending on the severity of the injury, the provider may use musculoskeletal sports ultrasound or order an MRI to give a more defined evaluation of the knee cartilage and meniscus.

HealthFit’s approach to torn meniscus treatment

Treatment for meniscal tears is dependent on the size and location of the injury. A person’s age, activity level and other injuries are considered when determining which course of treatment is the best option. Torn meniscus treatment generally starts with a conservative approach, which includes the RICE protocol: rest, ice, compression and elevation of the injury. This also can be done by the individual at home.

Other nonsurgical treatment options include the following.

  • Steroid/cortisone shot – treats the inflammation to alleviate swelling and increase range of motion. This does not treat the underlying issue (the tear), but a cortisone shot is often used in conjunction with injury rehabilitation.
  • Physical rehabilitation – patients work with the provider (or a kinesiologist or physical therapist) on a series of exercises and stretches designed to increase their range of motion.
  • Platelet-rich plasma (PRP) injections – each person’s blood platelets contain human growth factors that stimulate the body’s healing processes.
  • Stem cell therapy – a patient’s own stem cells are used to repair damaged tissue.

If the knee is stable and doesn’t lock up, nonsurgical treatments are generally sufficient.

Torn meniscus healing and recovery

To expedite the healing processes, patients can follow these guidelines.

  • Limit activities, including walking if there is pain.
  • Avoid running or jumping.
  • Ice to reduce pain and swelling. Ice for 15-20 minutes every 3-4 hours for 2-3 days, or until the pain and swelling subside.
  • Compress the injury with an elastic bandage to control swelling.
  • Elevate the injury, using a pillow under the knee while sitting or lying down.
  • Take an anti-inflammatory like Advil, Aleve or Motrin.
  • Stretch and exercise; a HealthFit provider can recommend a regimen.

Nonsurgical treatments are generally the best treatment option for a torn meniscus. The BMJ recently published a study conducted by the University of Oslo that found after two years, patients who had corrective surgery for a meniscus injury had the same outcome as patients who only received physical therapy/rehabilitation.