Unfortunately, we have seen quite a few knee injuries involving the meniscus at the clinic lately. Here is a little more information about the meniscus and how it is injured.
The knees take a lot of impact when doing medium- or high-impact activities such as running, jumping, hill-walking and playing field sports. The meniscus is commonly damaged during these activities, and can be a cause of significant pain and movement dysfunction if damaged. What exactly is this mysterious meniscus, and why is it so important?
What is the role of the meniscus?
The meniscus is a thin, fibrous cartilage lining the bones of the knee. Its main function is to absorb shock when performing weight-bearing activities such as walking, running or hopping.
The meniscus in the knee is c-shaped, and there is one on the outside (lateral) and one on the inside (medial) knee joint. The medial meniscus is more commonly damaged than the lateral meniscus, because of the fact that more weight is transferred through the medial knee joint in normal movement.
What causes meniscal damage?
Twisting forces most frequently damage the meniscus. For example, if a soccer player’s foot is planted on the ground and their body rotates around the knee, the meniscus will often be unable to withstand the pressure and will sustain a strain or a tear. This can be of varying degrees, to a few stretched fibres right up to a large tear involving multiple areas of the cartilage. A locking, clicking or clunking may be felt in the knee upon movement. Your physiotherapist will be able to perform clinical tests to check whether the meniscus is likely to have been damaged or not.
Can I recover from a meniscal injury?
Depending on the extent and location of the injury, many patients have excellent functional outcomes with physiotherapy management. This typically involves strengthening the muscles around the knee as well as increasing the range and training task-specific activities. Sometimes, a referral to an orthopaedic doctor can help to determine whether or not surgery may be appropriate. If you have any doubts, talk to your physiotherapist about your options.
The symptoms of a meniscal tear will depend largely on the specific individual as well as the location(s) and extent of the damage to the menisci. Common symptoms of a meniscal tear may include:
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- Localized pain near the area of the tear. In tears of the lateral meniscus, this discomfort will be present along the outside edge of the knee. Pain will manifest on the inside edge of the injured knee for tears of the medial meniscus.
- Immediate pain after the injury. A torn meniscus will often be obvious from the moment that the injury occurs. In these instances, the tearing of the meniscus is typically accompanied by the feeling of a pop or snap within the leg during an overexerting twisting or stretching motion.
- Slow onset of symptoms. Conversely, for some, the meniscus can tear without much of a sign or initial pain. This slow onset of symptoms is more common in older individuals and those with damaged knee cartilage from osteoarthritis.
Pain with movement. The pain will reflect the location of the tear but extend throughout the knee with movement. In the event that the knee has locked, bending it will cause searing pain to worsen.
- Pain after resting. Pain will likely diminish somewhat with rest; however, it will return with movement in most cases. Movement may also exacerbate swelling.
- Fluid accumulation within the knee joint. This accumulated fluid will cause the entire area to swell up and reduce mobility. This symptom, which may occur as a result of a number of knee injuries, is known as “water on the knee.”
- Knee locking. If a piece of the meniscus breaks free of the disc structure due to a tear, it may lodge within the joint of the knee itself. This lodging can cause knee locking, in which a person loses the ability to fully straighten the leg when sitting or standing.