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MY KNEE HURTS, HAVE I GOT A MENISCAL TEAR?

by Saffron Blackwood, Sports Rehabilitation & Massage Therapist

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Meniscal tears are commonly associated with sports or jobs that require lots of squatting and/or kneeling, rapid acceleration or deceleration, changing direction quickly, and jumping.  Degenerative changes can also take place, which means less force is needed to create a tear. This is more common in individuals over the age of 40.

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So, what is a ‘Meniscus’?

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Anatomy

The meniscus is a crescent-shaped structure which sits in the knee joint and is separated into 2 compartments: Lateral and Medial. The lateral meniscus sits on the outside part of the knee joint and the medial meniscus sits on the inside.  During movement, they play an essential role in shock absorption when various forces and loads are passed through the knee.

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The meniscus is also classified as an avascular structure, meaning it has a limited blood supply. Therefore, when any damage is caused, the healing process tends to be delayed.

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What causes a meniscal tear?

Meniscal tears are commonly the result of excessive rotational force of the knee whilst the foot is still in contact with the ground. This can occur due to awkwardly landing from a jump or needing to change direction quickly.

However, we also see a number of tears that occur over a longer time period, this can often be associated with osteoarthritis of the knee and can also cause a spontaneous tear through a weakening and breakdown of the meniscus.

 

Tear classification;

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Acute    

Result of trauma or sporting related injury.

E.g. Running, Rugby, Tennis, Football...

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Chronic

Most commonly in elderly individuals

Can occur from minimal stress placed on the knee.

Can be associated with previous damage to other knee ligaments (ACL or MCL)

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Degenerative

No trauma

Due to age and activities of daily living

e.g. gardening, which requires kneeling and twisting movements of the knee

 

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Symptoms

With the different classifications, the symptoms experienced can vary from individual to individual.

The associated symptoms can include:

• Localised pain to the joint line

• Swelling

• Popping or clicking

• Giving way

• Increased pain when walking or squatting

• Knee movements feel restricted

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Treatment we can offer;

Depending on the seriousness of the tear, there are two options which can be discussed.

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Firstly, there is conservative management. This is the use of hands-on treatment, for example Massage or Focussed Shockwave Therapy, alongside Physiotherapy and Rehabilitation to encourage the healing process and restore strength and full function back to the knee.

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However, in cases where we feel there is a larger tear present and you are experiencing high levels of pain, locking and/or giving way, it would be important to include imaging. This would be done via an MRI (Magnetic Resonance Imaging) Scan, which would allow for a clearer understanding of what the clinical presentation is. Depending on what the results show, surgical input may be required.

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Rehabilitation

Both conservative and surgical options require rehabilitation input. By doing so, the success of recovery from a meniscal tear is greater than without.

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Rehabilitation will aim too:

• Strengthen muscles of the lower limb, including quadriceps and hamstrings, as well as gluteal muscles to assist with hip stability (this is often weakened with a meniscal tear)

• Increase range of motion

• Reduce pain

• Return to normal functioning and/or sporting goals whilst reducing the risk of further injury

 

If you would like to find out more or you have any questions please contact the clinic on 01949 485084 or email info@primeperformancephysio.co.uk