Knee Meniscal Injury
The meniscus, also commonly called “knee cartilage”, consists of two C-shaped discs, made of tough cartilage found in the knee joint between the femur (thigh bone) and tibia (lower leg bone). There are two menisci within each knee joint (medial and lateral), each acting to distribute load and absorb shock at the knee joint.
A common injury of the meniscus is a tear, often referred to as a “tear of the cartilage” or a meniscal cyst. Due to its’ poor blood supply, the meniscal cartilage may not heal very well once damaged.
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The two most common causes of meniscal injuries are traumatic injury and degenerative meniscal tears. Degenerative tears occur progressively due to wear or as a result of habitual, prolonged squatting. They are most common in older people (>40) where a gradual breakdown of the cartilage occurs leading to a weakening of the cartilage and subsequent tears. The traumatic injury is quite common in athletes and is generally caused by a twist occurring on a slightly bent knee. Sports such as football, netball, basketball, soccer and wrestling have a high incidence of meniscal injury. Several factors can increase a person’s risk of meniscal injury. These include:
- Participation in sports requiring a rapid change of direction.
- Twisting injury of the knee, particularly with the knee bent or the foot is planted
- Repetitive or prolonged squatting
- Knee arthritis
- Age (Over 40)
- Previous knee injury
- Abnormal biomechanics of the knee, feet or hips
- Lower limb muscle imbalance, particularly around the knee
The knee is one of the largest and most complex joints in the body. Its joints bring together 4 bones which are supported by numerous muscles, tendons, and ligaments. Differentiation between these structures after an injury takes care and knowledge of specific orthopaedic tests. This is why many of Mandurah’s elite sports clubs trust the Physiotherapists at 4 Life Physiotherapy with the management of their complex player knee injuries.
Meniscal tears typically present with immediate pain and some swelling. The pain can be worse with bending, straightening or twisting the knee. More serious injuries to the meniscus may present with catching, locking, popping or clicking within the knee joint and difficulty taking your full body weight through the knee joint.
It is important to assess the knee with a Physiotherapist as soon as possible following injury to determine the extent of injury to the meniscus and to commence the appropriate course of treatment.
Initially, treatment aims to reduce associated pain and inflammation by encouraging rest and using crutches to reduce weight-bearing. Depending upon the type of meniscal tear and its location, treatment may include compression, elevation, massage, ultrasound, taping, ice/heat therapy and an exercise program.
Your Physiotherapist will be able to advise whether a surgical opinion is recommended. A large tear may produce a flap of cartilage that could interfere with normal joint movement. In this case, arthroscopic (keyhole) surgery will be indicated to remove the flap, smooth the surface of the meniscus, or repair a torn meniscus. Your Physiotherapist will keep in regular contact with your surgeon and guide your post-op care, and later your return to sport/activity rehabilitation.
Meniscal tears managed conservatively (without surgery) by a Physiotherapist will typically see a return to sport in 4-8 weeks. Post-op recovery depends upon the nature of the surgery and will typically see a return to sports in 4-12 weeks.