Meniscus Tears

Causes, Symptoms and Treatment

Overview of Meniscus Tears

Injury to the meniscus in the knee is common and usually caused by the knee twisting or rotating. There is increased risk of meniscus injury if the twisting motion is combined with deep knee bending or the knee is in a fully extended position while weight bearing or jumping.

The upper leg bone (femur) and lower leg bone (tibia) have two pieces (medial and lateral) of cartilage between them that provide cushioning and shock absorption. A meniscus tear typically causes stiffness, swelling, pain and it may be difficult to bear weight on the knee.  A painful and audible “popping or clicking” noise may be heard or felt, often with a sense of increased pressure and inability to further move the knee.

Conservative treatment options including rest, ice, and a progressive rehab plan that allows time for a meniscus tear to heal. However, depending on the type and severity of meniscus tear, a surgical intervention may be needed to regain full function and ability.

Common Causes of Meniscus Tears

Activities that involve quick, forceful cutting, change of directions, starting, stopping, or jumping lead to an increased risk of meniscus tear.  Increased age and de-conditioning (being out of shape) increase your risk of meniscus tear injuries as well. A well rounded fitness training routine focusing on balance, posterior chain strength, core/hip stability, and mobility will help to decrease your risk of meniscus injury. Injuries and increased pressure on joints can lead to an earlier onset of osteoarthritis (OA) or degenerative joint disease (DJD).

Commonly Associated Activities

  • Football
  • Soccer
  • Basketball
  • Hockey
  • Weight lifting
  • Tennis
  • Skiing
  • Snowboarding
  • Squats

Symptoms Associated with Meniscus Tears

Meniscus tear symptoms are frequently immediately apparent as they often include pain, swelling, restricted movement and clicking and popping.  You may not have all of these symptoms but it is good to keep a look out for them and get evaluated if you suspect it may be more than just a sprain.  There are many ways to diagnose a tear including range of motion testing, palpation, orthopedic testing, muscle tests and gait analysis.  A suspected meniscus tear is typically confirmed with a magnetic resonance image (MRI). This advanced imaging method allows us to see the cartilage, muscles, tendons, and ligaments that are not visible on an x-ray study though some physicians may start with a x-ray to rule out a fracture or other causes of knee pain.

Commonly Associated Symptoms

  • pain in the knee
  • pain is made worse with movement and/or weight bearing
  • swelling / inflammation in the knee
  • stiffness / decreased active range of motion
  • “clicking or popping” noise and/or sensation
  • knee getting stuck with an inability to bend or straighten

Treatment and Prevention of Meniscus Tears

Treatment of meniscus tears should be led and monitored by a physician knowledgeable and experienced in meniscus tear injury and the full rehabilitative process.  If improvement progression stops through any of the stages of the rehabilitative process or if pain is still felt after treatment is completed, surgical intervention may be necessary. Surgical interventions include meniscus tear repair, where the torn piece is sewed back together, or an ectomy / removal of the tear. After surgery it is common to need to go back through the rehabilitation process to regain full and pain free range of motion. 

Prevention of meniscus tears is usually accomplished by strengthening the surrounding tissues and learning better technique specific to the activities that put a person at risk.  Movement done with proper form and a properly conditioned body dramatically decreases the risk of re-injury.

Common Treatments for Meniscus Tears

  • Protection or bracing if knee is unstable
  • Rest
  • Ice
  • Compression
  • Elevation
  • Restore active range of motion
  • Strengthen muscles of core, hips, knees, and ankles
  • Improve balance / proprioception
  • Activity / Sport specific training