Meniscus Injuries

We have all heard of someone with a sore knee! One of the common structures that contributes to knee pain is the meniscus.

“I hurt my knee walking.”

“I hurt my knee in a tackle at football.”

“I have knee pain but don’t know what’s causing it.”

Knee pain is very common and there is a long list of possible causes. Knees can be injured in a variety of ways, from acute incidents or trauma to the knee, overuse injuries, or degenerative changes. One of the very common causes of knee pain is the meniscus.

What is the meniscus?
The meniscus is cartilage material that sits in between the femur and the tibia. The meniscus is a very important part of the knee as it allows the femoral condyles to move smoothly over the tibia plateau. Additionally, it has a very important role in shock absorption within the knee, providing cushioning when weight is transferred through the lower limb.

Injuries or pain from the meniscus:
One of the ways the meniscus can be injured is from an acute injury to the knee, commonly seen in change of direction sports such as football, netball, and soccer. The mechanism of injury most commonly associated with meniscal tears is a twisting action of the knee. This often occurs when changing direction or with unexpected tackles in contact sports. Tears are more common in the medial meniscus.

Degenerative changes are frequently seen in the meniscus. Consequently, these tears are more often seen in older adults. Pain can arise from a degenerative meniscus gradually as the changes in the cartilage worsen, or after placing the knee under more load or stress.

The meniscus can also cause knee pain due to overuse. This is when the knee is placed under greater loads than normal and it can become irritated. This is often seen when the meniscus has pre-existing degenerative changes. Increasing time spent on your feet, running distance or time in the garden are all ways pre-existing degenerative changes can start to become painful.

Common symptoms of meniscus injuries:
There are several signs and symptoms of meniscus injuries:

  • Swelling (in acute injuries)
  • Clicking
  • Locking
  • Pain with twisting
  • Tenderness along the joint line of the knee

If there is an acute injury it is common to see a reduction in range of motion of the knee as well as swelling.

What to do if you have knee pain?
If you are experiencing any type of knee pain it is a great idea to see a health professional such as a physiotherapist to get a correct diagnosis and treatment plan. A physiotherapist can do numerous tests to determine if the meniscus is the source of knee pain. Your first session with a physiotherapist will look something like this:

  • Questioning, to determine when/how the pain started, where the pain is, what makes the pain worse, and what activities you would like to get back to.
  • Range of motion testing
  • Strength testing
  • Functional movement testing i.e. squats, lunges, jumping
  • Orthopaedic testing (to determine which structures are contributing to the pain)
  • Palpation of the knee

Your physiotherapist will be able to compile all this information to determine the cause of your knee pain. In some cases, it may be necessary for further scanning, such as an MRI to gather more information. From here they will be able to determine a clear treatment plan to reduce pain and get you back to the activities you love.

Treatment of Meniscus injuries:
Treatment for meniscus injuries can vary slightly from case to case depending on the cause of the injury, the extent of the injury, and the activities that you want to return to. The majority of cases can be managed conservatively, that is through exercise rehabilitation. Your physiotherapist can guide you through a strengthening program, targeting not only muscles surrounding the knee but also the hip muscles that provide a lot of stability through the lower limb. After a period of strengthening, rehabilitation can differ depending on your goals. For example, if you have injured your knee playing basketball you will need to do plyometric training, which involves jumping and landing exercises. This will be followed by a change of direction and agility training to ensure your knee can withstand the load of the sport. Alternatively, if you are not returning to jumping, running, or change of direction activities your rehabilitation program may solely focus on strength training and functional movements. This is often seen in older adults who have degenerative changes in their meniscus. No matter what activities you want to return to, your physiotherapist will tailor your rehabilitation to reach these goals.

Meniscus injuries are common right across the lifespan whether it be from sporting injuries or degenerative changes. Getting treatment for them is a great way to resolve your pain and improve your function.