Meniscus Tear and Torn Knee Cartilage
Meniscus tear causes, prevention and risk factors, plus rehabilitation exercises for torn knee meniscus.
by Brad Walker | Updated August 29, 2021
A tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee called menisci.
How are the Meniscus Injured?
A torn meniscus is commonly the result of either a traumatic incident, or degeneration. The meniscus receives very little blood flow. In fact, most of the meniscus receive no blood flow at all, which makes recovery extremely difficult.
- Traumatic meniscus tears are most common in physically active people under the age of 45. Most traumatic meniscus tears are the result of forceful twisting of the knee or a sudden impact to the knee.
- Degenerative meniscus tears are more common in the over 40’s age group. Degenerative tears are associated with the aging process and result from a breakdown in the collagen fibers that make up the meniscus.
Torn Meniscus Anatomy of the Knee
The meniscus are ‘C’ shaped discs, made of tough cartilage called fibrocartilage. They help to improve the fit between the femur (thigh bone) and the tibia (shin bone) and are important for distributing load and absorbing shock at the knee joint.
The picture below shows the bones, tendons and ligaments that make up the knee joint (right knee). In the middle of the knee joint there are two round structures called the “Lateral Meniscus” and the “Medial Meniscus.” It is this structure that is damaged in a meniscus injury.
Signs and Symptoms of a Meniscus Tear
The most common symptoms associated with a meniscus tear are pain and swelling around the knee joint. Tenderness at the injury site is also common.
Another common problem associated with a meniscus tear is joint locking. Joint locking prevents the knee joint from either fully straightening or fully bending, and is the result of a piece of the torn cartilage being lodged within the knee joint.
Treatment for Meniscus Tear
A minor meniscus injury is just like any other soft tissue injury and should be treated accordingly. This involves the application of R.I.C.E.R. (R) rest, (I) ice, (C) compression, (E) elevation and obtaining a (R)referral for appropriate medical treatment. The following two points are of most importance.
- Rest & Immobilization: Once a meniscus injury is diagnosed it is important that the affected area be rested immediately. Any further movement or stress will only aggravate the condition and prolong recovery. It is also important to keep the injured area as still as possible.
- Ice: By far the most important part. The application of ice will have the greatest effect on reducing bleeding, swelling and pain. Apply ice as soon as possible after the injury has occurred or been diagnosed.
The most common recommendation is to apply ice for 20 minutes every 2 hours for the first 48 to 72 hours. These figures are a good starting point, but remember they are only a guide. My personal recommendation is that people should apply ice for as long as it is comfortable. Obviously, there will be a slight discomfort from the cold, but as soon as pain or excessive discomfort is experienced, it is time to remove the ice. It is much better to apply ice for 3 to 5 minutes a couple of time an hour, than not at all.
During the first 24 to 72 hours after an injury, be sure to avoid any form of heat at the injury site. This includes heat lamps, heat creams, spas, Jacuzzi’s, and saunas. Avoid all movement and massage of the injured area. Also, avoid excessive alcohol. All these things will increase the bleeding, swelling and pain of your injury.
Torn Meniscus Surgery
Surgery isn’t always necessary for a meniscus tear and in some cases the individual can lead a totally normal life without any surgery at all. Your doctor or physical therapist can perform several tests to help determine the extent of the damage of the torn meniscus. An x-ray and MRI are two common tests used.
If surgery is necessary, there are two options: a meniscus repair; or a meniscectomy.
- Meniscus Repair: In some cases, the meniscus can be repaired with surgery. Surgical repairs are only successful when the tear occurs in the vascular region (where there is blood flow) of the meniscus.
- Meniscectomy: If the tear is in a part of the meniscus with no blood supply, (remember that most of the meniscus has no blood supply at all) surgical repair won’t be effective. In this case a meniscectomy is performed to remove the torn portion of the meniscus and reform the remaining portion.
After surgery, expect to be on crutches for at least three weeks. Full recovery, using a comprehensive rehabilitation program will generally take about three to four months and athletes involved in high demand sports can be back on the field in about six to eight months.
Meniscus Tear Prevention
Although it is important to be able to treat meniscus injury, prevention should be your first priority. So here are some things you can do to help prevent a meniscus injury.
- Warm-Up properly: A good warm-up is essential in getting the body ready for any activity. A well-structured warm-up will prepare your heart, lungs, muscles, joints, and your mind for strenuous activity.
- Avoid activities that cause pain: This is self-explanatory, but try to be aware of activities that cause pain or discomfort, and either avoid them or modify them.
- Rest and Recovery: Rest is very important in helping the soft tissues of the body recover from strenuous activity. Be sure to allow adequate recovery time between workouts or training sessions.
- Balancing Exercises: Any activity that challenges your ability to balance, and keep your balance, will help what is called, proprioception: – your body’s ability to know where its limbs are at any given time.
- Footwear: Be aware of the importance of good footwear. A good pair of shoes will help to keep your knees stable, provide adequate cushioning, and support your knees and lower leg during the running or walking motion.
- Strapping: Strapping, or taping, can provide an added level of support and stability to weak or injured knees.
- Stretch and Strengthen: To prevent meniscus injury, it is important that the muscles around the knee be in top condition. Be sure to work on the strength and flexibility of all the muscle groups in the leg.
Research and References
- Bahr, R. Maehlum, S. (2004) Clinical Guide to Sports Injuries, 1st Edition (ISBN: 978-0736041171)
- Bhan, K. Muacevic, A. Adler, J. (2020). Meniscal Tears: Current Understanding, Diagnosis, and Management. Cureus, 12(6): e8590.
- Doral, M.N. Bilge, O. Huri, G. Turhan, E. Verdonk, R. (2018). Modern treatment of meniscal tears. EFORT Open Reviews, 3(5): 260–268.
- Gu, Y. Wang, Y. (2010). Treatment of meniscal injury: a current concept review. Chinese Journal of Traumatology (English Edition), 13(6) 370-376.
- Martini, F. Tallitsch, R. Nath, J. (2009) Human Anatomy, 9th Edition (ISBN: 978-013432076X)
- Rath, E. Richmond, J. (2000). The menisci: basic science and advances in treatment. British Journal of Sports Medicine, 34:252-257.
- Walker, B. (2018). The Anatomy of Sports Injuries, 2nd Edition (ISBN: 978-1623172831)
- Wikipedia contributors. (2021, August 25). Meniscus tear, In Wikipedia, The Free Encyclopedia.
About the Author: Brad Walker is often referred to as the "Stretch Coach" and has even been called the Stretching Guru. Magazines such as Runners World, Bicycling, Triathlete, Swimming & Fitness, and Triathlon Sports have all featured his work. Amazon (author page) has listed his books on five Best-Seller lists. Google cites over 100,000 references to him and his work on the internet. And satisfied customers from 122 countries have sent 1,000's of verified customer reviews. If you want to know about stretching, flexibility or sports injury management, Brad Walker is the go-to-guy.
Disclaimer: The health and fitness information presented on this website is intended as an educational resource and is not intended as a substitute for proper medical advice. Please consult your physician or physical therapist before performing any of the exercises described on this website, particularly if you are pregnant, elderly or have any chronic or recurring muscle or joint pain.
