The menisci are two half-moon-shaped cartilage cushions in the knee that absorb shock and keep the joint stable. Meniscus tear symptoms are pain on the inner or outer side of the knee, swelling and sometimes locking. In young people the tear usually happens during sport, with a twist of the body while the foot is planted on the ground. After the age of 40 the meniscus wears down and can tear even during an ordinary squat.
Symptoms
- Pain on the inner or outer side of the knee.
- Swelling that appears a few hours after the injury.
- Pain when squatting, twisting and on stairs.
- Clicking, or a feeling that something is catching in the knee.
- Locking: the knee gets stuck and won’t straighten fully.
- The knee gives way.
- Difficulty sitting on your heels or cross-legged.
After a sports injury you can often finish the game, and the pain and swelling come later, in the evening or the next day. With a worn meniscus there is often no clear injury: the pain appears gradually or after one awkward squat.
Why it happens
- Twisting the knee with the foot planted on the ground in football, basketball or skiing.
- Deep squatting, especially with weight.
- Weak thigh muscles, so the knee takes more of the strain when you jump and twist.
- Wear of the meniscus after the age of 40 (a degenerative tear).
- An injury to the ligaments at the same time, for example with a torn anterior cruciate ligament.
The meniscus has a poor blood supply, especially in its inner part. That is why not every tear can heal. However, many very small tears stop hurting once the muscles around the knee get stronger.
How we treat it
Kaloyan tests the menisci and ligaments and looks at your MRI result, if you have one. Many people, especially with a degenerative tear, do well without surgery, with strengthening and mobility exercises. In these cases Kaloyan uses TECAR therapy for pain and swelling and gradually increases the load. If the knee often locks, treatment without surgery is usually not enough, and Kaloyan will send you back to your orthopaedic doctor. If the orthopaedic doctor decides you need arthroscopy (keyhole surgery), pre-operative rehabilitation strengthens your thigh and teaches you the first exercises before the operation.
After surgery, post-operative rehabilitation restores movement, strength and a normal walking pattern. Bring the discharge summary from the operation. In the first weeks the aim is to straighten the knee fully, control the swelling and walk without limping, and then strength and balance follow. Kaloyan works within your surgeon’s time frames, because they depend on whether the meniscus was stitched or part of it was removed. After part of the meniscus is removed, getting back to sport usually takes 1–2 months, and after the whole meniscus is removed, 2–3 months or more. After stitching, it takes 4–6 months, and up to 9 months if there are complications. The last part of treatment is for balance, jumping and changing direction, if you are going back to sport.
What you can do yourself
- In the first days, with swelling: rest, cold for a short time and your leg raised.
- Avoid deep squatting and twisting the knee.
- Move the knee gently within the range that doesn’t hurt.
- Once the swelling has gone down, cycling is usually safe and helpful.
- If you are waiting for surgery, do the thigh exercises every day.
- After surgery, follow your surgeon’s instructions on weight-bearing and crutches exactly.
When to see a doctor first
See a doctor or an orthopaedist first if:
- the knee is locked and you can’t straighten it;
- there is severe swelling straight after the injury;
- you can’t put weight on your leg;
- the knee keeps giving way;
- your lower leg is swollen, warm and painful, especially after surgery.
