Meniscus Injury | Symptoms, Diagnosis & Physiotherapy Treatment

Every contact sport is incredible to watch. The suspense, the thrill, and the strategy of every move keep all of us on the hook. Physical strength, agility, smooth twists, and turns require a lot of muscle and knee strength. Every such athlete playing sports like football, basketball, or rugby is at a high risk of a meniscus tear. 

Despite the knee joint typically being strong and sturdy, it’s not necessarily flexible. Knees bear a lot of our weight and are more susceptible to wearing down. Meniscus tears are among the most common knee injuries.

What is Meniscus Injury?

Femur and Tibia are the two long bones that essentially make our knee joint. For protection, the kneecap (patella) sits in front of the joint. Knock joints are susceptible to frequent shocks from athletes playing contact sports and through normal day-to-day exercises. 

Here comes the meniscus, the knight in the shining armor placed beautifully between the two bones acting as shock absorbers and helping in stability by transmitting the weight from one bone to another. Two crescent-shaped bands of thick, rubbery cartilage, the medial meniscus, and lateral meniscus are on the inner and outside of the knee joint respectively. Any injury or tear on this is called meniscus injury.

Meniscus Injury Causes

Several things can hurt our hero: a twist of the knee, say you change directions while running or a piece of the cartilage shredding, breaking, and being stuck in the knee joint when the meniscus loses its resiliency. 

A tear can be of various sizes: the shape of a C, bucket handle, flap, radial, or hanging like a thread and of different intensities: mild in the beginning but triggered later by a simple activity like tripping over a stone.

The meniscus can also tear from acute trauma or as the result of degenerative changes that happen over time.   As people age, so does our hero. Aged, worn tissue is more prone to tears. 

An awkward twist when getting up from a chair may be enough to cause a tear in an aging meniscus. More than 40% of people of age 65 or more have them.

 

Meniscus Injury Symptoms

There is usually a pop when there is a tear in the meniscus. It might take 24 hours to 3 days till the knee becomes stiffer and swollen.

The most common symptoms of a meniscus tear are:

  • Pain followed by swelling 
  • Stiffness
  • Locking your knee with difficulty straightening it up
  • The sensation of your knee giving way
  • Limping
  • Inability to move your knee through its full range of motion

Meniscus Injury Diagnosis

Initially, the doctor will ask you to lie on your back and try to bend and straighten your leg with his or her other hand on the outside of your knee as he or she rotates your foot inward. The amount of pain and first appearance of swelling can give important clues about where and how bad the injury is.

After examining the injury, the orthopedist will note the health history and inquire about your physical and athletic goals. She can order X-rays and magnetic resonance imaging (MRI) to confirm the diagnosis and further evaluate the knee joint. 

An X-ray is a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. When a standard X-ray is not accurate enough, a joint X-ray with contrast dye may also be used to examine joints such as the knee or hip.     

An MRI is a diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body; can often determine damage or disease in a surrounding ligament or muscle. The meniscus shows up as black on the MRI whereas any tears appear as white lines. An MRI is 70 to 90 percent accurate in identifying whether the meniscus has been torn and how badly. However, meniscus tears do not always appear on MRIs.

Meniscus tear knee injury, indicated by MRI, is classified into three grades. Grades 1 and 2 are not considered serious. They may not even be apparent with an arthroscopic examination. Grade 3 is a true meniscus tear, and an arthroscope is close to 100 percent accurate in diagnosing this tear.

Meniscus Injury Physiotherapy Treatment

The meniscus injury treatment the doctor recommends will depend on several factors, including the type, size, and location of the injury as well as your age, symptoms, and activity level.

Happily, not all meniscal tears require surgery. If the knee is stable, and symptoms resolve, nonsurgical treatment may suffice. To speed the recovery the RICE protocol can be followed. RICE stands for Rest, Ice, Compression, and Elevation.

  • Rest the knee. Limit activities to include walking if the knee is painful. Use crutches to help relieve pain.
  • Ice your knee to reduce pain and swelling. Do it for 15-20 minutes every 3-4 hours for 2-3 days or until the pain and swelling are gone.
  • Compress your knee. Use an elastic bandage or a neoprene-type sleeve on your knee to control swelling.
  • Elevate your knee with a pillow under your heel when you're sitting or lying down.

Other treatments recommended are:

  • Take anti-inflammatory medications. Non-steroidal anti-inflammatory drugs (NSAIDs), like Advil, Aleve, or Motrin, will help with pain and swelling. However, these drugs can have side effects, such as an increased risk of bleeding and ulcers. They should be only used occasionally unless your doctor specifically says otherwise.
  • Use stretching and strengthening exercises to help reduce stress on your knee. Ask your doctor to recommend a physical therapist for guidance.

Cautionary Advice

Meniscus tears are tough to prevent but some precautions might lower the risks of a knee injury which are:

  • Regular exercises to keep your thigh muscles strong.
  • Give your body time to rest between workouts. Also, never abruptly increase the intensity of your workout. 
  • Make sure your shoes have enough support and fit correctly.
  • Maintain flexibility. 

After recovering from the meniscus injury, before returning to your old level of physical activity make sure:

  • You can fully bend and straighten your knee without pain.
  • You feel no pain in your knee when you walk, jog, sprint, or jump.
  • Your knee is no longer swollen.
  • Your injured knee is as strong as your uninjured knee.