Meniscus Tears

A meniscus tear is a common cause of knee pain that can affect the very young and very old. In each knee there is a medial and a lateral meniscus.  The purpose of a meniscus is to act as a shock absorber for the knee.  This allows us to run, jump and squat without causing any damage to our knee joint.  However, when the medial or lateral meniscus is torn pain, inflammation, swelling and decreased range of motion will often develop.  If left untreated a torn meniscus can lead to more pressure on the knee joint during weight bearing activities such as running which can eventually lead to osteoarthritis of the knee.

A common way a person tears their meniscus is by partially bending the knee while their foot in planted in the ground and then quickly twisting the knee.  This is a fairly common motion during sports and is often the mechanism by which a younger person tears their meniscus.  For individuals over the age of 40 degenerative changes is usually the cause of a tear.  For these individuals they often are unaware of how or when they injured their knee.  People who have sustained a meniscus tear are usually able to still walk after the initial injury, but it is usually painful.  Also, pain is often experienced when fully straightening or bending the knee.  A person may feel as though their leg locks while trying to straighten their leg. An audible click or pop may be experienced while bending and straightening the knee as well.  In severe tears the knee may even feel unstable as if it could give out.

For a small tear RICE (rest, ice, compression, elevation) may be a sufficient treatment, but for more moderate and severe tears physical therapy or surgery is usually recommended.  If a patient elects to have therapy the physical therapist will use hands on techniques to reduce swelling and restore range of motion of the knee.  The therapist will also focus on exercises that strengthening the muscles that surround the knee that do not increase the patient’s pain.  As the patient progresses the therapist will begin grading the patient back to their recreational activities (i.e. running).

If a patient elects to have surgery a partial/full meniscetomy or a meniscus repair is usually performed.  A meniscetomy is where part or the entire meniscus is removed or shaved down. A meniscetomy is usually performed on older individuals.  Here the recovery is much faster than a meniscus repair and the overall duration of physical therapy is usually shorter.  The physical therapist will focus on breaking down scar tissue, reducing swelling and strengthening the muscles around the knee joint which includes the quads, hamstring, calf and the hip muscles.  By strengthening the muscles around the joint the overall pressure on the knee joint is reduced.

A meniscus repair is usually conducted on athletes and younger individuals.  Here the meniscus is actually sutured back together.  Because the meniscus has a poor blood supply it takes a much longer time to heal.  The surgeon may elect to have the patient’s knee immobilized and/or limit their weight bearing tolerance on the affected knee.  Here the physical therapy is much more extensive.  Usually swelling and decreased range of motion is a significant impairment that they physical therapist will correct.  Also if the knee is immobilized the muscles surrounded the knee will usually become much weaker.  The therapist will select exercises that strengthen the muscles around the knee, but do not put extensive pressure on the meniscus.  As range of motion and strength is restored the therapist will then begin selecting plyometrics and agility exercises which will allow the patient to return to their sport or favorite recreational activity.

If you have been having difficulty walking or running due to knee pain stop by Total Performance Physical Therapy for an evaluation today.