Question 1

Overview of the anatomy

Accepted Answer

You have two menisci in your knee, the medial (inner knee) meniscus, and the lateral (outer knee) meniscus. These c-shaped cartilage discs act like miniature shock absorbers.

They protect your knee joint when walking and running and increase the joint surfaces’ congruency, allowing the bones to “sit” and fit better on top of each other.

Usually, a meniscus tear happens when your body twists over your planted foot. It can also occur during deep squatting-type movements, but sometimes a subtle twist can cause it, such as a miss-step while running or walking. A meniscus injury most commonly involves the medial meniscus.

Question 2

Symptoms of a torn meniscus

Accepted Answer

The symptoms you experience can vary depending on your type of tear. For minor tears:

You may not notice when you tear it. For example, you miss-step and feel a twinge but then nothing further, only to sense your knee is a bit swollen and sore later that day.
You may not have much swelling and only be aware of some puffiness in the area, or your joint may feel a little stiff.
Your range of motion is usually full, with only the last 10 to 20 degrees of full extension (straightening) or flexion (bending) of your knee causing you pain.
Twisting on your legs with your feet planted in the ground may be painful.
You can usually walk with a near-normal gait pattern, but walking on uneven ground may cause pain.
Kneeling may hurt.

For severe tears:

It can be very sore if you sustain a large tear, and you will likely have to stop your activity and rest your leg.
Your knee will become very swollen.
You’ll have a very restricted range of motion, and you likely won’t be able to straighten and bend your knee completely.
Putting weight on the sore leg when walking will be painful and difficult.
You might experience clicking inside the knee joint, and it may lock from time to time.

Question 3

When to see a doctor

Accepted Answer

Most minor to moderate meniscus tears can be successfully treated at home using a conservative exercise-based treatment plan as outlined in the app.

Consider seeing a medical practitioner if you have any concerns about your injury, particularly if:

Your knee feels unstable or gives way when you stand or walk – indicating knee ligament involvement which needs further investigation.
Your knee locks from time to time, indicating a bucket handle meniscus tear that may require surgical repair.
You’re not able to straighten your knee fully after 3 or 4 weeks of gentle exercise.
You have lots of swelling and bruising with a limited range of motion.
Any part of your leg, including your thigh, calf, or foot, is extremely swollen, red, hot to touch, or throbs with pain—it signals a blood clot and needs investigation as soon as possible.
You have sharp pain at night that keeps you awake or interrupts your sleep.
You feel pins and needles or tingling in your leg, suggesting a nerve injury. Our treatment plan may not be ideal for you if this is the case.
Your symptoms are getting worse.
Your injury is not healing as expected (see the approximate healing times below).

Question 4

Causes of a meniscus tear

Accepted Answer

There are 2 main reasons why you may tear a meniscus:

Trauma: A sudden strong force that usually involves a rotation movement of the knee. For example, you turn around on a planted foot while playing football. Or miss-step while running, resulting in a quick twist of your knee.
Wear and tear: The menisci lose some of their strength with age, meaning that simple activities like picking something up off the ground or walking uphill can sometimes injure them. Although this may sound alarming, research tells us that these types of tears respond very well to an exercise-based treatment plan and usually do not require surgery.

Question 5

Treatment, recovery times & prevention

Accepted Answer

Treatment

Most minor and moderate meniscus tears can recover with a conservative treatment plan consisting of the following steps:

First, allow the acute injury to settle down by following the PRICE regime.
Then, do gentle range of motion and muscle activation exercises.
As you recover, progressively strengthen the muscles that control and help to stabilize the knee joint.
Include exercises for your core and hip muscles, as well as balance and proprioception tasks to improve your general leg control and decrease the load on your knee.
Once you have optimal strength and control, you can ease back into your sports.

The app’s treatment plan guides you through this process smoothly.

Healing time

The average recovery times are:

Minor meniscus tears: 4 to 6 weeks
Moderate tears: 6 to 12 weeks
More severe tears that don’t require surgery: 12 to 24 weeks

Prevention

Doing strength training twice a week can help protect your menisci from injury. Regular strengthening keeps your muscles strong and improves your leg and knee control, reducing the forces passing through the joints.
Adding balance exercises to your routine helps you develop and maintain better movement control, which decreases your risk of making sudden and awkward movements and straining your knee.

Question 6

Research References

Accepted Answer

Meniscal injury: I. Basic science and evaluation. Greis PE, Bardana DD, Holmstrom MC, Burks RT. J Am Acad Orthop Surg. 2002;10:168–176. [PubMed] [Google Scholar]
Bhan K (June 13, 2020) Meniscal Tears: Current Understanding, Diagnosis, and Management. Cureus 12(6): e8590. doi:10.7759/cureus.8590
Shiraev T, Anderson SE, Hope N. Meniscal tear – presentation, diagnosis and management. Aust Fam Physician. 2012 Apr;41(4):182-7. PMID: 22472678.
Snoeker BA, Bakker EW, Kegel CA, Lucas C. Risk factors for meniscal tears: a systematic review including meta-analysis. J Orthop Sports Phys Ther. 2013 Jun;43(6):352-67. doi: 10.2519/jospt.2013.4295. Epub 2013 Apr 29. PMID: 23628788.
Howell R, Kumar NS, Patel N, Tom J. Degenerative meniscus: Pathogenesis, diagnosis, and treatment options. World J Orthop. 2014;5(5):597-602. Published 2014 Nov 18. doi:10.5312/wjo.v5.i5.597
Beaufils P, Pujol N. Management of traumatic meniscal tear and degenerative meniscal lesions. Save the meniscus. Orthop Traumatol Surg Res. 2017 Dec;103(8S):S237-S244. doi: 10.1016/j.otsr.2017.08.003. Epub 2017 Sep 2. PMID: 28873348.
The Meniscus in Normal and Osteoarthritic Tissues: Facing the Structure Property Challenges and Current Treatment Trends Caroline A. Murphy, Atul K. Garg, Joana Silva-Correia, Rui L. Reis, Joaquim M. Oliveira, Maurice N. Collins. Annual Review of Biomedical Engineering 2019 21:1, 495-521
Fukuta S, Kuge A, Korai F. Clinical significance of meniscal abnormalities on magnetic resonance imaging in an older population. Knee. 2009 Jun;16(3):187-90. doi: 10.1016/j.knee.2008.11.006. PMID: 19179080.
Lento PH, Akuthota V. Meniscal injuries: A critical review. J Back Musculoskelet Rehabil. 2000 Jan 1;15(2):55-62. doi: 10.3233/bmr-2000-152-302. PMID: 22388443.

Strong Knees: Meniscus Stability