What Is a Torn Meniscus?
The tough and flexible knee meniscus cartilage provides cushioning in the knee joint. Each knee has two c-shaped menisci that sit where the shinbone (tibia) meets the thighbone (femur) and kneecap, absorbing shock and stabilizing the joint.
The meniscus is prone to injury in sports, often caused by twisting and forceful impacts. A meniscus tear is the most frequent knee injury in sports.
The meniscus can also wear down over time as tissue quality degenerates from overuse or aging. The meniscus pain location can be throughout the knee (the inside, the outside, and behind the knee). Sometimes a tear can cause the knee to lock, making it difficult to walk, run, or do other activities.
What are torn meniscus symptoms?
Pain is the most obvious symptom of a torn meniscus. Another key sign of a torn meniscus includes a catching or snagging feeling when moving the joint. In more severe injuries, the knee may lock, and the athlete won't be able to extend their leg fully.
Additional torn meniscus symptoms include:
- Grating or popping sounds and sensations when moving the knee joint
- Stiffness in the knee
- A reduced range of motion
- Instability of the knee
- Swelling, typically up to 24 hours after the injury
Increased knee pain when going up or down stairs
What causes a meniscus tear?
A knee meniscus tear can occur with a sudden injury or develop over time. In sports, a torn meniscus can be caused by twisting or bending the knee and overstressing the meniscus. It can also be caused by a hit or impact to the knee. Tearing the meniscus is the most common knee injury in athletics.
Chronic overuse of the knee and stress on the joint can cause the meniscus cartilage to wear down. The meniscus can also become rough and degenerate over time.
Risk factors for a meniscus tear
Participating in sports with hard falls and physical impact to the knee can increase your risk. The most common sports for meniscus tears include soccer, running, football, basketball, lacrosse, and skiing.
Common causes of a meniscus tear during athletic activity include:
- Sustaining a hard hit to the knee, whether by running into an opponent or falling on the ground
- A traumatic twisting of the knee
- Repetitive impacts on the knee joint
If not left to heal properly, a meniscus tear can further damage the area around the knee, including the bones. Returning to activity before the meniscus has fully healed can escalate the injury and increase the chance for knee arthritis to develop within the joint.
How to diagnose a meniscus tear
A provider can diagnose a meniscus tear with a physical examination and imaging technology. A physical examination focused on diagnosing meniscus tears often includes:
- Questions about the injury and extent of knee pain
- Observations that include a comparison of the injured knee with the non-injured knee to determine swelling and range of motion
- Movement testing to evaluate pain, range of motion, and stability
Imaging technology can further evaluate the meniscus to determine if you have a medial meniscus tear (inside the knee) or a lateral meniscus tear (outside of the knee). A magnetic resonance imaging (MRI) scan can see cartilage and ligaments. An X-ray can help rule out any bone damage while showing if the bones are touching because of a lack of cartilage.
Request an appointment with a Mass General Brigham Sports Medicine specialist to learn more. about meniscus tears and treatment options.
Torn meniscus treatment
Torn meniscus treatment can vary based on the extent of the tear, the age of the patient, and the level of symptoms.
Following an acute injury, providers advise rest, ice, and over-the-counter anti-inflammatory medication to reduce swelling. Since the meniscus does not have a direct blood supply, it can take longer to heal. Some tears may not heal without the aid of surgery.
Physical therapy and stretching designed to strengthen muscles around the joint can improve stability.
Surgical procedures to repair the meniscus can include a meniscectomy, to shave off a small portion of the torn cartilage, or a meniscus repair to stitch torn pieces together. The recovery time for a meniscectomy can take up to eight weeks, while a repair can take three to six months.
The recovery time for a meniscus tear depends on the extent of the injury and the age of the athlete. Without surgery, recovery can happen in three to six weeks. Meniscus tear surgery can take up to six months for a full recovery.
As athletes return to activity, they must carefully monitor knee pain and limit activities that increase the likelihood of another injury.
Preventing meniscus tears
A strong knee joint and proper warm-up can help limit the risk of a meniscus tear. Tips for further meniscus tear prevention include:
- Strengthening muscles and the knee joint through exercises and stretching
- Ensuring you are fit enough for your activity of choice
- Properly warming up and stretching before activity
- Improving athletic technique to reduce the risk of abnormal twisting or bending
- Staying at a healthy weight
FAQs
A minor or moderate meniscus injury will often heal on its own through rest and physical therapy.
Pain in the knee from a torn meniscus typically intensifies with twisting, bending, and forceful movements. Most people can still walk with a torn meniscus, but walking can cause further damage and prolong recovery.
A knee brace can help stabilize the knee to prevent further stress from twisting or bending, helping protect the meniscus as it rests during recovery.
A cortisone shot is a temporary solution that can help reduce pain levels and inflammation in the knee after a torn meniscus.
The symptoms of a meniscus tear and ACL injury are quite similar. An MRI scan can reveal whether the meniscus or the ACL is damaged. It's common for an injury that tears the ACL to include at least partial damage to the meniscus.
While ice can limit swelling in the early hours after an injury, a meniscus tear will require both heat and cold to promote healing.
The most common surgery for a meniscus tear is a meniscectomy, which removes a portion of the damaged meniscus. This removal limits the ability of the meniscus. Any injury to the knee could speed the onset of arthritis, so the knee may not return to the state it was in before an injury.
