MENISCUS INJURIES / MENISCUS TEAR

Meniscal injuries are extremely common. They can occur from any activity where an individual performs a rotary movement, especially when putting full body weight onto the knee. Meniscus lesions account for approximately 15% of all sports injuries.

Before we explore the possible causes, treatments and preventative methods for meniscal injuries, it is important to understand the anatomy of the meniscus.

The menisci are 2 C-shaped pieces of rubbery cartilage that act as a cushion within the knee. They prevent direct contact between the femur (thigh bone) and the tibia (shinbone). The menisci act as a shock absorber within the knee complex.

Meniscus injuries can be from a direct incident (traumatic) or may happen slowly over time (degenerative).

Traumatic meniscal lesions or tears are often caused by the person describing twisting on a semi-flexed limb through a weight bearing knee.

Degenerative injuries occur without trauma, are usually seen in elderly people but can occur at any age, and are more common in men!

Clinical Presentation

So how do physiotherapists assess to see if there is meniscal damage?

There are many conservative assessments that can be done in the clinic to assess the likelihood of a meniscal lesion. However, all injuries are different and sometimes it is necessary to have an MRI of the knee to determine whether or not a meniscal lesion of the knee has occurred.

On initial assessment your physiotherapist will ask you to relay the events that led to you presenting to the clinic. This will determine the possibility of a meniscal injury and also what type - traumatic or degenerative. Locking of the knee is a very common symptom of a traumatic lesion. Clicking is also a common symptom. With a degenerative lesion, it is more common to see a decrease in tolerance of fully weight bearing on the knee. Activities like walking and squatting become painful. Your physio will then assess your range of movement as well as performing a series of specific clinical movement tests to assess further. Based on your ability and physios findings, together you will set goals and come up with a rehabilitation program that suits you.

Types of meniscus lesions

Types of tears are split into 3 groups. Have a read of the table below to see how we classify meniscus lesions.

The exact type of lesion you have can only be determined through medical imaging. This may guide your rehabilitation and allow for a more accurate prediction of the timeframe that you will require physiotherapy intervention for.

Treatment

Treatment for meniscal lesions depends on the severity of the lesion, the age of the individual, the location of the tear, the chronicity of the lesion and the level of pain an individual is in. In some cases, surgical repair, such as a full or partial meniscectomy may be necessary. This is only done as a last resort and most surgeons will advise you to try with physiotherapy first. In most cases, it is favourable to stick with a conservative approach and stick with a personalised rehabilitation program.

Whichever route you will be required to take, all acute management should begin the same, with “PEACE & LOVE”. This elevated protocol takes the place of the “RICE” protocol by ensuring the best start to your recovery process.

Conservative management will consist of:

● Soft tissue work by your physiotherapist

● Quad and hamstring strengthening

● Flexibility / range of motion exercises

● Balance exercises

● Joint mobilisations

If your Doctor recommends surgical repair then the return to sports can take longer. You will be required to follow an intensive rehabilitation program and will have to meet certain tests set out by your physio and surgeon.

Meniscal injuries are extremely common. This means that any treatment you receive will be based on the best and most up to date current available evidence. Here at Physio K we are committed to providing you with the best service and getting the best results. Book in with us online today!