Meniscus Injuries

A meniscus tear is a common knee injury involving damage to the knee joint’s flexible cartilage, which serves as a cushion between the bones. The meniscus is a springy, c-shaped disc that protects your knee. Each knee has two menisci (the plural of meniscus), one on the outer edge and another on the inner edge. They help stabilize your knee by distributing your weight evenly across it. A torn meniscus can hinder your knee’s functionality. This type of injury typically occurs when twisting or forcefully rotating the knee while bearing weight.

A meniscus injury is typically caused by twisting or turning quickly, often with your foot planted while your knee is bent. It can also occur when you lift something heavy or engage in sports. As you age, your meniscus wears down, which can lead to an increased likelihood of tears.

Risk factors for meniscus injuries include age, unhealthy weight, previous injuries, occupational risks and sports that require sudden stops and turns. Activities like climbing stairs, kneeling and squatting also place individuals at higher risk. Those with other conditions, such as osteoarthritis, discoid meniscus or ligamentous laxity, are at higher risk for meniscus injuries.

Proper strengthening exercises and warm-up techniques before strenuous activities can prevent meniscus injuries. To support the meniscus, consider targeted exercises that focus on strengthening the quadriceps, hamstrings and calf muscles. Be sure to warm up and cool down before and after exercise and wear proper footwear and support equipment, such as knee braces or pads.

Symptoms of a meniscus tear depend on the size and location of the tear. They also depend on your age and the health of your knee. Common symptoms include pain, swelling and stiffness. The knee may catch, pop or lock. It may be hard to walk.

Some people experience severe pain and swelling right away when a tear occurs. Others might have less pain and swelling at first but notice that it worsens over a few days. Older people sometimes don’t notice when the tear happens but notice symptoms later.

A meniscus injury can be diagnosed through a physical examination and tests like an X-ray or magnetic resonance imaging (MRI) scan. During the physical exam, your doctor may check for tenderness in the knee joint, look for swelling and perform range-of-motion tests. Knee X-rays can show other potential causes of your pain, such as fractures, but they cannot directly reveal a meniscus tear. An MRI is usually used to accurately assess the severity of the tear when diagnosing a meniscus injury.

Treatment may include resting your knee, applying ice, wrapping it with an elastic bandage and propping it up on pillows. It may also include physical therapy and surgery. Your treatment depends on the type of tear, its location and its seriousness. It also depends on your age and how active you are.

The decision about whether to have surgery depends on the kinds of symptoms you have and how bad they are, not just on how big the tear is. You may have a large tear but still decide not to have it repaired.

Meniscus repair is more successful if:

• You are younger. People younger than 40 do best.
• Your knee has good stability from the ligaments.
• The tear is on the outer edge of the meniscus.
• The repair is done soon after the injury.

The experts at the Montefiore Einstein Department of Physical Medicine and Rehabilitation will help you heal, repair or recover from a meniscus injury or surgery by providing therapeutic exercises, non-opioid oral pain management or local cortisone injections.

If you have a new meniscus tear or are experiencing severe pain from a flare-up of an existing tear, you can take these steps to reduce pain and swelling:

• Rest and limit your activities.
• Avoid motions or positions that cause discomfort.
• If advised, follow your doctor’s recommendations for crutches or a knee brace.
• Apply ice or a cold pack to your knee for 10 to 20 minutes at a time. Aim to do this every one to two hours while awake for three days or until the swelling subsides. Place a thin cloth between the ice and your skin.
• Wrap your knee with an elastic bandage, like an Ace wrap, to help reduce swelling.
• Elevate the affected leg on a pillow for three days when icing your knee, sitting or lying down. Keeping your leg elevated above the level of your heart helps decrease swelling.
• Consult your doctor about taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to relieve pain and reduce swelling. Use medications safely by reading and following all instructions on the label.

Adhere to your doctor’s instructions for resting and caring for your knee. If you continue to experience pain from a meniscus tear, collaborate with your doctor to develop a rehabilitation (rehab) program aimed at helping you regain as much strength and flexibility in your knee as possible. Your rehab program will likely include physical therapy and home exercises.