Knee injuries: Understanding meniscal tears

If you’re a sports fan, you may be familiar with anterior cruciate ligament (ACL) injuries. But how much do you know about meniscal tears?

Your 2 menisci are pads of cartilage in your knee joints, between your thigh and shin bones.

Each meniscus acts like a shock absorber, cushioning the impact of your upper legs on your lower legs. They also help to stabilise your knee joints and keep your knee movements smooth.

A common knee injury, meniscal tears are often caused by twisting your knee joint when playing games like footy, soccer, basketball or tennis.

Like an ACL injury, tearing your meniscus can be incredibly painful and is often signified by a loud ‘pop’ sound.

The main difference between the 2 injuries is that after a meniscal tear, it can be hard to fully extend or bend your knee, and your joint might feel like it’s locking in place, which usually doesn’t happen with an ACL injury.

Recovery time from a meniscal tear is generally shorter, too. It usually heals within 3 months, either with or without surgery. An ACL injury, on the other hand, can take between 3 and 6 months to recover from, even if you don’t need surgery (and up to a year if you do).

You can generally still immediately walk following a meniscal tear, and many athletes keep playing with the injury. But, over the 2 or 3 days after the tear, your knee may slowly become stiffer and more swollen.

Meniscal injuries are not just athletic-based. As you get older, the cartilage in your knees usually wears down, and a simple awkward twist could be enough to cause a tear.

Common signs and symptoms of a meniscal tear include:

• an audible clicking or popping sound during the injury
• pain in your knee (which can vary from severe to mild and, for some, can come and go)
• swelling (usually several hours after the injury)
• feeling like your knee is catching or locking
• a ‘loose’ feeling in your knee (like it’s going to give way)
• being unable to fully bend and extend your knee
• a tender feeling along the line of your knee’s joint.

Unfortunately, most meniscal tears don’t heal on their own. If you have symptoms of the injury, you should see a GP or sports medicine professional as soon as possible.

Treatment will depend on a variety of factors, including:

• the size and location of the tear
• the severity of the injury
• your age.

The first thing you should do following a meniscal tear is manage the pain and swelling using the ‘RICE’ and ‘HARM’ methods. For RICE: Rest for the first 2 or 3 days, ice the painful area with a cold compress, compress the injured area with a bandage and elevate the injury.

And for HARM: Avoid heat, alcohol, running or other moderate activity, or massaging the injured area.

A doctor or physiotherapist may recommend a series of exercises to improve movement and function in your knee.

Common approaches to recovering from a meniscal tear include:

Either with or without surgery, physiotherapy is an important part of recovering from a meniscal tear. The aim is to help your knee get back its full range of movement, strength and stability. For many people, the results of physiotherapy can be just as effective as surgery.

After assessing your knee, your physiotherapist will most likely plan an individualised program of rehabilitation exercises. These will help gradually strengthen your knee and leg muscles. If you’re having difficulty putting weight on your knee, you may need to use crutches or wear a brace for temporary support.

Over-the-counter painkillers like paracetamol or ibuprofen are commonly used to help with pain from a meniscal tear. However, your doctor may prescribe stronger painkillers if your pain is severe.

If you have a large meniscal tear, or if physiotherapy hasn’t worked by itself, you may need an operation to either repair your torn meniscus or, in some cases, remove the damaged part of the cartilage.

An orthopaedic surgeon typically performs a procedure during a knee arthroscopy. This uses a very fine video camera with a light and tiny surgical instruments that are inserted through small cuts in your knee.

Following surgery, you will most likely require physiotherapy to help restore your knee back to its normal function.

Always talk to your medical team about the pros and cons of surgery, and how it might help in your unique circumstance, before committing to a procedure.

The Australian Physiotherapy Association can help you find a physio near you.

Chronic Pain Australia provides education and support for those living with chronic pain.

Musculoskeletal Health Australia provides information and support for people living with arthritis and musculoskeletal conditions. Visit their website or call them on 1800 263 265.