Do you know how many people are walking around on a torn meniscus without even knowing they have a tear??

💥Approximately 5% of young people and up to 67% of older people have asymptomatic (non-painful) meniscus tears! 💥

How is that possible?

Depending on the type of injury and how it is treated, the symptoms of a meniscus tear may disappear within days to weeks or months; and you might not even know the tear exists!

The initial injury may not have even been severe enough to warrant a visit to an orthopedist or ordering of an x-ray or MRI, especially if the knee only hurt for a few days before the pain subsided. 

Here’s what to know about meniscus injuries so they don’t hold you back in your favorite activities…

Where is the meniscus?

The meniscus is a “C” shaped disc made of cartilage located within the knee, between the tibia and femur bones. It sits on the weight bearing surface of the tibia, or the shin bone, inside the joint capsule, . 

There are two menisci, one on the lateral (outside) aspect of the knee, and one on the medial (inside) aspect.  A healthy meniscus provides space, cushion, and lubrication to the joint so the knee can comfortably bend, straighten, and bear weight.

The meniscus is located deep within the knee along with the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). Because of its deep location, the menisci do not have a very good blood supply, so certain portions are not likely to heal from injury. 

💥 🤯 However, just because the meniscus does not heal well on its own, does not mean a tear always needs to be fixed!

What does the meniscus do and why is it so important?

Shock-Absorption: The meniscus acts as a shock absorber for impact sustained during everyday activity, such as walking, running, jumping, and sports. As we move, force travels through the foot and up the tibia to the knee, where the meniscus absorbs and disperses that force throughout the knee so that the impact is spread out and not focused on one area.  

Stability: The meniscus also acts as a wedge that supports the front and back side of your knee, so that the knee does not go beyond a certain range of motion, such as hyperextension, which may put you at risk for other injuries.

How does the meniscus get injured? 

The meniscus is most commonly injured while rotating at the knee when the foot is planted on the ground. Rotational stress or “shearing” can cause the femur and tibia to rotate beyond what the meniscus can handle, resulting in a tear in the cartilage. 

Meniscus tears are common in athletes who place a large amount of force on one leg and turn their body to another direction, like football 🏈, soccer ⚽️, lacrosse 🥍, tennis 🎾, or basketball 🏀. Court and field athletes frequently plant their feet to stop and change direction; and it is in a fraction of a second where the knee rotates with enough force to cause a meniscus tear. 

Snow sports, such as skiing ⛷ and snowboarding 🏂, also have a high risk of meniscus injuries. The edge of a ski or board can unexpectedly catch the snow, causing a sudden rotation of the leg. The long lever arm can quickly generate a high velocity rotational force, strong enough to result in a meniscus injury.

Meniscus tears happen to people of all ages, including athletes and non-athletes. In middle-aged and older adults, meniscus tears can occur as a result of wear-and-tear on the knee joint. As the body ages, a degeneration in cartilage tissue occurs as joints are exposed to years of force. 

Osteoarthritis, a condition in which cartilage wears down over time, is prevalent in older adults, and is often associated with a torn meniscus. A meniscus tear earlier in life can also predispose the knee to earlier-onset osteoarthritis, which is why it is so important to learn the right movements and exercises to protect your knees!

I have a meniscus tear. Now what?

Depending on the type of meniscus tear, you may be experiencing symptoms like pain, swelling, catching, or locking of the knee. While a meniscus injury cannot be identified on x-ray, it can be diagnosed through a careful examination or an MRI.  

Most meniscus tears will initially be treated conservatively (without surgery); although an orthopedic doctor may recommend surgery if symptoms persist and daily activities are limited.

Meniscectomy: The most common surgery for a meniscus tear is called a menisectomy, which is where the surgeon removes the torn piece of cartilage and cleans up surrounding frayed tissue. Although it is a surgical procedure, recovery from a meniscectomy is relatively short. Most people can return to daily activities within a couple of weeks, and sports within a couple of months. 

It is important to add that everyone responds differently to surgery; and a “minor” surgery for one person may be a more stressful experience and lengthy rehabilitation for someone else.

Meniscus Repair: An alternative surgery is a meniscus repair, which is performed when the orthopedic surgeon believes the torn cartilage structure can be stitched down, saving cartilage to prevent osteoarthritis in the future. This procedure is typically performed more on younger people in order to preserve cartilage rather than remove it. Recovery from a meniscus repair is longer than a menisectomy, and involves close monitoring of range of motion, weight bearing, and activity progression during the rehabilitation.

Non-surgical treatment of a meniscus tear is very common and, in most cases, results in great outcomes! A meniscus tear diagnosis does NOT mean surgery is always needed!

Though a meniscus tear will not heal itself, you can strengthen the knee and improve movement patterns to disperse forces and reduce stress at the location of the tear, resolving symptoms. 

💪 With the right exercises and learning to move the right way, most meniscus tears can be managed conservatively WITHOUT surgical intervention. 

💥 It is important to remember that you are not your MRI result; and a meniscus tear should not define the rest of your life.

How can you manage a meniscus injury without surgery?

A meniscus injury must be appropriately guided through the phases of healing. Pain and inflammation will likely be early symptoms, while stiffness and weakness may be the primary impairments after a few weeks. Managing injuries with “PEACE & LOVE” is a good reference for dealing with acute injuries.

For progressing back to normal activities, follow the guidance of your physical therapist, who will develop a plan of care for strengthening, balance training, improving mobility, and getting back to sports. 

👉 Doing the right exercises with good form and consistency will significantly enhance your ability to recover from a meniscus tear and prevent future injuries.

When you are ready to begin strengthening at home, ACL Strong has courses that encompass all of the necessary components of exercise and movement to train your body and brain to protect your knees now and long-term. 

Whether you have a torn meniscus or not, doing the right exercises, the right way, will help keep your knees strong and stable so you are less susceptible to further injury, and more equipped to live an active lifestyle for as long as you want!

You can LIVE with a torn meniscus….

And you can PREVENT them too!