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Meniscal Injuries

We have two menisci (singular ‘meniscus’) within the knee joint – a medial and a lateral meniscus. These are ‘C shaped’ cartilage structures that assist with shock absorption and distributing the loads that go through the knee joint, such as when you walk, jump, etc.

‘Traumatic’ meniscal injuries normally occur with twisting motions of the upper leg while the knee is slightly bent and the foot is planted on the ground. These injuries are commonly seen in athletes. Meniscal injuries can occur in combination with some ligament damage too.

‘Degenerative’ meniscal injuries occur with progressive wear of the knee joint, as a result of habitual activities like squatting, and/or old age.

Signs and symptoms

When a meniscus is injured, you may feel pain when bending, straightening or twisting the knee. Depending on the severity of the injury, you may also feel the knee locking. This can happen when the torn meniscus catches between the surfaces of the thigh and shin bones. You may also feel localised tenderness depending on which meniscus was injured (medial – inside of the knee, lateral – outside of the knee). Popping sounds alongside intermittent pain are also characteristics of meniscal injuries.

Physiotherapy management

Initially, as with all soft tissue injuries, we need to RICER (rest, ice, compress, elevate, referral) the knee to minimize pain, swelling and any bleeding within the joint. If the pain persists after 2-3 days, you may need to see your physiotherapist to provide you with a thorough assessment and extent of injury, and an individual management plan.

Physiotherapy rehabilitation is an effective option for the management of meniscal injuries, and is particularly effective when the suspected meniscal tear is partial. Muscle strengthening in conjunction with hands-on treatment has been shown to improve the quality of the menisci, reduce pain and improve knee strength.

However, if the pain persists after trying rehab, the tear is major, the knee feels unstable, and/or you are planning on returning to activity/sport, surgical options are available. The surgical approach depends by the type of tear, location, age of the client, and how long you have had the tear for. Certain meniscal tears, such as bucket-handle tears, may require surgical repair to prevent the rupture from worsening.

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