What are Meniscal Knee Injuries (a.k.a. Meniscal tear of the knee)?
The meniscus is a C-shaped pad made of cartilage within the knee joint. Each knee joint has two menisci, one on the medial aspect (inner edge) and one on the lateral aspect (outer edge).
The menisci provide several vital functions in the knee joint:
- They provide lubrication and nutrition of the joint.
- They increase surface contact within the joint for improved weight distribution, congruency.
- They provide shock absorption during weight-bearing activities.
Meniscus tears often happen during twisting activities when the knee is bent and the foot is planted. It is also possible for the menisci to get injured gradually with age and overuse.
What are the Symptoms of Meniscal Knee Injuries?
Signs and symptoms of a meniscus injury include the following:
- Swelling of the knee joint – the amount can range depending on the severity of the meniscus injury
- Pain within the joint, often worse with twisting or squatting activities
- A feeling that the knee is going to lock, buckle or give way without warning
- A consistent click deep within the joint
A physiotherapist, chiropractor or sports medicine doctor can use a number of special tests to determine if you have a meniscal knee injury. In some cases, diagnostic imaging is used to determine the extent of the meniscal tear.
Physiotherapy or Chiropractic Treatment of Meniscal Knee Injuries
Depending on the location and severity of the meniscal injury, it can often be treated successfully with conservative treatment. Physiotherapists and Chiropractors are trained to treat meniscus injuries through strengthening areas of weakness around the knee (or other areas of the body which may be contributing to poor mechanics at the knee). They can also use manual techniques and modalities to provide pain relief and they can give advice regarding activity modification and return to sport.
If the tear is too severe or in a location of the meniscus with poor blood supply, arthroscopic surgery may be required. If this is the case, physiotherapy or chiropractic treatment is still an important part of the process. It helps reduce swelling and strengthen before surgery and then after surgery it helps to improve range of motion, strength and stability of the knee joint with the goal of returning to full function as soon as possible.
How Can I Treat Meniscal Knee Injuries at Home?
If you suspect you have a meniscal tear and after an aggravating activity swelling occurs it is best to apply ice, elevate and compress the area. This is applied for 10 min ON/OFF for about 3x immediately after the activity.
You will want to start a rehabilitative exercise program early, which includes exercises similar or equivalent to the ones mentioned below.
You also may find some relief with a brace. The brace works by adding awareness of the knee in space with a tight compression sleeve around your knee as well this helps to control swelling.
If your symptoms are not resolving, your knee is locked (i.e. cannot fully straighten) or it is getting worse, booking an assessment with a trusted health care provider is going to help direct your care, set goals and get you on the road to recovery faster.
What are the Best Exercises to Help with Meniscal Knee Injuries?
Position yourself standing in a long stride stance with your pelvis squared forward. Keeping your trunk in an upright position bend both knees, which will lower your body towards the ground. Ensure that there is about a 90-degree bend in both knees and then straighten your legs to return to standing.
Check out this Instagram post for correct form:
Hamstring, Quad and Calf Stretching
When performing stretches it is important that you do not stretch so far that the stretch becomes painful or shaky. A stretch is all you want to feel. You can choose to hold your stretch 30sec or if it feels better move in and out of the stretch position repeating up to 20x.
Standing or lying on your stomach reach back to hold your knee at the ankle (if you cannot reach use a towel or belt to help). Pull your foot directly towards your buttock until your feel a stretch along the front of your thigh.
What Should be Avoided if I have a Meniscal Injury?
The best rule to go by is avoid any activity that hurts during or after or causes your swelling to increase. Movements such as kneeling, twisting or pivoting on the knee especially when bent, jumping, running or walking on uneven surfaces will most likely be aggravating.
How long does it take to recover from meniscal knee injury?
If the injury occurs in part of the meniscus that has good blood supply and you are taking steps to help it heal you should see improvements in your pain and symptoms within 3 weeks and be fully recovered and back to activities by 8-12 weeks.
However, if your injury is more severe, meaning a large tear, indicated with your knee locking and swelling often. You most likely will have a longer recovery. This may include the need for MRI imaging and a consult with an orthopedic surgeon for arthroscopic surgery. After surgery, physiotherapy or chiropractic care will take about 6-8 weeks to get you back to the activities and sports you enjoy.
Written By: Reanna Montopoli, FCAMPT Physiotherapist