Your knees have a significant impact on your day to day activities. You use your knees for standing, sitting, walking, and lifting. When your knee suffers injuries, it can have a debilitating impact. One common knee injury occurs in the form of a torn meniscus.
The meniscus is a cartilage pad shaped like a C found in your knees. It attaches to the top of the tibia bone and provides cushioning and support needed for the tibia and femur to hinge together. When a tear occurs to the meniscus, you may find yourself without the proper range of motion. Knowing the causes, symptoms, and treatments of a meniscus tear can help you in dealing with this injury.
Tears to the meniscus occur when you twist your body or turn too quick while your knee is in a bent position and your foot is firmly planted on the ground. You may also experience a tear to the medial meniscus from heavy lifting or just by getting older.
Unfortunately, age can play a role in the health of your meniscus. As you age, standard wear and tear may cause damage to the meniscus. Keep in mind, however, that athletes and other individuals who commonly play sports are at a higher risk of tears.
Meniscus pain and tears will most commonly occur among athletes. Athletes that are among the highest risk include football, basketball, and soccer players. Athletes who participate in tennis or golf may also experience these tears.
Part of what makes football, basketball, and soccer so risky is that players must be able to stop on a dime and make sudden shifts in direction. Players in each sport are also more likely to take a hard impact compared to other sports, which could also lead to a meniscus injury.
As previously mentioned, age can also increase your risk of developing a tear to the meniscus. Generally, adults who are older than thirty are at a higher risk for tears. Once you are over the age of thirty, your meniscus is not as stable as it once was, which is caused by degeneration. Degeneration makes tears more likely to occur.
Aging athletes should pay attention to the health of their knee. Athletes who are edging closer to thirty may find themselves at risk of developing tears to the meniscus as a combination of degeneration and injuries caused by impact.
Symptoms of a Tear
There are several types of tears, including degenerative, longitudinal, radial, and bucket handle tears. Despite the differences in tears, the symptoms remain the same. When the meniscus first tears, you may hear an initial popping sound. Afterward, the following symptoms are likely to appear:
- Pain (worsened when someone touches the knee)
- Feeling like knee is weak and unable to provide you with support
- Feeling like knee locks up
- Trouble moving your knee properly or your knee lacks full range of motion
- Popping or slipping sensation (indicates cartilage is loose and is likely creating a blockage in your knee joint)
If you have any of the symptoms above, it is a good indication that you likely have a torn meniscus. The tear may range from mild to severe, as will the symptoms associated with the tear.
Diagnosing a Tear
Symptoms may indicate a tear, but they do not confirm it. Your doctor will have to diagnose you to confirm a torn meniscus. First, your doctor will examine your knee and use manipulation to test the range of motion in your knee.
Your doctor may suggest a McMurray test, which also uses knee movement. During the test, you will have to bend, straighten, and rotate your knee. The doctor will watch your range of motion and listen for a popping sound that indicates a tear to the meniscus.
If testing your range of motions is not enough, your doctor may confirm the issue using imaging. For instance, your doctor may ask for an X-ray. Although meniscus injuries do not appear on an X-ray, it can help rule out other causes of knee pain.
An MRI, on the other hand, can capture images of your cartilage and ligaments, which allows your doctor to locate a meniscus tear. Unfortunately, an MRI is not always the most reliable source of imaging. In fact, an MRI may only offer between 78% and 79% accuracy.
An ultrasound is also an option. The ultrasound machine sends sound waves through your body to capture images. The images can help your doctor determine if there is any cartilage loose in your body creating blockages in your knee.
Although it is not common, your doctor may want better accuracy than what an MRI or an ultrasound can provide. In that case, he or she may decide to use an arthroscope on your knee. Your doctor will make a tiny incision and insert the arthroscope through it. The arthroscope is a thin, fiber optic tool that has a light and camera attached to it. It is also commonly used during surgical procedures.
Your doctor will be able to confirm a meniscus tear using one of the methods above, or a combination of techniques. Typically, doctors opt for a combination of methods to determine the presence of a meniscal tear. It is better to be confident rather than to treat a patient with a misdiagnosis.
Your treatment options vary depending on the severity of the tear. Your doctor will start you off with the RICE method, which includes:
Whenever you injure any part of your body, you should rest it as much as possible. The same holds true for a meniscus injury. Avoid anything that puts a weight-bearing load on your knee. Make sure to avoid any activities that make your knee feel worse.
You should also apply ice to the affected area. Typically, a doctor will recommend placing ice on your knee every 3 hours or so for 30-minute intervals. The ice helps relieve swelling, which may also alleviate some of the pain and discomfort you feel.
Compression is another recommended method of treatment. Wrap a bandage around your knee to help compress the area. Although the bandage should have a snug fit, it should not be so tight that it cuts off circulation. The compression will help reduce any inflammation of the knee.
Finally, elevate your knee. Many doctors will recommend that you raise the affected area of your body above your heart. Lie back in bed and prop a pillow under your knee until it is elevated above your heart. By raising your knee above your heart, you can reduce inflammation.
If your doctor has not prescribed you one, make sure you also take an OTC anti-inflammatory medication, such as ibuprofen. You may take ibuprofen every 6-8 hours as needed for pain and swelling. Keep in mind that there are other medications you might use, but you should take to your doctor before taking anything so he or she can approve it.
As a non-surgical option, your doctor may recommend physical therapy to help improve the mobility and strength of your knee. Cortisone injections may also come up as a recommendation. Both options allow you to avoid surgery while providing your knee with strength and support for healing.
In some cases, the knee does not respond well to non-surgical methods of treatment. In those instances, your doctor will opt for surgery. In some situations, the meniscal tear is so severe that surgery is unavoidable.
Fortunately, arthroscopic surgery is a somewhat reliable and less invasive form of surgery than needing to cut your knee wide open. Instead, the surgeon will make tiny incisions that allow the arthroscope entry. Once inside, the surgeon will either trim or repair your damaged meniscus. The entire operation will take roughly an hour from start to finish.
Once your surgery is complete, your doctor will go over your at-home methods of care and treatment. He or she will also likely recommend physical therapy and rehabilitation afterward. The healing processing can take roughly six weeks, which is why physical therapy is so important. It prevents your knee from losing strength or becoming used to inactivity.
Overall, surgery is highly effective. Although there are other methods of surgery, such as a meniscectomy, arthroscopic repair is better for you. Doctors will consider arthroscopy for:
- Healthy patients who would like to continue to lead an active lifestyle
- Patients who understand that there is a rehabilitation and recovery period after surgery
- Patients with healthy meniscus tissue that is optimal for reparation
Keep in mind that you can always discuss your treatment options with your doctor. In fact, you should ask questions about your treatment. If your doctor opts for surgery, ask questions to find out why. If your doctor recommends non-surgical procedures, you should still ask why and determine the effectiveness of non-surgical options for your meniscal injury.
Keep in mind that no two injuries are alike and treatment plans will vary per patient. Whereas a surgery might work for one person, non-surgical treatments may work for another. Your doctor will determine the best treatment for you based on the extent of your injuries, your age, your health, and your lifestyle.