What is a meniscus?
The meniscus is a fibrous cartilage structure that sits in your knee joint, separating the thigh bone (femur) from the shin bone (tibia).
There are two menisci in each knee, the medial meniscus (the one on the inside of the knee) and the lateral meniscus (the one on the outside of the knee). The meniscus is often referred to as the “cartilage” in your knee.
The menisci are wedged, crescent shaped structures. They act as shock absorbers in the knee. When we walk, run and jump, the knee has to absorb great forces and the menisci help to absorb these forces, thereby protecting the bone surfaces. The menisci also help with keeping the knee stable as we twist or rotate the knee
A meniscus tear is a common knee joint injury. If there is a history of a specific injury, usually involving twisting the knee when it is slightly bent, these tears are referred to as “traumatic.”
However, symptoms of pain and discomfort can gradually come on with “degenerative” meniscal tears, when there is no apparent history of injury. Degenerative tears are more commonly seen in adults from aged 35 years upwards.
- Various symptoms including pain, locking, catching, clicking and the knee giving way
- Localised pain over the knee joint
- Stiffness or swelling around your knee, the swelling may take a couple of hours or days to come on
- Difficulty bending or straightening your knee
The location, type and size of the tear within the meniscus can affect the healing. Tears at the outer edge (red zone) tend to heal better because there is a better blood supply. The inner area (white zone) lacks a good blood supply and therefore does not heal as well.
Sometimes the type of tear can determine whether a tear can be repaired. Recent research shows that for most people, particularly those with degenerative tears, the most effective management is conservative management, that is exercise, medication and, if appropriate, a steroid injection.
Exercise
Your rehab programme should include advice from your physiotherapist and exercises to improve strength, and flexibility. As we have discussed, an important role of the menisci is shock absorption. The other big absorber of shock around your knee is your muscles. If these can be strengthened, they can help absorb forces and protect the meniscus and bone surfaces.
The exercises will target the muscles at the front of the thigh (quadriceps), back of the thigh (hamstrings), calf muscles and buttock muscles (glutes)
Pain relief
Painkillers such as paracetamol and ibuprofen or anti-inflammatory gels may be helpful to control the pain and allow you to continue exercising. Discuss this with your GP or pharmacist.
Sometimes putting an ice pack (or bag of frozen peas) wrapped in a towel on your knee for up to 20 minutes every 2 to 3 hours can help with pain and swelling