Anatomy

The menisci are load bearing structures in your knee. They fill the gaps between the round shape of the femur (thigh bone) and the flat, upper surface of the tibia (shin bone).

  • Thus, this improves shock absorption; it disperses the distribution of force across the whole joint articulation. This avoids mere bone-on-bone weight bearing.

Your knee has two types of cartilage – articular and meniscal.

  1. Articular cartilage is involved in the smooth gliding of joint surfaces.
  2. Meniscal cartilage provide shock absorption, joint stability and lubrication.

A healthy meniscus is vital for pain-free, comfortable knee function.

Presentation

Meniscal tears have a few key mechanisms, signs and symptoms which differentiate it:

Mechanism of Injury:

  • Commonly involves a twisting force with the foot planted.
  • Rare to occur in children (5% of meniscal tears occur in children)

Delayed Swelling:

  • The menisci have very poor blood supply, compared to other knee ligaments.
  • When the meniscus tears, there isn’t a lot of bleeding involved, thus it takes hours for swelling to be observed.

Signs/Symptoms

  • Tenderness and pain along the joint line
  • Clicking, catching, locking
  • May hear an audible ‘pop’ during injury

Diagnosis

Your physiotherapist will run through a series of assessments to determine potential damage to your meniscus.

The Gold Standard for meniscal diagnostics is an MRI scan.

Treatment

Treatment can take a conservative or surgical approach. Both methods require an extensive rehabilitation program aimed at the following goals:

  1. Range of motion restoration:
    – Reach full knee extension before 4 weeks post-injury/op.
    – Graded, slow return to knee flexion (avoid knee flexion past 90deg)
  2. Eliminate swelling:
    – Soft tissue massage, compression bandages and elevation to reduce joint effusion.
  3. Strength gains:
    – Quadriceps strengthening targeting VMO
    – Global glut strengthening
    – Straight leg raises
    – Core strengthening
    – Commence gentle single leg strengthening after 4 weeks.
  4. Movement control/proprioception:
    – This includes a progression of exercises across different surfaces
  5. Return to sport:
    – Can commence dynamic control exercises at a minimum of 3 months post-injury/op

Note: The above is a guideline! Book in to a physiotherapist to get an individualised treatment plan at your stage of recovery.

Notable mention: UW Health for an outstanding Meniscal Repair Protocol, view here