MENISCAL TEARS
There are two types of cartilage in the knee that can be damaged.
Articular cartilage is the smooth tissue that covers the ends of bones and allows
the knee joint to move freely. It can be torn away by impact during contact sports
or it can gradually wear thin with age.
The other type of cartilage is meniscus cartilage and it refers to the u-shaped
cushions between the lower part of the thigh bone and the upper part of the shin
bone. The meniscus provide cushioning for the joint, preventing the bones
rubbing on each other and also provide nutrition for the joint. There are two
menisci—one (lateral) on the outside of the knee joint, the other (medial) on the
inside. Medial is the most commonly injured.
Causes of meniscal tears
A medial meniscus tear occurs when there is a blow to the outside of the knee,
forcing it inward and tearing the structure, or by some combination of bending or
compressing the knee joint, whilst twisting, pivoting, changing directions.
Degenerative changes can also contribute to torn meniscus. With degenerate
changes the meniscus becomes frayed or jagged along the edges of the
meniscus making it more susceptible to tears. These tears may happen in simple
motion such as squatting.
Symptoms







Pain on the inside or outside of the knee joint or a dull pain throughout the
joint.
Swelling within 24-48 hours after an injury.
Stiffness, tightness in the knee joint.
Inability to fully bend/straighten the knee due to pain and stiffness.
Pain on squatting.
Difficulty putting weight on the knee joint and instability of the knee.
Locking or catching of the knee.
Initial treatment




Rest. Use crutches, if necessary.
Apply ice packs for 15-20 minutes, 3-4 times a day, for at least the first 72
hours.
Use an elastic wrap around your upper leg for compression (to control
swelling).
Seek physiotherapy advice re management to help reduce swelling,
reduce pain and mobilise the knee.




The physiotherapist will then also give you a strength program, sport
specific rehab program and time frames for return to sport.
Location of the meniscal tear will determine management of this injury. If a
tear has occurred on the outer rim, there are enough blood vessels to
allow the structure to heal. If the tear is in the central area where there
isn't a good supply of blood, the tissue may not ever heal and may need to
be removed through arthroscopic surgery.
Recovery without surgery may take six to eight weeks.
Recovery with surgery may take three to four months.
How to avoid this injury
Meniscal tears are hard to avoid, just one of those injuries that can happen in
sport. Some factors to consider are:



Be especially careful doing squats to avoid excessive compression of the
meniscus.
Do an adequate preseason and ensure adequate strength training.
Work with a knowledgeable coach to ensure proper sport-specific
technique to reduce the risk of meniscus injuries.