Todd Kuslikis

Todd Kuslikis

MMT, MPA
Knee Pain Specialist and Injury Prevention Expert

Meniscus Tear Guide: Symptoms, Diagnosis, and Treatment Options

Share on facebook
Share on google
Share on twitter
Share on linkedin

A meniscus tear is a common knee injury, and it’s one of a variety of reasons why people can suffer from arthritis-like symptoms. It’s often caused by an aggressive twisting motion, being hit while on one foot, or falling after landing from a jump. From high performance athletes to casual rec team players, sports are often the cause.  But not always.   

 

Meniscus tears occur when one of the four menisci is pulled from its place and begins moving around in an irregular fashion, stabbing into nearby tissues, muscles and tendons.  And yes, it can be very painful.

 

Anatomy of Meniscus Tear

The meniscus is a rubbery, flexible piece of cartilage that provides support and shock absorption between the bones in your knee. They’re nature’s cushions.  

 

Meniscus Tear Anatomy

Actually, there are two on each side of the joint for double protection; together they have different shapes to fit their respective areas. 

 

There is a C-shape on the medial (inner) side and a U-shape on lateral (outer). This is because there needs to be stability while reducing impact from motion or standing.  

 

Very little blood flow is found on these inner edges.  They don’t need much oxygenated blood to be healthy, but they do have some circulation at their outer edge in order to heal more quickly if damaged.  

 

Meniscus Tears – Why They’re So Common!

Meniscus tears are just as common in the elderly as they are in athletes, but both groups experience them due to different reasons.

 

Meniscus tear - why they are common?

Meniscus tears happen more often with age because your tissues deteriorate over time, while sports-related injuries are most likely caused by intense jumping or twisting motions that result in a shockwave through the knee joint.

 

Playing sports that require sudden turns and stops can put you at higher risk for a meniscus tear. Research shows that these are some of the games that are higher risk:

  • Football
  • Basketball
  • Wrestling
  • Baseball

 

As people get older, they are more likely to have a degenerative meniscus tear.  Unfortunately, a certain amount of tissue degeneration is normal as we age.

 

Common Symptoms and Signs of Torn Meniscus

When you’re experiencing pain, it’s important to note what activities you’re participating in. The most common symptoms of a torn meniscus are pain in the knee, especially during or after activities that involve bending, twisting, or pivoting. 

 

The pain will typically intensify with activity and can become debilitating. You might also experience swelling around the affected area. 

 

Other symptoms could include bruising near or on the knee (in severe cases), difficulty walking, feeling like your kneecap is unstable, and a popping sensation when you move the joint.

 

Self Diagnosis Meniscus Tear at Home

Thessaly Test

The first sign of a meniscus tear is often pain or popping in the knee. The simple “Thessaly Test” will tell you if it’s time to get checked out by your doctor.  Be prepared.  Your doctor will likely order an MRI to confirm. 

 

The good news is that Thessaly Test is easy and only takes a minute.

  • From a standing position, bend your non-painful knee about 5 degrees then twist side to side, rotating at the hip joint.
 
  • Repeat this process on the painful knee but bend it 20 degrees.  Grab something sturdy, like a chair, for stability.
 
  • If you hear a clicking or catching sound along with feeling significant discomfort or pain, you might have a tear!  Time to make an appointment.

 

Confirming you’ve torn your meniscus is sometimes tricky, and there isn’t a specific test doctors use to diagnose it. The most common way for them to be certain is by questioning you about the circumstances of the injury and by examining your knee with an MRI.  Don’t worry.  Both are painless.

 

Types of Meniscus Tears: What Does it Mean?


Intrasubstance or Incomplete Tear

Intrasubstance tears are a sign of degenerative changes in the meniscus. The tear may not be visible at first, but can often be seen through an MRI scan as well as during surgery.  These are seen most often in older adults with degenerative changes in the meniscus.

 

Bucket Handle Tear

A bucket handle tear is when the meniscus tears in two places, with a piece of it missing in the middle. This type is more serious because there’s no way to repair it and therefore the tissue must be removed entirely through surgery.  These typically happen in middle-aged adults.

 

Horizontal Meniscus Tear

A horizontal meniscus tear is when the ligaments inside the knee joint–the medial or lateral collateral ligament–are torn, leaving a horizontal gap in the upper part of the meniscus.  These are most common in middle-aged adults as well and are usually due to an injury from contact sports or excessive running on hard surfaces.

 

Radial Tear

A radial tear of the meniscus is a common type that often needs surgery. The tears are located in an area where there isn’t a blood supply, so it’s difficult for them to heal naturally without surgical treatment. 

 

Surgery can be performed either by shaving or repairing the damage and cutting out any damaged tissue from around the site of injury.

 

Flap Tear

A flap tear is a rare type of meniscus injury. It can cause severe knee pain, as it alters the mechanics and stability in that area.  The good news is that surgery to remove the small piece will usually alleviate discomfort.

 

Complex Tear

A complex tear is a variety of tears that are not always the easiest to diagnose. Complex tears usually involve both radial and horizontal patterns, but this type of injury poses many challenges in terms of treatment.  It can be difficult to repair.

 

Meniscus Tear Risk Factors – Am I at Risk?

Meniscus tear risk factors include:

  • Physical risk factors such as repetitive bending or twisting of the knee, obesity, and past knee injury.
  • Environmental factors that increase risk are overuse, running on hard surfaces like concrete, and contact sports.
  • People with a family history of torn meniscus are also more susceptible.
  • Meniscus tears are also more common among elderly people, smokers and people who have gout.
 

In short, there are many different risk factors, and a torn meniscus can happen at any age.  But don’t stress!  Keeping yourself healthy and being careful during athletic events can lower your risk.

 

The BEST Home Remedies for a Torn Meniscus!

You did the test, and it doesn’t look good.  What now?  Ready to take action? These are some popular remedies for a torn meniscus:

  • Apply cold packs to the knee.
    Knee compression sleeve for PFPS
  • Wear compression wraps (sometimes called an ACE wrap) around your leg and knee.  These will help reduce swelling and pain.
  • Don’t forget about using crutches if you can’t walk or bear weight on your injured knee.
  • Get outside and walk on a soft surface to get your blood flowing, or go for a stroll in the park. Just be sure you’re not overusing the injured leg!
 

It’s important that you stay moving during rehabilitation, so be sure to include lots of aerobic activity like biking, hiking, or even swimming.  When you think you have a problem, though, always make the first call to your doctor.

 

Confused About What To Do With A Meniscus Tear? Here Are Some Exercises You Can Do!

It’s important to stay active while a torn meniscus is healing. Try our strength, flexibility, and posture correction and soft tissue therapies in order to rehab your torn meniscus.  Building up strength and flexibility in the muscles around the knee and those that function with it will build stability.

 

Strength Exercises

Do 3 sets of 10 reps of the following exercises:

 Rotated Leg Lifts

A Rotated leg lift is a type of strength exercise that can be performed to help strengthen the inner thigh. 

Rotated Leg Lifts for Meniscus Tear

  • To start, lay on your back on your bed with one leg straight and one knee bent.
  • Gently rotate the straight leg’s foot out to the side.
  • Slowly lift up your straight leg, trying to keep that rotation the entire lift, two-second pause, and lower.  You should feel your inner thigh working!
  • Decrease range of motion for modification.
 
 Side Lying Leg Lifts

Side lying leg lifts are a great exercise for those who have a meniscus tear, because they build up hip strength.

Side Lying Leg Lifts for Meniscus Tear

  • Lay on your side with your bottom knee bent and your top leg straight.  It’s common for the top leg to swing forward a little, so you may have to bring it back an inch or two. Your body should be in a straight line from the tip of your head to the tip of the foot on your straight leg. 
 
  • Slowly lift your top leg towards the ceiling about 6-12 inches.  Don’t let it float forward. Then, lower your leg back down.
 
  • Keep your hips and shoulders square to the wall in front of you while your leg moves.
 
 Clamshells

These work your outer thighs.

Clamshells for Meniscus Tear

  • Start by laying on your side with both knees bent.

  • Keeping your feet in contact with each other, rotate your top knee towards the ceiling. Make sure you keep your spine in alignment and your hips don’t rock back! If you feel your back moving, use a smaller range of motion.

  • Rotate your top leg back down to the starting position.  

  • To increase the difficulty, pause at the top of the lift.  To make it easier, don’t rotate the knee as far.

 

 

Flexibility Exercises

Do each of these stretches for 30 seconds, three times each.

 

Hamstring Curls

Hamstring curls are a great way to stretch your hamstrings. You’ll need a towel or strap.

Hamstring Curl for Meniscus Tear

  • Lie on your back with one leg bent and one straight. Wrap the towel around the foot of the straight leg, and gently pull your leg up towards the ceiling.

  • Think about driving the heel as close to the ceiling as you can without causing pain. Hold for 30 seconds. Relax and repeat on the opposite leg.

To make this easier, decrease your range of motion when lifting your leg.

 

Piriformis Stretch

The piriformis stretch targets tight glutes.

Piriformis Stretch

  • Begin by lying on your back with both knees bent.

  • Cross your left leg over your right, then using both arms gently pull your left knee towards your right shoulder.

  • Hold for 30 seconds. 

  • Relax and repeat on the opposite leg.

    Modification: Only pull your knee across a few inches, and reduce your range of motion.

 

Hip Flexor Stretch

Stretch out those hips and improve posture with the hip flexor stretch.

Hip Flexor Stretch

  • Stand tall with your hands placed on a steady surface. You can use a counter, sink, or chair (without wheels) to hold onto for balance.

  • Step back with your right leg. Keeping your right leg straight, bend your left knee a little. Keep your hips squared and facing forward while in this position. You should feel a pull in the front of your right hip.

  • Hold 30 seconds then switch legs, stepping back with your left leg.

To decrease the stretch, don’t step back as far.  To increase it, step back further and, if there’s no pain, bend your knee a bit more.

 

Posture Correction and Soft Tissue Therapies

Knee cap mobility 

Another great way to release the tension on your knee cap is by performing a simple self-massage. 

  • Start by pulling your left calf muscle a little towards your buttock.
  • You should feel tension in the back of your left thigh and calf.
  • Once you feel the tension, put enough pressure in between your elbow and leg to push the knee cap outwards.
  • Hold for 10 seconds, before repeating 2 or 3 times.
 

Roller for IT band

  • Lay on your side, so that the IT band of your leg closest to the ground is resting on the foam roller.

  • Rest your arm above your head and allow it to relax against a wall or table. You want a flat surface to rest your arm on while doing this exercise.

  • Slowly allow yourself to roll from one side of your body onto your back. Keep as much pressure on the foam roller as possible for 5 seconds before returning back to the start position.

  • Repeat this process 3 or 4 times.
 

Tip: Sit and stand with good form.

Sitting and standing with good form can be as helpful as an exercise or stretch when it comes to keeping things working properly.  When sitting in a chair, keep your feet flat on the floor and your knees in line with your hips. 

When standing, consciously focus on keeping your weight evenly distributed between both legs.

 

Lifestyle Changes You Can Ease Meniscus Pain

There are many lifestyle changes you can make to ease meniscus pain. First and foremost, stop any activities that make your pain worse.

It’s also important to ice the area often and massage the muscle for a few minutes each day. Avoid standing too long and stay off of your feet when possible.

Quitting smoking is one lifestyle change which we know can increase your overall health, but it can also ease meniscus pain.

Smoking causes the blood vessels in your body to constrict and makes your blood pressure rise.  This can cause a spike in pain that worsens the condition.

To prevent your meniscus from ripping, make sure you are at a healthy weight. Obesity puts more pressure on your knees than normal weight, which is why being too heavy can result in an increase in the chance that your meniscus will tear. 

This is especially true if you don’t have any supporting muscle tissue around the medial meniscus to provide additional stability and protection for the strained joint.  Keep doing those exercises!

When you have a meniscus tear, it is important to keep up with balanced exercising, strengthening, and stretching. You should take care of your body while resting and icing your knee and performing some soft tissue therapy around the affected area. 

If you’re experiencing intense pain, it’s always best to see a doctor as soon as possible. You may need surgery or other treatment options in order to help fix the problem and address your symptoms.

A doctor will be able to tell you what’s wrong and give you appropriate treatment so that you can get back to doing the activities you love with your friends and family.

 

Things to Avoid with a Torn Meniscus

When you’re injured, the main thing is to avoid exercises that place a lot of pressure on the meniscus. For example, if you have a tear in your medial meniscus, avoid exercises like squats and lunges. These types of exercises force the knee joint to bend which can worsen pain or cause more damage to your meniscus.

For those who have had surgery, avoid exercises that involve kneeling on one leg for a prolonged period of time. You should also avoid putting too much weight on your knee and stay off stairs, even though it may feel stable at first. 

Be careful when returning from injury so as not to make things worse or hurt yourself again.  Recovery can feel like it takes forever!  Don’t do anything that could set you back even further.

 

How to Prevent a Torn Meniscus?

The best way to prevent a torn meniscus is to strengthen the muscles and ligaments around your knee joints. Studies have shown that strengthening the supporting muscles may reduce the chance that you will tear your meniscus by up to 60%! 

Strengthening these muscles can also relieve some of the pressure on your meniscus which can help elongate the life of your joint.

It’s also vital that you don’t sit still for too long with your knees bent as bending your knees over time can cause them to get weaker. This means there may not be enough strength to support them when you’re playing sports, so they are more likely to tear. 

The safest way to exercise after suffering from a meniscus injury is walking, biking, or swimming because these exercises don’t put any pressure on your knee.  If you want to return to more strenuous activities, wait until the pain has decreased and swelling around the joint has gone down before resuming a rigorous sports routine.

 

Signs You Need Surgery

Signs that you might need surgery to repair your meniscus include signs of nerve impingement, a continued pain post-op, or other disorders in the surrounding tissue.

If you are experiencing any of those symptoms, have your doctor examine your knee. If there are any signs of damage in the surrounding tissues, surgery will be necessary. The doctor will be able to tell what type of treatment would best suit you as a patient.

 

What other Conditions Can Mimic a Meniscal (Cartilage) Tear?

If the pain in your knee is severe but does not improve with conservative treatment, it could be an indication of a more serious condition. Make sure that you get a thorough examination by a doctor to rule out causes for the symptoms you’re having. Other possible conditions that might mimic meniscal tear include:

Osteoarthritis

Patellofemoral arthritis

– Ligament injury

– Tendonitis

– Patellar tendonitis

– Patellar dislocation

– Tear in the anterior cruciate ligament (ACL)

The most important thing you can do is to seek treatment for your injury as soon as possible. Ignoring a torn meniscus could lead to long term problems such as osteoarthritis, so it’s best not to wait and see if it will go away on its own.

 

Meniscus Tear Recovery Time — How Long Does it Take to Recover From a Meniscus Surgery?

There are two procedures that doctors can perform to fix a meniscus injury. Meniscectomy is the removal of all or part of your damaged tissue and has shorter recovery time than other treatments.  It is  typically 8-12 weeks before you’re back on your feet again. 

If it’s more severe, then they will use repair techniques where they sew up any damage in order for it to heal properly over 16-24 months while keeping daily activities at bay until full recovery occurs.

 

Myth or Fact: Sitting “TOO MUCH” is bad for your Meniscus Tear

Fact.  Sitting for too long can weaken your knees and make them tear easier. The truth is that while sitting for long periods of time isn’t good for you, it won’t directly lead to a meniscus tear. If you choose to sit all day then it’s best to try and sit up straight with your feet flat on the floor.

More to Explore

2 Responses

  1. This was very helpful. My knees are the main problem, keeping me from greater physical activity, like reaching spaces in my garden to wrangle weeds up from a retaining wall. flower bed. I still walk my pooch daily, garden in assessable areas, and participate in other activities, even doing the cleaning in my large house. Kneeling,, standing for extended periods are out. I will be 80 in three months. Gail Pearce, La Mirada, C A

    1. Gail, I am so happy to hear that you found this helpful! It sounds like you are very active. That's awesome! Thank you for reading!

Leave a Reply

Your email address will not be published. Required fields are marked *

ANNOUNCEMENT: Medical-Grade Knee Sleeves Back in Stock! Get 40% OFF TODAY!