There are two types of cartilage in the knee that can be damaged. Articular cartilage is the smooth, semi-rigid 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 like football or hockey, or it can gradually wear thin with age, causing arthritis in the knee joint.
The other type of cartilage is meniscus cartilage and it refers to the crescent-shaped cushions between the lower part of the thigh bone and the upper part of the shin bone. Without the menisci, the bones of the upper and lower leg grind against each other, which may cause short-term pain and long-term arthritis. There are two menisci—one (lateral) on the outside of the knee joint, the other (medial) on the inside. The inside meniscus is the one most frequently injured in sports and the type of injury discussed below.
How a Torn Meniscus Happens
An athlete typically suffers a torn meniscus when they take 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, twisting, pivoting, changing directions, or decelerating. It isn’t unusual for a torn meniscus to happen simultaneously with another traumatic injury, such as a torn anterior cruciate ligament (ACL).
For older athletes, the meniscus often becomes weak and frayed, making it more vulnerable to both contact and non-contact injuries. Something as simple as the up and down motion of squatting may cause a minor meniscus tear.
Degenerative changes involve frayed or jagged edges of the meniscus. A tear that occurs along the length of the meniscus is called a longitudinal tear. A tear where a portion of the meniscus becomes detached from a bone and forms a flap is called a bucket-handle tear.
Torn Meniscus by the Numbers
The increased amount of body weight force placed on the knee joints when walking.
The increased amount of body weight force placed on the knee joints when running.
The inside (medial) meniscus is five times more likely to be injured than the outside (lateral) meniscus..
The percent of meniscus tears that can be diagnosed (by a physician) with a careful injury history and physical examination.
Who’s at Risk of a Torn Meniscus
A soccer, basketball, lacrosse, tennis, or football player who plants a foot to change directions or who takes a hit from another player is vulnerable to meniscus injuries. Runners who misstep or step in a hole can sustain the same injury. Men are more likely to tear a meniscus than women, but that may be because of the number of men that participate in sports as opposed to a gender-specific cause.
- Pain on the inside of knee joint or a dull pain throughout the joint.
- Pain that may subside for a few days, but return with physical activity.
- A popping sound at the time of the injury.
- Swelling within 24-48 hours after an injury.
- Stiffness, tightness
- Muscle weakness
- Inability to fully bend the knee.
- Inability to put weight on the knee joint or buckling of the knee.
- Locking or catching of the knee at a 45-degree angle.
- Rest and don’t try to play through the pain (use crutches if needed).
- Apply ice in 20-minute intervals several times a day during the first 48-72 hours after the injury.
- Use a pillow or cushion to elevate the knee while at rest during the day and while sleeping at night.
- Aspirin, acetaminophen, ibuprofen, and naproxen may relieve pain.
- After 48-72 hours, use moist heat to increase circulation and relieve discomfort.
- Get medical attention if the pain persists for a week or more, or if you think you have torn a meniscus.
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.
- Wear a knee brace or sleeve for protection.
Incorporate these prehab exercises into your comeback routine:
How to Avoid a Torn Meniscus
- Some meniscus tears aren’t preventable and might be considered an occupational or recreational risk that accompanies a sport.
- Be especially careful doing squats to avoid excessive compression of the meniscus.
- Work with a certified strength and conditioning coach to ensure proper lifting techniques in the weight room.
- Work with a knowledgeable coach to ensure proper sport-specific technique to reduce the risk of meniscus injuries.
Incorporate these movement prep exercises into your dynamic warm-up routine:
Jim Brown, Ph.D. has written 14 books on health, medicine, and sports. His articles have appeared in the Washington Post, New York Post, Sports Illustrated for Women and Better Homes & Gardens. He also writes for the Duke School of Medicine, UCLA School of Medicine, Cleveland Clinic and Steadman-Hawkins Research Foundation.
Cardio, Diet, Fitness, Health, Lifting