Assisting the efficient joint relationship in the knee, two cartilaginous menisci rest on the flat surface of the larger lower leg bone (tibia). The inner (medial meniscus) and outer (lateral meniscus) have a flat under surface that sits on the tibia bone and the concave (depressed) overlying surface of the menisci houses the convex (rounded) end of the thigh (femur) bone.
Both of the menisci act as shock absorbers for weight-bearing by providing extra protection to the articular cartilage of the femur and the tibia. It also helps distribute forces throughout the knee while adding stability to the entire knee joint.
An injury to either of the menisci can be both painful and difficult to bear.
The medial meniscus, located in the inner side of the knee, is by far more prone to be injured compared to it lateral (outer) counterpart. This is due to its direct attachment to other structures of the knee such as the medial collateral ligament and the medical capsule of the knee joint.
The “unhappy triad” injury is a common injury in contact sports involving resulting in damage to the medial meniscus, medial collateral ligament and the anterior cruciate ligament.
Only the peripheral zone of the meniscus cartilage is well supplied with blood while the remaining central region of the meniscus lacks a direct blood supply. Therefore, meniscus injuries affecting the central zone do very little healing. Only if the meniscal tear is on the peripheral edge is a meniscal repair possible. If a meniscus repair is not an option, a meniscectomy or a meniscus trimming is a surgical option if necessary.
How to Tear a Meniscus
Common causes of medial include direct forces to the outer knee, aggressive knee twisting, overuse trauma, hyper flexion with rotation and excessive birthdays. These factors can result in thinning and tears of either the medial or lateral meniscus.
Injuries to the medial collateral ligament and anterior cruciate ligament will stress the medial meniscus and result in a medial meniscus tear (MMT). Degenerative conditions predispose the medial meniscus to injury. This is a painful injury initially accompanied by swelling and tenderness.
Signs & Symptoms of Medial Meniscus Tear
- Knee joint line pain which can be increased with twisting and grinding movements.
- Swelling and tenderness usually accompany the inflammation along the medial joint line.
- Possible joint locking and “catching” from the tears and loose piece of the meniscus and/or articular cartilage.
- Range of motion for both bending and straightening of the knee joint may be compromised.
- Difficulty bearing weight with the involved knee.
Professional Treatment for Medial Meniscus Tear
The severity and type of tear sustained will guide the proper treatment approach to medial meniscal injuries.
- Seek clinical evaluation of the injury. Improperly diagnosed and managed meniscal injuries can result in problems that you don’t want to experience.
- RICE – rest, ice, compression & elevation to minimize the inflammation and decrease the symptoms.
- Utilize the latest physical therapy modalities and rehab devices to reduce swelling and decrease pain.
- Knee braces and sleeves will assist in supporting the knee and reducing the excessive motion that will increase the medical meniscus symptoms.
- Maintain knee range of movement as early as possible.
- ·Progressive resistive strengthening exercises for the quadriceps as early as possible maintain dynamic knee stability.
Asking the Right Questions Like a Pro
Here’s what a smart pro athlete would ask his/her sports medicine specialists to ensure a fast and safe return to sports:
- Is this injury related to my biomechanics?
- Exactly what structures in my knee are damaged?
- Do I need an MRI to assess what exactly my knee hurts so much?
- Do I have any articular cartilage damage in any of the three (3) compartments of my knee? If so, do I have arthritis and where?
- What kind of exercises do I need to avoid?
- Are there any long-term complications with this MMT?
- Do I need to visit a physical therapist?
Elite Sports Medicine Tips from Mike Ryan
- Be Smart Now – Resting early on for 3-5 days can prove to pay off if the MMT quiets down quickly.
- It’s Not About Medications – Avoid pain medications for pain unless you REALLY need them.
- Quads Are MCL Guards – If your quad are strong, your MCL will recover fast and with better results. It’s that simple.
- Avoid Bending With Twisting – That’s a common way to tear a meniscus so avoid this movement combo whenever possible.