This means looking after the injured body part by stopping playing or taking some weight off it.
This page has been designed to provide you with the right information about meniscal injuries and how to manage them from a physiotherapy point of view. It also contains the right information if you have had surgery to address your meniscal issue.
If you have had, or are planning to have, a meniscal surgery, you can jump straight to this information by clicking on the text below.
What is a meniscus and what does it do?
A meniscus is a structure in your knee that has many roles, but its main one is to help with the cushioning between your femur (thigh) and your tibia (shin). You have two menisci in your knee, with one on the inside and one on the outside of your knee joint. Most people will know their meniscus by a different name, that name being ‘cartilage’. The menisici are a type of cartilage but for consistency, this information page will use the name meniscus.
Are they strong?
Yes, your knees in general are unbelievably strong as they are designed to run, jump and kick. Your menisci are also incredibly strong as they are designed to help the knee manage all that running, jumping and kicking without too many issues.
Can you injure a meniscus?
Like any body part, you can injure it and menisci are no different. Just like any normal sprains and strains, you can have a mild issue where the meniscus might be grumpy and a bit upset, all the way up to a meniscus that has actually undergone some trauma.
How would you upset a meniscus?
As mentioned above, your menisci are very strong and are designed to be worked hard, but can be upset if too much stress is put through them. Commonly, kneeling or squatting down for a long time (especially if you’re not used to it) can irritate your knee and possibly the meniscus. Menisci can be injured more extensively with a bending, twisting action of the knee, like changing direction on the sporting field.
What are the symptoms of a meniscal problem?
The most common symptoms include localised knee pain (possibly to the back of the knee) and tenderness around the knee joint itself. Often meniscal issues will be most sore with your knee fully bent (squatting/crouching or kneeling), or if you stand on your feet for a long time or with standing/ twisting movements. Sometimes, a clicking or popping feeling or locking (sticking) sensation can be felt and these may indicate a meniscal tear.
What should I do to help my knee?
If you have recently upset your knee, try not to worry.
Follow the new way of managing acute (early) muscle and joint injuries using the POLICE principle.
I’ve heard the term “meniscal tear”, what does that mean?
A torn meniscus is when the actual structure of the meniscus has undergone some damage. As detailed above, sometimes this happens due to accidents (see above), but sometimes they can exist without you even knowing (or causing any issues). Horga et al. (2020) found that 30% of people who had an MRI of their knees showed meniscal issues, including tears. The interesting thing is that these people had NO pain in their knees, which suggests you can have a meniscal tear in your knee and live quite normally with no symptoms.
Why do some meniscal tears need surgery then?
Good question - there’s lots of ways to answer this and ultimately, it’s complicated. We are all different and so are meniscal tears. Where the tear is, how big is it, how long it’s been there, how fit you are, how strong you are and how much you understand about your knee all affect how well you can manage any knee problem.
Often, if the tear is causing locking of the knee (when the knee actually gets stuck) and it is not settling, then it might be that surgery is considered.
So can meniscal issues be managed without surgery?
In short, yes. If your meniscus is irritated, it can calm down and there are some easy ways to do this.
OK, I’ve got all that, but what exercises are good to build it back up as you say?
Remember, sometimes you have to ‘calm things down’ first before you can ‘build them back up again’. Make sure you have read and tried to put some of these ideas in place before jumping straight into the exercises.
The exercises below are all about getting the knee gently moving first and then progressing onto some strengthening when you feel ready.
Movement Exercises
All Knee Strengthening Exercises
Horga, L.M. , Hirschmann A.C., Henckel J., Fotiadou A., Di Laura, A., Torlasco C., De Silva, A., Sharma, S., Moon J.C., & Hart A.J. (2020). Prevalence of abnormal findings in 230 knees of asymptomatic adults using 3.0 T MRI. Skeletal Radiol. 2020; 49(7): 1099–1107. doi: 10.1007/s00256-020-03394-z
Sherman, S.L., DiPaolo, Z. J., Ray, T.E., Sachs, B.M. & Odaldeji, L.O. (2020). Meniscus injuries: a review of rehabilitation and return to play. Clinics in Sport Medicine. 39(1), 165-183.