Meniscus Tears

What is a meniscus tear?

A meniscus tear is an injury to one of the rubbery, C-shaped pieces of cartilage in your knee called the meniscus. Each knee has two menisci - one on the inner side of the knee (medial meniscus) and one on the outer side (lateral meniscus). The meniscus acts as a shock absorber between your thighbone (femur) and shinbone (tibia), helping to keep your knee stable.

At Tangram Health, our team of Physiotherapists, Chiropractors, and Exercise Physiologists often see patients with meniscus tears. We understand just how worrying this injury can be, so we’ve put together this guide to help you understand more about what meniscus tears are, the treatments available, and how you can recover from them.

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What are the different types of meniscus tears?

There are several types of meniscus tears, each with its own characteristics:

1. Bucket handle tear: A large tear where a portion of the meniscus is displaced, resembling a bucket handle.
2. Flap tear: A small tear where a small piece of meniscus hangs loosely.
3. Radial tear: A tear that starts from the inner edge of the meniscus and extends outward.
4. Horizontal tear: A tear that splits the meniscus into upper and lower halves.
5. Complex tear: A combination of two or more types of tears.

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What are the symptoms of a meniscus tear?

The symptoms of a meniscus tear can vary depending on the size and location of the tear. Common signs include:

• Pain in the knee, especially when twisting or rotating your knee
• Swelling and stiffness in the knee
• A popping sensation at the time of injury
• Difficulty straightening your knee fully
• A feeling that your knee is locked in place when you try to move it
• Weakness in your knee, making it feel unstable

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What causes meniscus tears?

Meniscus tears can occur due to various reasons:

• Traumatic injury: Sudden twisting or rotating of the knee, often during sports
• Degenerative changes: As we age, the meniscus can become worn and more prone to tearing
• Repetitive stress: Certain activities or jobs that put repeated stress on the knee
• Obesity: Excess weight puts more stress on the knee joints
• Pre-existing knee conditions: Such as osteoarthritis, which can make the meniscus more vulnerable

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How are meniscus tears diagnosed?

When you visit one of our Tangram Health clinics with symptoms of a meniscus tear, our Physios, Chiros, and EPs will use several methods to diagnose your condition:

• Medical history: They'll ask about your symptoms, how the injury occurred, and how it affects your daily life.
• Physical examination: Your Physiotherapist or Chiropractor will check your knee for tenderness, swelling, and range of motion. They may also perform specific tests, such as:
  • McMurray test: Involves bending, straightening, and rotating your knee
  • Apley's Grind test: Applies pressure to the knee while rotating it
  • Thessaly test: Involves standing on one leg, squatting, and twisting.
• Imaging tests: In some cases, X-rays, MRI, or ultrasound scans may be recommended to get a closer look at your knee structures.

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Do I need any scans for a meniscus tear?

While many meniscus tears can be diagnosed through physical examination, imaging tests can be very helpful in confirming the diagnosis and determining the extent of the injury. These may include:

• X-rays: While they can't show meniscus tears directly, X-rays can rule out other knee problems like fractures or arthritis.
• MRI (Magnetic Resonance Imaging): This gives a detailed view of the soft tissues in your knee, including the meniscus. It's the most accurate imaging test for diagnosing meniscus tears.
• Ultrasound: This can sometimes be used to visualise meniscus tears, especially when combined with a physical examination.

At Tangram Health, our Physiotherapists and Chiropractors in Sydney can refer you for these scans if necessary and explain what the results mean for your condition and treatment.

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How are meniscus tears treated?

Treatment for meniscus tears depends on the size, type, and location of the tear, as well as your age and activity level. At Tangram Health, we offer a range of treatments, including:

• RICE protocol: Rest, Ice, Compression, and Elevation to manage pain and swellin
• Exercise rehabilitation: Our Physiotherapists, Chiropractors, and Exercise Physiologists can design an exercise program to improve your knee flexibility, control, strength, and endurance.
• Pain management: Over-the-counter pain relievers or prescription medications may be recommended
• Bracing: A knee brace can provide support and stability
• Activity modification: Avoiding activities that aggravate your symptoms
• Injections: Corticosteroid injections can help reduce inflammation in some cases
• Surgery: In severe cases or when conservative treatments haven't helped, surgery might be necessary

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When are injections used for meniscus tears?

Injections, particularly corticosteroid injections, may be used in some cases of meniscus tears to reduce pain and inflammation. They can provide temporary relief and may help you progress more comfortably with your physical therapy. However, injections are not suitable for all types of meniscus tears and are typically not a long-term solution.

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When is surgery required for meniscus tears?

Surgery for meniscus tears is generally considered when:

• Conservative treatments haven't improved your symptoms after several weeks or months
• You have a large tear or a tear in the outer part of the meniscus (which has a better blood supply and healing potential)
• Your knee is locking or catching frequently
• You're an athlete wanting to return to sports quickly

The most common surgical procedures for meniscus tears are:

• Meniscus repair: Stitching the torn pieces together
• Partial meniscectomy: Removing the damaged part of the meniscus
• Total meniscectomy: Removing the entire meniscus (rarely done nowadays)

If surgery is being considered, our Physiotherapists, Chiropractors, and Exercise Physiologists can help recommend some good orthopaedic surgeons, help you understand the procedure, and provide the post-operative rehabilitation after surgery.

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What exercises should I do for a meniscus tear?

Exercise is a crucial part of treating many meniscus tears, whether you're having surgery or not. It helps to:

• Strengthen the muscles around your knee
• Improve flexibility and range of motion
• Reduce pain and swelling
• Improve your overall knee function
• Prevent future knee problems

Our Physiotherapists, Chiropractors, and Exercise Physiologists at Tangram Health can design an exercise program tailored to your specific needs and stage of recovery. This might include:

• Range of motion exercises: To improve knee flexibility
• Strengthening exercises: For the muscles that support your knee
• Balance and proprioception exercises: To improve knee stability
• Low-impact cardiovascular exercises: To maintain overall fitness without stressing your knee

Remember, it's important to start slowly and gradually increase the intensity of your exercises.

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Can meniscus tears heal on their own?

Some meniscus tears can heal on their own, particularly if they're small and located in the outer part of the meniscus where there's a good blood supply. However, many tears, especially those in the inner two-thirds of the meniscus (which has a poor blood supply), may not heal without treatment. Even if a tear doesn't heal completely, many people can manage their symptoms and maintain good knee function with proper treatment and rehabilitation.

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How long does it take to recover from a meniscus tear?

Recovery time can vary greatly depending on the severity of the tear, the treatment approach, and individual factors:

• For minor tears treated conservatively: You might see improvement in a few weeks to a couple of months
• For tears requiring surgery: Recovery can take 3-6 months, with some people needing up to a year to regain full function

Remember, everyone's recovery is different. Factors like your age, overall health, and how well you follow your treatment plan can all affect your recovery time.

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How can I prevent meniscus tears or stop them from getting worse?

While you can't prevent all meniscus tears, there are steps you can take to reduce your risk or prevent existing tears from worsening:

• Maintain a healthy weight: Excess weight puts more stress on your knees
• Stay physically active: Regular exercise helps keep your leg muscles strong
• Warm up before physical activities: This can help prepare your muscles and joints for exercise
• Wear proper footwear: Shoes with good support can help protect your knees
• Use proper technique: When playing sports or exercising, use correct form to avoid unnecessary stress on your knees
• Avoid sudden increases in activity: Gradually increase the intensity and duration of your physical activities
• Listen to your body: If you feel pain or discomfort in your knee, stop the activity and rest

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When should I see someone about my knee pain?

You should consider seeing a healthcare professional if:

• You have persistent knee pain or swelling
• Your knee feels unstable or gives way
• You can't fully straighten or bend your knee
• You hear a popping sound in your knee accompanied by pain
• Your knee pain is affecting your daily activities or sleep

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Take home message

Meniscus tears are common knee injuries that can significantly impact your mobility and quality of life. However, with proper diagnosis and treatment, most people with meniscus tears can find relief and improve their knee function.

At Tangram Health, our team of experienced Physiotherapists, Chiropractors, and Exercise Physiologists are dedicated to helping you manage your meniscus tear effectively. We have clinics conveniently located across Sydney in Mt Kuring-Gai, Asquith, Willoughby, Milsons Point, Dural, and Blacktown so you can get the right treatment for your meniscus tear.