Welcome to Orleans Physiotherapy's patient resource about Meniscal Injuries.
The meniscus is a commonly injured structure in the knee. The injury can occur in any age group. In younger people, the meniscus is fairly tough and rubbery, and tears usually occur as a result of a forceful twisting injury. The meniscus grows weaker with age, and meniscal tears can occur in aging adults as the result of fairly minor injuries, even from the up-and-down motion of squatting.
This guide will help you understand:
where the meniscus is located in the knee
how an injured meniscus causes problems
what can be done for an injured meniscus
Hear from some of our patients who we treated for Knee Pain
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I had a knee and leg injury that required physiotherapy and I was fortunate to find an excellent physiotherapist Jagruti Asudani, who has offered a range of treatments at every stage of my recovery.... ”
“ I had a knee and leg injury that required physiotherapy and I was fortunate to find an excellent physiotherapist Jagruti Asudani, who has offered a range of treatments at every stage of my recovery. Thanks to her effective treatments and exercise plan I have had a successful recovery. I strongly recommend Jag if you are looking for a strong thorough physiotherapist. ”
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Today I had my first meeting with Natasha Green for knee pain in 2 months (possible meniscus tear). I was nervous and Courtney the receptionist greeted me warmly and reassured me. Natasha explained to... ”
“ Today I had my first meeting with Natasha Green for knee pain in 2 months (possible meniscus tear). I was nervous and Courtney the receptionist greeted me warmly and reassured me. Natasha explained to me what she was going to do and how she was going to assess my injury. Her kindness, professionalism, clear explanations, and exercise recommendations made me realize that I was in good hands with her. Excellent physiotherapy treatment after the evaluation. Then, she sent me by email, in French, the exercises I have to do at home and explained to me what she will do at the next meeting. I already have my 2 appointments scheduled for next week! Dominique Guy ”
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I can’t stress enough just how amazing Clint Dulude is as a human and a Physiotherapist. I went to him with legitimate, seriously painful conditions I didn’t know existed until they happened to... ”
“ I can’t stress enough just how amazing Clint Dulude is as a human and a Physiotherapist. I went to him with legitimate, seriously painful conditions I didn’t know existed until they happened to me. He 100% cured my patella-femoral in both knees and my tennis elbow in both arms in a totally reasonable amount of sessions (they don’t try to “upsell”you trying to make you come back more often) and the experience is just pleasant. Great staff, great tools and technology and more importantly - it works. Back there for plantar fasciitis treatment and have no doubt the shockwave treatment will work for me. ”
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I have injured my knee helping my husband shovel the pathway last February. Covid-19 delayed my request for an X-ray. Clifton is great, and he is patience with me because I keep re-injuring my leg.... ”
“ I have injured my knee helping my husband shovel the pathway last February. Covid-19 delayed my request for an X-ray. Clifton is great, and he is patience with me because I keep re-injuring my leg. Love the clinic and strongly recommend anyone need help to see Clifton. In the spring I will take up his offer for my allergies by Auricular Acupuncture treatments. Thanks a bunch, Susan. ”
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I took my son at Orleans Physiotherapy for a knee injury. After one full treatment, his knee was 100% better. The level of care and attention was excellent. I can trust this place when faced with a... ”
“ I took my son at Orleans Physiotherapy for a knee injury. After one full treatment, his knee was 100% better. The level of care and attention was excellent. I can trust this place when faced with a painful injury that needs immediate treatment. Thank you OP. ”
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(Translated by Google) Today I had my first meeting with Natasha Green for knee pain in 2 months (possible meniscus tear). I was nervous and Courtney the receptionist greeted me warmly and reassured... ”
“ (Translated by Google) Today I had my first meeting with Natasha Green for knee pain in 2 months (possible meniscus tear). I was nervous and Courtney the receptionist greeted me warmly and reassured me. Natasha explained to me what she was going to do and how she was going to assess my injury. Her kindness, professionalism, clear explanations, and exercise recommendations made me realize that I was in good hands with her. Excellent physiotherapy treatment after the evaluation. Then, she sent me by email, in French, the exercises I have to do at home and explained to me what she will do at the next meeting. I already have my 2 appointments scheduled for next week! Dominique Guy (Original) Aujourd'hui, j'ai eu ma première rencontre avec Natasha Green pour douleur au genou depuis 2 mois (possibilité d'une déchirure au ménisque). J'étais nerveuse et Courtney, la réceptionniste m'a accueilli chaleureusement et ma rassurée. Natasha m'a expliqué ce qu'elle allait faire et comment elle allait évaluer ma blessure. Sa gentillesse, son professionnalisme, ses explications claires, et recommandations d'exercices m'ont fait réaliser que j'étais entre bonne mains avec elle. Excellent traitement de physiothérapie apres l'évaluation. Ensuite, elle m'a envoyé par courriel, en français, les exercises que je dois faire a la maison et ma expliquer ce qu'elle va faire à la prochaine rencontre. J'ai déjà mes 2 rendez-vous planifié pour la semaine prochaine ! Dominique Guy ”
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I am thrilled to say how pleased I am with the amazing, professional, knowledgeable and always up-to-date staff at Orleans Physiotherapy from the front desk staff to the health care professionals. I... ”
“ I am thrilled to say how pleased I am with the amazing, professional, knowledgeable and always up-to-date staff at Orleans Physiotherapy from the front desk staff to the health care professionals. I had gone to see them 15 years ago for a back issue and later a knee issue. I am now there for neck, shoulder, arm pain. Natasha Green is one of the newer members on the team and I cannot say enough about her expertise, compassion and knowledge. She uses techniques that work magic on my pain - dry needling, manual therapy (where she pinpoints precisely the area of need), laser etc. And of course, Orleans Physiotherapy follows all Covid protocols to ensure everyone is safe. I highly recommend Orleans Physiotherapy! ”
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Went to Orleans Physio due to a knee/hip injury. Celine is easy to talk to, she understands and makes you feel like you are important and that she wants to get you and your body working better. She... ”
“ Went to Orleans Physio due to a knee/hip injury. Celine is easy to talk to, she understands and makes you feel like you are important and that she wants to get you and your body working better. She takes the time to ask how you are doing and modifies the treatment when there are improvements. It is a warm and friendly atmosphere. Celine is the best! ”
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I was referred for physio because of arthritis in my knee. I had pain and difficulty walking. Even through this pandemic, I had a prompt phone call from Clifton and he sent me a series of exercises... ”
“ I was referred for physio because of arthritis in my knee. I had pain and difficulty walking. Even through this pandemic, I had a prompt phone call from Clifton and he sent me a series of exercises that would help...and it did. After 2 weeks of exercises, I am pain free and can go back to my usual activities and exercises. This was a free service. In previous years, both my husband and I did require services from Orleans Physiotherapy and we were always very pleased and our issues were resolved. ”
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I have been seeing Clint at Orleans Physiotherapy on and off for several years for different problems either for shoulder issues. back issues or knee issues and I had always received excellent care.... ”
“ I have been seeing Clint at Orleans Physiotherapy on and off for several years for different problems either for shoulder issues. back issues or knee issues and I had always received excellent care. Most important. I have always recover with the help of the treatments and the exercises.I am now seeing Clint for knee issues and in spite of the pandemic I feel safe as the staff take all the safety measures necessary to protect their clients. The receptionists are polite, knowledgeable and will do their best to accommodate my schedule. ”
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Over the past year I have had two experiences with Orleans Physiotherapy - one for a torn rotator cuff in my shoulder; the other for an injured knee. In both cases the care provided by Orleans... ”
“ Over the past year I have had two experiences with Orleans Physiotherapy - one for a torn rotator cuff in my shoulder; the other for an injured knee. In both cases the care provided by Orleans Physiotherapy was top notch. Even during when they were closed during the first part of the pandemic they went out of their way to reach out and suggest exercises to help. Staff are friendly and personable. Very highly recommended ”
“
Staff is extremely friendly and professional! Prayusha has helped me so much with my knee issues . She is very professional, friendly and I would highly recommend her . ”
“ Staff is extremely friendly and professional! Prayusha has helped me so much with my knee issues . She is very professional, friendly and I would highly recommend her . ”
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I am very happy with the results I got from my physiotherapy treatments for my knee. I went from barely being able to walk on my leg to being fully functional in a short period of time All the staff I... ”
“ I am very happy with the results I got from my physiotherapy treatments for my knee. I went from barely being able to walk on my leg to being fully functional in a short period of time All the staff I came into contact with were pleasant, friendly and helpful. My physiotherapist, Janik, was calm, pleasant and very professional. I would not hesitate to go there again. ”
There are two menisci between the shinbone (tibia) and thighbone (femur) in the knee joint. (Menisci is plural for meniscus.)
Menisci
The C-shaped medial meniscus is on the inside part of the knee, closest to your other knee. (Medial means closer to the middle of the body.) The U-shaped lateral meniscus is on the outer half of the knee joint. (Lateral means further out from the center of the body.)
These two menisci act like shock absorbers in the knee. Forming a gasket between the shinbone and the thighbone, they help spread out the forces that are transmitted across the joint. Walking puts up to two times your body weight on the joint. Running puts about eight times your body weight on the knee. As the knee bends, the back part of the menisci takes most of the pressure.
Articular cartilage is a smooth, slippery material that covers the ends of the bones that make up the knee joint. The articular cartilage allows the surfaces to slide against one another without damage to either surface.
Aricular Cartilage
By spreading out the forces on the knee joint, the menisci protect the articular cartilage from getting too much pressure on one small area on the surface of the joint. Without the menisci, the forces on the knee joint are concentrated onto a small area, leading to damage and degeneration of the articular cartilage, a condition called osteoarthritis.
The menisci add stability to the knee joint. They convert the surface of the shinbone into a shallow socket, which is more stable than its otherwise flat surface. Without the menisci, the round femur would slide on top of the flat surface of the tibia.
Meniscal injuries can occur at any age, but the causes are somewhat different for each age group. In younger people, the meniscus is a fairly tough and rubbery structure. Tears in the meniscus in patients under 30 years old usually occur as a result of a fairly forceful twisting injury. In the younger age group, meniscal tears are more likely to be caused by a sport activity. The entire inner rim of the medial meniscus can be torn in what is called a:
Bucket Handle Tear
The meniscus can also have a flap torn from the inner rim.
The tissue that forms the menisci weakens with age, making the menisci prone to degeneration and tearing. People of older ages often end up with a tear as result of a minor injury, such as from the up-and-down motion of squatting. Most often, there isn't one specific injury to the knee that leads to the degenerative type of meniscal tear. These tears of the menisci are commonly seen as a part of the overall condition of osteoarthritis of the knee in aging adults. Degenerative tears cause the menisci to fray and become torn in many directions.
Menisci Degeneration and Tearing
Symptoms
What does a torn meniscus feel like?
The most common problem caused by a torn meniscus is pain. The pain may be felt along the edge of the knee joint closest to where the meniscus is located. Or the pain may be more vague and involve the whole knee.
The knee may swell, causing it to feel stiff and tight. This is usually because fluid accumulates inside the knee joint. This is sometimes called water on the knee. This is not unique to meniscal tears, since it can also occur when the knee becomes inflamed.
The knee joint can also lock up if the tear is large enough. Locking refers to the inability to completely straighten out the knee. This can happen when a fragment of the meniscus tears free and gets caught in the hinge mechanism of the knee, like a pencil stuck in the hinge of a door.
A torn meniscus can cause long-term problems. The constant rubbing of the torn meniscus on the articular cartilage may cause the joint surface to become worn, leading to knee osteoarthritis.
Diagnosis begins with a history and physical exam. Your physiotherapist at Orleans Physiotherapy will try to determine where the pain is located, whether you've had any locking, and if you have any clicks or pops with knee movement.
Some patients may be referred to a doctor for further diagnosis. Once your diagnostic examination is complete, the physiotherapists have treatment options that will help speed your recovery, so that you can more quickly return to your active lifestyle.
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Our Treatment
Non-surgical Rehabilitation
When you visit Orleans Physiotherapy, our initial treatments for a torn meniscus focus on decreasing pain and swelling in your knee. Rest and anti-inflammatory medications, such as aspirin, can help decrease these symptoms. You may need to use crutches until you can walk without a limp.
Our physiotherapist will treat your swelling and pain with the use of ice, electrical stimulation, and rest periods with your leg supported in elevation. Exercises are used to help you regain normal movement of joints and muscles. Exercises to improve knee range of motion and strength are added gradually. Our physiotherapist may also help you to obtain and use a knee brace.
Although recovery time varies, nonsurgical rehabilitation for a meniscal injury typically lasts six to eight weeks. You can return to your sporting activities when your quadriceps and hamstring muscles are back to nearly their full strength and control, you are not having swelling that comes and goes, and you aren't having problems with the knee giving way.
Post-surgical Rehabilitation
Rehabilitation proceeds cautiously after surgery on the meniscus, and treatments will vary depending on whether you had part of the meniscus taken out or your surgeon repaired or replaced the meniscus.
Patients are strongly advised to follow their physiotherapist's recommendations about how much weight can be borne while standing or walking. After a partial meniscectomy, we may instruct you to place a comfortable amount of weight on your operated leg using a walking aid. After a meniscal repair, however, you may be instructed to keep your knee straight in a locked knee brace and to put only minimal or no weight on your foot when standing or walking for up to six weeks.
Orleans Physiotherapy patients usually need only a few physiotherapy visits after meniscectomy. We may recommend additional treatments if there are problems with swelling, pain, or weakness. Rehabilitation is slower after a meniscal repair or allograft procedure. At first, expect to see our physiotherapist two to three times a week. If your surgery and rehabilitation go as planned, you may only need to do a home program and see our physiotherapist every few weeks over a six-to eight-week period.
Orleans Physiotherapy provides services for physiotherapy in Orleans.
Surgery
If the knee keeps locking up and can't be straightened out, surgery may be recommended as soon as reasonably possible to remove the torn part that is getting caught in the knee joint. But even a less severely torn meniscus may not heal on its own. If symptoms continue after nonsurgical treatment, surgery will probably be suggested to either remove or repair the torn portion of the meniscus.
Surgeons use an arthroscope (mentioned earlier) during surgery for an injured meniscus. Small incisions are made in the knee to allow the insertion of the camera into the joint.
Partial Meniscectomy
The procedure to take out the damaged portion of the meniscus is called a partial meniscectomy. The surgeon makes another small incision. This opening is needed to insert surgical instruments into the knee joint. The instruments are used to remove the torn portion of the meniscus, while the arthroscope is used to see what is happening.
Surgeons would rather not take out the entire meniscus. This is because the meniscus helps absorb shock and adds stability to the knee. Removal of the meniscus increases the risk of future knee arthritis. Only if the entire meniscus is damaged beyond repair is the entire meniscus removed.
Meniscal Repair
Whenever possible, surgeons prefer to a torn meniscus, rather than remove even a small piece. Young people who have recently torn their meniscus are generally good candidates for:
Repair
Older patients with degenerative tears are not.
To repair the torn meniscus, the surgeon inserts the arthroscope and views the torn meniscus. Some surgeons use sutures to sew the torn edges of the meniscus together. Others use special fasteners, called suture anchors, to anchor the torn edges together.
Special Fasteners
Meniscal Transplantation
Surgeons are beginning to experiment with different ways to replace a damaged meniscus. One way is by transplanting tissue, called an allograft, from another person's body. Further investigation is needed to see how well these patients do over a longer period of time.
The most common problem caused by a torn meniscus is pain. The pain may be felt along the edge of the knee joint closest to where the meniscus is located. Or the pain may be more vague and involve the whole knee.
