What are Meniscal injuries?
Knee meniscal injuries are a common type of knee injury that can occur in people of all ages. The meniscus is a C-shaped piece of cartilage in the knee that acts as a shock absorber and helps distribute weight evenly across the joint. It is located between the thigh bone (femur) and the shin bone (tibia). There are two menisci in each knee, one on the inside (medial) and one on the outside (lateral).
The most common mechanism of meniscal injury is a twisting or rotational force on the knee joint. This type of force can occur during sports activities, such as basketball, soccer, or football, or it can occur during everyday activities, such as walking or climbing stairs.
Meniscal injuries can also occur as a result of a direct blow to the knee, such as a car accident or a fall. In older adults, meniscal injuries can occur due to degeneration or wear and tear on the knee joint over time.
It is also possible to have a meniscal injury without a specific injury or traumatic event. In some cases, meniscal injuries can occur due to underlying conditions, such as osteoarthritis or rheumatoid arthritis.
SYMPTOMS of a meniscal injury may include:
- Pain: Pain is often the most noticeable symptom of a meniscal injury. The pain may be felt commonly along the side of the knee of which meniscus is affected. It may be worse when twisting or turning the knee.
- Swelling: The swelling may be noticeable within a few hours or days of the injury and is commonly diffuse around the whole joint.
- Stiffness: It may be difficult to straighten or bend the knee fully due to stiffness in the joint or there may be a locking sensation.
- Popping or clicking sensation: Some people with a meniscal injury may feel a popping or clicking sensation when moving the knee.
- Difficulty moving the knee: It may be difficult to walk or perform activities that involve bending the knee or loading the knee joint.
Diagnosis of a meniscal injury is usually made through a physical examination, imaging tests (such as an MRI or CT scan), and possibly arthroscopy. In the absence of real mechanical dysfunction, the majority of meniscal injuries and irritations will improve over 3-6 weeks of rest and gentle rehab.
TREATMENTS
The best treatment for a meniscal injury depends on the severity of the injury and the patient’s symptoms. The most common treatment options are;
1. Rest and therapy: In the majority of cases of meniscal injury, rest and physical therapy may be sufficient to help the injury heal. Simple exercises can help strengthen the muscles around the knee and improve range of motion and things settle within 2-3 weeks. Initial assessment by a qualified health care practitioner is imperative to set up an appropriate treatment plan and rehab goals.
2. Restoring normal movement and function is important especially after the initial 2-3 days post injury. Exercises are an essential part of the treatment of meniscal injuries.
a. Quadriceps strengthening exercises: These exercises target the muscles in the front of the thigh (quadriceps) and can help improve stability and support for the knee joint. Examples include leg presses, squats, and leg extensions.
b. Calf raises: These exercises can help strengthen the muscles in the lower leg (calf muscles) and improve stability around the knee joints.
c. Balance exercises: Improving balance can help reduce the risk of falls and further injury to the knee. Examples of balance exercises include standing on one foot or using a balance board.
It is important to consult with a physical therapist or other healthcare provider before starting any exercise program. They can help create a customized exercise plan that is appropriate for your specific injury and goals. They may prescribe some specialised rehab equipment which can be seen here.
3. Knee braces can potentially help with meniscal injuries by providing additional support and stability to the knee joint. Wearing a knee brace may help reduce the stress on the meniscus and reduce pain. There are various options from basic support sleeves to more advanced supports that can unload the knee joint . As function returns a knee brace can help to give you more support and confidence.
4. Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation, especially while the knee is in the acute phase of injury. As you progress through rehab you may have periodic increases in discomfort as your loading increases. This is normal and you should be comfortable to use meds such as paracetamol during these times.
5. Icing: In the initial stages if injury icing can be an effective way of reducing pain and swelling. As function and loading increases, icing can also be useful to control these normal increases in discomfort. A simple ice pack such as the Resista Cryocuff or the Freeze Sleeve can do the trick.
6. Surgery: In more severe cases of meniscal injury, surgery may be necessary to repair or remove the damaged meniscus. There are several different surgical options. Surgery is generally arthroscopic and may result in partial meniscectomy, total meniscectomy or meniscal repair. A rehab program post surgery is recommended to get the knee back to full function.


The evidence-based care for meniscal injuries typically involves a combination of non-surgical and surgical treatments.
For non-surgical treatment, rest and therapy are typically recommended as the first line of treatment. Physical therapy can help strengthen the muscles around the knee and improve range of motion, which can help reduce pain and improve function. Non-steroidal anti-inflammatory drugs (NSAIDs) can also be helpful in reducing pain and inflammation.
If non-surgical treatments are not effective, surgery may be considered. The most common surgical treatment for meniscal injuries is arthroscopic surgery, which involves making small incisions in the skin and inserting a small camera (arthroscope) into the joint to visualize the inside of the knee. The surgeon can then repair or remove the damaged meniscus using small instruments. There is evidence to support the use of arthroscopic surgery for meniscal injuries, but the evidence is mixed as to whether it is more effective than non-surgical treatment. In general, arthroscopic surgery is considered most effective for acute meniscal tears that are causing significant mechanical restrictions such as locking and clicking, and pain.
It is important to work with a healthcare provider to determine the best treatment option for your specific situation so please consult your treating clinician for advice and guidance.
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