Torn Meniscus: What to Know About This Knee Injury

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If you're an active person, or even a sports fan, you've probably heard of a torn meniscus. It's a common knee injury, particularly among athletes. But what is it, exactly?

A meniscus is a C-shaped piece of cartilage in your knee joint that provides cushioning. It can be torn with a quick, twisting motion. This is called an acute injury and is more common in athletic injuries. But the meniscus can also wear down over time, leading to what's called a "degenerative" tear.

The good news is that many meniscus tears don't need surgery. At-home treatments, including rest, ice, and exercise, can help. Learn more about the different types of meniscus tears, causes, symptoms, and treatments.

What is a meniscus tear?

The knee is a large weight-bearing joint of your lower body. Because it supports so much of your body weight, it has a form of "padding" to absorb shock and reduce pressure. Each knee has a meniscus on the inner and outer side of the joint. These menisci are C-shaped pieces of cartilage that provide the cushioning the knee joints need.

There are several different types of meniscus tears. Some are worse than others. These tears are different based on their size and where in the meniscus they're located.

Types of meniscus tears include:

• Vertical or longitudinal: This is a tear that runs along a vertical line from front to back.

• Bucket handle: A progression of a vertical tear that causes a portion of the meniscus to flip into the middle of the knee joint, resembling a bucket handle.

• Radial: When a tear that starts from the middle of the knee joint extends outward.

• Parrot beak or oblique: This is a progression of a radial tear deeper into the meniscus that creates a flap that resembles a parrot beak.

• Horizontal: A tear that separates the meniscus into upper and lower parts.

• Flap tear: A progression of a horizontal tear where the torn slice peels away and flaps out from the rest of the meniscus.

• Root tear: This is a tear that detaches the meniscus from the root or attachment point.

• Complex tear: This is a combination of more than one type of tear.

Most degenerative tears are horizontal and occur in the back of your medial meniscus. Traumatic tears are commonly vertical or radial.

What causes a torn meniscus?

Acute meniscus tears can occur from knee injuries related to sports or other activities. Twisting the leg while the foot is planted places a lot of stress through the knee and can tear the meniscus. Sports-related knee injuries that result in a meniscus tear also cause other injuries, like an ACL rupture.

Degenerative meniscus tears occur slowly over time. Many times, they happen without an acute injury. Degenerative tears are linked with knee osteoarthritis (OA), but experts aren't sure whether meniscus injury causes OA, or if OA leads to meniscus degeneration.

What does a torn meniscus feel like?

It's important to note that degenerative meniscus damage doesn't always cause symptoms. As mentioned, it's common with age and can actually be present without causing symptoms.

That said, a torn meniscus often causes pain and swelling in your knee joint. With an acute injury, symptoms can be severe enough to limit mobility. Pain from a torn meniscus tends to get worse with activities that increase pressure in your knees. These include running, going up and down stairs, and deep squatting. Pain can be sharp or achy at rest.

Other symptoms include:

• Swelling

• Catching, clicking, or locking within your knee joint

• Difficulty fully bending or straightening your knee

• Knee instability, or the feeling that your knee "gives way"

How do you treat a torn meniscus?

Fortunately, symptoms of a torn meniscus often improve with conservative treatment methods. When possible, it's recommended to avoid surgery for degenerative meniscus tears due to the increased risk of developing knee osteoarthritis.

Torn meniscus treatment includes:

• RICE method: RICE stands for "rest, ice, compression, and elevation." These simple treatment strategies are recommended for many injuries to decrease pain and improve healing. Resting your knee from activities that make pain worse is essential. Applying ice, compression, and elevating your leg can also help reduce pain and swelling.

• Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications help with pain and swelling. Make sure you ask your primary care provider if they're safe for you.

• Physical therapy: Physical therapy focuses on strengthening exercises for the muscles surrounding your knee joint. It's common for the quadriceps muscles to stop working properly after knee injury. Improved strength in these muscles will help stabilize and ease pressure from your knee. Exercises can also help restore your range of motion if you're unable to fully bend or straighten your knee.

• Steroid injection: Sometimes a steroid injection directly into your knee can help with symptoms so you can tolerate exercises better.

If these treatments don't help, your healthcare professional may recommend surgery. Diagnostic imaging such as magnetic resonance imaging (MRI) will help your surgeon decide which surgical approach is best to treat your type of meniscus tear.

For meniscus tears that require surgery, two options are available. Degenerative meniscus tears are more likely to be treated with a meniscectomy. This surgical procedure cuts off the torn portion of the meniscus. For acute meniscus tears in a young or athletic person, the meniscus may need to be stitched back together with a meniscus repair.

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