What is it?
A meniscal tear refers to damage to one of the two C-shaped pieces of cartilage which separate the bones in the knee joint. These cartilages act as shock absorbers within the knee to assist in cushioning forces that transmit through the joint.
How does it happen?
The menisci in the knee are most commonly injured when the knee is twisted while weight bearing. This often occurs when changing directions quickly whilst the foot is fixed on the ground. It may also occur if a fellow competitor hits your knee causing it to twist or buckle.
How does it feel?
The first sensation felt when a meniscus is injured is pain within the knee joint. This may be associated with a sensation of something tearing. Depending on the severity of the injury, the knee may swell and you may have difficulty walking due to pain. Swelling may be immediate or occur over a period of hours. The knee may also feel weak and ‘unstable’, and may produce clicking noises, lock or give way.
What should you do for a Meniscal tear?
To limit the severity of this injury it is advised you stop your activity immediately and start initial treatment. The most important time in the treatment of any injury is the first 24-48 hours. Swelling is a necessary step in the healing process; however, too much swelling can delay healing and cause further tissue damage. To control the amount of swelling and limit the degree of damage to the knee, the RICE regime should be commenced (Rest, Ice, Compression, Elevation). This will help to reduce blood flow to the injured area, thereby reducing the extent of swelling and tissue damage.
Rest – ceasing your activity or sport, and limiting the amount of weight you put through your leg. Crutches may be required if you are having difficulty walking.
Ice – applied to the injured site for 15-20 minutes every 1-2 hours. Ideally, it should be applied using crushed ice wrapped in a moist cloth or towel.
Compression – apply a firm elastic bandage around your knee. It should be firm but not tight enough to cause pain.
Elevation – lying with your knee resting comfortably on a chair or pillows so that it is above the level of your heart. You should continue the RICE regime until you consult a physiotherapist, preferably within two days of the initial injury.
What shouldn’t you do?
Following injury to the knee, you shouldn’t undertake activities which increase blood flow to the injured area. These include hot showers, heat rubs and excessive activity. These may increase the bleeding and swelling within the knee and potentially prolong your recovery.
Could there be any long-term effects?
Because the menisci in the knee have a poor blood supply, this means that sometimes when they are injured they are unable to heal completely by themselves. Unfortunaelty a tear can result in ongoing problems depending on the severity of the injury and the location of the tear. These problems include persistent knee swelling, clicking, locking and giving way. To limit these ongoing problems, surgery is often performed to remove the damaged portion of the meniscus. Recovery from surgery normally takes a number of weeks and often requires physiotherapy treatment. If other structures in the knee have been damaged the recovery can be prolonged.
The assistance of a physiotherapist is important in the treatment of a knee injury. Initially they can assist in determining which tissues have been damaged and the extent of this damage. From this, they will be able to determine the most appropriate treatment. This may involve referral to an orthopaedic surgeon or for scans such as MRI, activity modification, demonstration of how to use crutches and strengthening and stretching exercises.