Meniscus sprain and/or tear - Medtick

Meniscus sprain and/or tear

What is it?

When there is a tear of the meniscus cartilage.

  • A torn meniscus is a tear to the semi circular cartilage in the knee joint causing pain on the inside of the knee, it is commonly injured through.
  • There are different ways in which the cartilage can tear including longitudinal, bucket handle tears, radial tear and degenerative.

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Medial Meniscus Tear

 

  • The meniscus is a wedge-shaped( C-shaped discs) piece of cartilage that cushions and stabilises your knee joint it cushion between your femur (thighbone) and tibia (shinbone).
  • Each knee joint has two crescent- shaped cartilage menisci. These lie on the inside and outside of the upper surface of the tibia or shin bone and act as shock absorbers for the knee, one on either side of the knee.

Medial meniscus

The medial meniscus is the central band of cartilage attached to the tibia, or shinbone. The band goes around the knee joint in a crescent-shaped path and is located between the medial condyles of the shin and the femur, or thighbone. The medial condyles are areas of these bones located on the inner sides of the knees.

  • The medial meniscus is often injured when the knee is twisted or sprained with sudden force.
  • It is less mobile than the lateral meniscus because it is firmly attached to the tibial collateral ligament. External rotation (rotating the knee outward) puts the most strain on the meniscus, while inward (internal) rotation is the least strenuous.

Healthline 


Grade

If symptoms are not easing, your medical Doctor will assess what grade your tear is.

  • Grade 1 or  2 means you will make a recovery by doing R.I.C.E and medication
  • Grade 3 may need further diagnosis testing and maybe surgery.

Diagnosis Tests

  • Please click for ‘Physiotutors’ diagnosis tests.
  • McMurray test – This test involves bending your knee and then straightening and rotating it.
    • One may hear a slight pop during this test, this may indicate a tear of the meniscus.
  • Other tests include:
  • Apley’s grind test
  • Thessaly test
  • Imaging tests
    • Knee X-ray (check for osteoarthritis)
    • MRI
    • Ultrasound
    • Arthroscopy (last resort if the above test do not provide an accurate diagnosis)
      • With arthroscopy, a small incision or cut is made near the knee. The arthroscope is a thin and flexible fibre-optic device that can be inserted through the incision.
      • It has a small light and camera.
      • Surgical instruments can be moved through the arthroscope or through additional incisions in your knee.
Please see your Medical Doctor If symptoms not improving after a week or if one is  in a lot of pain and/or: Immediately, if your knee locks and you’re unable to bend your knee after straightening it.

Healing could take between four and eight weeks without surgery. However, the time depends on the severity and position of the tear, if it carries on then see your medical doctor to consider other treatment options.

Cause

  • When one squat and/or twist the knee
  • Direct contact or pressure from a forced twist or rotation.
  • Sudden pivot or turn
  • Deep squatting
  • Heavy lifting
  • Sports where there is sudden rotation and twisting.
  • As one gets older, the meniscus cartiladge weakens and becomes thinner and degenerates  and is more likely to tear with any twisting motion.
  • Increased risk with Osteoarthritis

sportsinjuryclinic.net

Symptoms

  • Hear a ‘popping’ sound (Tearing or popping sensation)?
  • Hear a ‘tearing’ sound as you twist (Tearing or popping sensation)?
  • At first the injury might not hurt, But after one walks on it for a few days, the knee can become more painful?
  • Intense swelling and pain is expected during the first 24 hours following this injury?
  • Not be able to straighten your knee, feeling best when the knee is bent?
  • Developing gradual pain after stressing the knee?
  • Pain on the inside of knee(s)?
  • Pain on both side of kneecap?
  • Pain and swelling in the knee region?
  • Difficulty moving your knee or inability to move it in a full range of motion?
  • Locking and/or catching of the knee?
  • Difficulty walking due to the knee buckling or giving way?
  • Might hear a ‘popping’ noise and you may feel your knee give out from under you or feel knee may not support you?
  • Pain when fully bending the knee or squatting down?
  • Joint pain stiffness and swelling?
  • Bone and joint movement problems and/or difficulty legs and/or lack of stamina and/or walking difficulties?

Complications /Information to beware of/General tips:

Be aware of:

  • Baker’s Cyst – a collection of knee-joint fluid that pools in the back of the knee, most commonly as a result of arthritis. If a Baker’s cyst ruptures, the fluid may leak down into the calf region causing an aching pain in the calf, along with swelling.

General tips

  • Consider R.I.C.E method:
    • Rest the knee until it heals.
    • Hold ice on it for 20 minutes at a time, several times a day.
    • Wear a compression bandage to support the knee, but make sure it’s not too tight.
    • Elevate the injured knee on a pillow or several pillows.
  • Use crutches or a cane to take weight off the knee.
  • Knee braces tend to keep your leg straight and apply a lot of pressure to your knee, which can make your tear worse. It is better to use a different form of compression, such as a leg cuff, which reduces your blood flow to the area instead. Reducing the blood flow makes your body think it is working harder than it really is and aids in physical therapy exercises that strengthen the area.
  • Talk to your pharmacist regarding medication to take.

To help prevent swelling during the first 2 to 3 days, try to avoid:

  • Heat, such as hot baths and heat packs
  • Alcohol
  • Massages

When you can move the injured area without pain stopping you, try to keep moving it so the tendon doesn’t become stiff.


Do not go back to your old routine until:

  • You can fully bend and straighten your knee without pain.
  • You feel no pain in your knee when you walk, jog, sprint, or jump.
  • Your knee is no longer swollen.
  • Your injured knee is as strong as your uninjured knee.

Do

  • Warm up before exercising and stretch afterwards
  • Wear suitable shoes for exercise
  • Take regular breaks from repetitive exercises

Don’t

  • Over-exercise tired muscles
  • Start a new sport without some training or practice
  • Stick to the same repetitive exercises

NHS.UK


Surgery

If the above techniques relieve the condition then surgery will need to be considered if the cartilage is severely/irreversibly damaged.

  • The Common surgery types include arthroscopic repair, partial meniscectomy, and total meniscectomy.
    • Arthroscopic repair is a form of minimally invasive joint surgery.
    • Partial meniscectomy involves a partial removal of the meniscus, as opposed to the full removal that occurs during total meniscectomy

Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice

Detailed Information

Please copy and paste any key words from the title: Meniscus sprain and/or tear in the following respective 'Medtick References and/or Sources' to find out more about the disease (this also may include diagnosis tests and generic medical treatments).

  • NHS

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  • Medscape

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  • Pharmaceutical Journal

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New York-Presbyterian Hospital Weill Cornell Medical Center

The Physical Therapy Advisor

Primary Care Sports Medicine