Is it my meniscus?

How do I know if my knee problem is my meniscus?

One of the indicators that your meniscus is the problem relates to an injury. Meniscus tears happen typically with no contact with another person, and there is compression and a twist. Think you plant your foot on the ground and twists forcefully. Another way the meniscus can get injured is a repetitive motion where you squat deep over and over again.

What are symptoms of a meniscus tear?

Most people who have a meniscus injury have a feeling like their knee is going to give way. And if they have a particular kind of tear their knee can get locked in place where they can’t straighten out their knee past a certain point.

WHAT IS A MENISCUS?

The meniscus is a cartilage substance in your knee joint. You have two menisci (plural), in each knee, a medial (inner side of the knee) and a lateral (outer side of the knee) meniscus. The menisci act as extra cushion for you knee because of how much weight goes through the joint, your body was made with extra cushion. The menisci have some parts that have blood supply (10-30% of the outer zone) and other parts that don’t have as good supply. If the tear happens in the section with blood supply there is a chance the meniscus tear can heal with or without surgery, if the tear happens in the other parts of the meniscus there is no chance it will heal. Your body needs blood supply to heal the tissue.

WHAT IS A MENISCUS TEAR?

A tear in the meniscus can be a slit, a handle-looking flap, or a rip. These tears typically happen when you are putting weight through the joint and twist. This causes compression on the cushion and then a shearing force which can tear it. Most people talk about a click, a catch and/or a lock of their knee. These are classic signs of a meniscus tear. The catch and the lock happen because a flap of the meniscus gets in the way of the knee joint from moving properly so your knee essentially gets stuck (locked) in place until the meniscus flap gets out of the way.

WHAT DOES THE TEAR LOOK LIKE?

WHO tears their meniscus?

The tears can occur in the athletic or non-athletic population. Someone who is playing in a sport or activity and plants their foot and then twists, creating that tear. It can also just happen from normal activity where the meniscus has just worn out in some spots. Over time this worn out spot gets irritated and inflamed, causing pain and swelling. Meniscus tears may be more likely to occur in someone who has a job that involves a lot of squatting, ladder or stair climbing, or crawling on hands and knees.

WHAT IS MY PROGNOSIS WITH A MENISCUS TEAR?

Most people can live with a torn meniscus, it usually just depends on how inflamed and irritated your knee is. Sometimes, and especially if it’s a bucket-handle tear, the tear keeps flipping back and forth in the knee and it keeps getting inflamed. Other times the tear just sits there and if the irritation can be calmed down then the person can live with the tear and manage the symptoms.

DO I NEED SURGERY?

Maybe, maybe not. In some studies, it is suggested that arthroscopic meniscal debridement knee surgery occurs up to 700,000 times in a year in the US. Not everyone needs or gets the surgery. Two types of surgery are meniscectomy and meniscus repair.

A meniscectomy is an arthroscopic surgery where the surgeon debrides, cleans up, the meniscus. I imagine this as the surgeon takes a chomper and pac-mans the meniscus tear out of the knee.

A meniscus repair is where the surgeon takes sutures and sews the meniscus back together. This can only be done when the tear is in the part of the meniscus that has blood supply. If there is no blood supply the meniscus cannot repair even though it has been sewn back together.

WHAT ARE SOME THINGS I CAN DO TO PREVENT A TEAR?

Strengthen the muscles in your leg (hips, knees and ankles) so that your body has better control over the motions your body goes through daily and with sports or advanced activities. By keeping your legs strong you have an improved chance of your muscle memory kicking in when you do activities to keep your knee joint from getting into unwanted positions. Doing regular exercise also helps keep your joints healthy so there is plenty of lubricant in the joint to keep things moving smoothly.

WHAT ARE SOME THINGS I CAN DO TO HELP MY KNEE FEEL BETTER IF I HAVE A TEAR?

Some gentle knee exercises for meniscus tears, modified rest and ice can help your knee if you have a tear. The goal in the first 2 weeks after a new meniscus tear is to calm down pain and inflammation, and to maintain range of motion so your knee doesn’t get stuck. You want to perform light, gentle exercises to maintain blood flow to the knee and to improve mobility at your knee. An exercise like the quad-set helps bring blood flow to the area by activating your quadriceps muscle in your thigh. This increased blood flow brings in good nutrients and takes away the toxins that build up during an inflammatory reaction, thus decreasing swelling in the knee. Doing an exercise like a heel slide helps improve how much your knee bends, keeping it from getting too stiff. It also will help bring blood flow to the knee, which in turn helps the swelling as I mentioned above.

SHOULD YOU USE ICE OR HEAT?

I always recommend with a new injury use ice for the first week. After any new injury you will have an inflammatory reaction, this is your body’s first defense to injury. Now, an inflammatory reaction is good… when it is controlled. If it gets out of control that’s when the reaction can actually hinder healing: that’s a whole other topic for another blog post. For now, use ice for 10-20 minutes at a time daily, as often as you need to, typically 3-5x/day for the first 7 days. 

So to recap someone with a knee meniscus injury may feel pain, feel like their knee is giving way and may lock in place. The initial injury was from a non-contact twisting motion, or from repeated deep squatting for years at work. Building up good strength and flexibility can decrease the risk of injuring it. For more tips and tricks follow my page.

 

If you’re looking for knee pain relief check out this free guide I created just for you

Part of this post was originally posted in December 2019 by Dr. Ali’s sister site mobilept.us