Is a meniscus tear causing your painful and clicking knee?
Firstly, what is a meniscus?
The meniscus is a C-shaped piece of cartilage that acts like a cushion between your shinbone and your thighbone (see attached picture of the meniscus). We have 2 menisci in each knee, and a torn meniscus is one of the most common types of knee injuries people get.
What does a torn meniscus feel like?
A torn meniscus can often cause pain, clicking, locking, swelling, stiffness, and even sometimes stop you from fully straightening your knee. Many people report pain with squatting, steps, walking, and turning corners.
What causes meniscus tears?
Acute meniscus injuries usually happen from a pivoting action, such as changing direction suddenly. Sometimes these tears can happen without any major trauma at all, and are more common as we get older.
Do I need an X-ray or MRI?
Generally no. Whilst an X-ray and MRI can help, regardless of what they show. If we think you need an MRI, we can always work with your GP (or ours in our centre) to organise an MRI for you. Keep in mind though that meniscus tears are common findings especially as we get older, and can even be seen in people that have no knee pain at all.
I just hurt my knee recently and it really hurts! What should I do?
Show it some PEACE & LOVE!
Do I need a knee brace?
Knee braces and and taping can be used in the early stages to provide some extra support and comfort whilst you are healing. They work best as a reminder that you do have an injury and not to overdo it whilst it is trying to heal. We stock a range of knee braces in the clinic and can help you find the best one for your knee.
Do I need surgery?
For most people, there is no need for surgery and the knee will improve with time and suitable rehabilitation. For some types of tears though, especially those located on the inside of the meniscus, these tend to heal poorly and surgery may be required to resolve any locking, catching, and limited movements.
For those who play sports and have physically demanding jobs, surgery is sometimes recommended for those who continue to have symptoms after a good trial of non-surgical management. Your age also plays a part in any decision making, with younger people responding better to surgical repairs than older people.
For the best surgical advice, we recommend you speak to an orthopaedic surgeon. Our Physiotherapists can recommend you to a number of professional and friendly surgeons around Sydney.
What will happen in the physiotherapy sessions for my meniscus tear?
Our physiotherapists will listen to your story, assess your knee, help arrange for any imaging or orthopaedic surgeon referrals, and start you on a non-surgical management program.
This will likely involve PEACE & LOVE initially, followed by an individualised exercise program to get you back to your specific goal (e.g. work, sports, or just to be be able to walk the dog and climb stairs without pain).
What will my exercise program look like?
Everyone's program will be different, but as a general guide once the pain is under control, range of movement exercises are introduced to restore normal movements in and around the knee. The muscles around the knees (quadriceps, hamstrings, gluteals, calves) are then gently targeted to maintain activation and stay loose.
The next step is to introduce strength and endurance for the muscles around your knee. These might include bridges, banded exercises, lunges, box squats, or using an exercise bike). All of these will progressively get more challenging as your pain, strength, and endurance improves.
From here, balance and proprioception (joint awareness) exercises are introduced to help build your trust and confidence in your knee. Then hopping, running drills, and some early stage plyometric exercises can be used to challenge the knee.
At this stage, most people will be able to return to their usual activities without their knee limiting them. For those who play sports, the last stage is to get you back to running with change of direction, cutting movements, and any specific sports drills. Passing this lets you safely return to training, and getting back into the game.
If you have knee pain or feel you may have a meniscus tear and would like some more information, see one of our Physiotherapists at Dural Health today.