A meniscus tear is a common injury among the active population and, depending on the severity, can require surgery and an extended time on the sidelines. But what is a meniscus tear exactly? What are the symptoms? And, most crucially, can it repair on its own?

　　Six Physio's Ben Johnson has the answers…

　　What is the meniscus?

　　The meniscus is a vital structure in the knee joint - there are two in each joint, one on the inside of the knee (medial) and one on the outside of the knee (lateral).

　　They are C-shaped, made of fibrocartilage and play an important role in maintaining knee stability and function, acting as a suction cup to increase congruence in the knee.

　　However, when a meniscus is injured, such as in the case of a meniscus tear, it can lead to pain and discomfort.

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　　What is a meniscus tear?

　　Meniscus tears are relatively common injuries in the orthopaedic world. Meniscus tears can occur acutely, as a result of twisting or high impact through the knee.

　　It is more common for this to happen with sporting activities or with activities that require twisting under load through the knee, such as skiing, for example.

　　Sometimes meniscus tears can also occur over time, which is considered a degenerative tear. This is more common in older individuals or people with pre-existing knee conditions.

　　It is important to note that degenerative meniscus tears may be present without any symptoms until there is an instance in which they are aggravated, i.e. due to an injury.

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　　What are the symptoms of a meniscus tear?

　　When people do suffer a meniscus tear, the symptoms that people commonly describe include:

　　Pain around the knee joint, particularly when bending, twisting, or bearing weight.

　　Swelling/inflammation around the affected knee, which can cause stiffness and discomfort.

　　The knee may feel as if it's getting stuck, locked in place or catching when trying to move.

　　Difficulty fully straightening or bending the knee.

　　A feeling that the knee is giving way or unable to support weight.

　　Will a meniscus tear heal on its own?

　　There are different types of meniscus tears and some may heal on their own. The ability of a meniscus tear to heal without intervention depends on several factors, including the location, size, and type of the tear.

　　The only way to know exactly what type of tear has occurred and the extent is to have an MRI, although some of our testing and the signs/symptoms can give a decent indication.

　　In some cases, small tears near the outer edge of the meniscus may heal on their own with time and graded rehabilitation. However, larger or more complex tears may require further treatment.

　　Meniscus tear treatments

　　Possible treatment options for a torn meniscus include steroid injections, bracing, and arthroscopic surgery.

　　There are two main types of surgical procedure; the first is called an arthroscopic meniscectomy and is an excision, or removal of the damaged parts of the meniscus, which has a recovery time of around six weeks.

　　After this surgery, people are usually up and walking either with, or sometimes without crutches immediately. The crutches are removed as soon as comfortably possible.

　　The second type is a meniscus repair where the damaged part/s of the meniscus are sutured together/repaired, where the recovery time is typically around 12-16 weeks.

　　After this surgery, people may be in a knee brace and on crutches for 4-6 weeks to allow the repaired meniscus to heal. This can, however, vary between surgeons and type of surgeries performed.

　　Depending on the severity and location of the tear and the symptoms experienced, often a meniscus injury doesn’t require surgery and you will be able to strengthen the tissues around the knee joint to offload the meniscus.

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　　Can a torn meniscus heal naturally?

　　In many cases of a meniscus tear, non-operative treatment is the first line of treatment which usually involves physiotherapy.

　　The aim is typically to allow the meniscus injury to settle, alleviate swelling and maximise range of motion while building strength above and below to better support the knee.

　　A typical physiotherapy programme for a low grade meniscus injury/tear would last for 6-8 weeks, sometimes longer depending on the severity of the injury.

　　Initially, the focus is on achieving full knee range of motion and little to no swelling. This is often achieved through a combination of manual therapy and a tailored exercise programme.

　　Once achieved, typically we work on a combination of quad, hamstring, hip, calf and core strengthening and proprioceptive exercises to better support the knee with a graded return to functional activities.

　　The rehabilitation is individualised for each person, depending on their level of function pre-injury and their goals they would like to achieve.

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　　Summary

　　In summary, meniscus tears are a relatively common injury to the knee joint. The symptoms and functional issues with a lot of meniscus injuries resolve with physiotherapy alone.

　　However, recognising early on the signs and symptoms that may require onward referral for imaging and/or surgical opinion is important.

　　If you think you’ve sustained a meniscus injury and are experiencing the symptoms mentioned above, then getting an opinion from a physiotherapist is a great place to start your rehabilitation. Six Physio has multiple clinics across London and you can find out more here.

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