What is the Meniscus and why is it important?

Anatomy

The two crescent shaped meniscus are found inside the knee joint, they sit between the thigh (femur) and shinbone (tibia). They are crescent-shaped pieces of toughened tissue (a type of cartilage) and there are two in each knee. One sits on the outside part of the knee joint (lateral meniscus) and one sits on the inside part (medial meniscus).

They act as shock absorbers to the various loads and forces that pass through the knee during movement. They also have a slightly wedge-shaped appearance, being thicker around the outside compared to the inside, and this provides a deepening of the joint surface to allow for a more tapered joint.

The top of the shinbone (tibia) is relatively flat compared to the very rounded ends of the thighbone (femur). The meniscus’ help to stabilise this slight mismatch of joint surfaces.

thighbone

Who is at risk of meniscal injury?

You are more susceptible to injuring a meniscus in your knee if you participate in load bearing sports such as football, soccer, basketball, netball and skiing. Essentially any job or sport that requires repetitive squatting and kneeling can increase your risk of sustaining a meniscus injury.

Causes of Meniscal Tear:

The most common cause of a meniscus tear is an excessive or forceful twisting of the knee whilst the foot is planted on the ground.

This might happen as a result of landing awkwardly from a jump, or from the force of another person or opponent’s body acting on the knee. During this type of movement, if the force is too much for the meniscus to withstand, tearing may occur.

As well as the sporting population, you can also sustain chronic tears of the meniscus – or tears that develop over an extended period of time from a repetitive strain or motion. These tend to result in a more gradual onset over time and are typically only seen in the middle-aged population group.

The inside (medial) meniscus tends to be injured more often, than the outside (lateral) meniscus. This is because the medial meniscus attaches to other structures inside the knee joint, leaving it less mobile to forces acting on it, in comparison to its lateral counterpart

Signs and Symptoms of Meniscal Tear:

The experience of a meniscal tear will vary from person to person depending on the cause of injury. For example, a footballer whom has been injured during a tackle where high forces are involved, will likely present with a high amount of pain, and a swollen and restricted knee. These injuries are likely to be more severe with associated ligament injuries as well.

On the contrary, an older person who has been gardening for the weekend spending lots of time squatting and kneeling may present to the clinic with a very different history.

There may be no high force movement involved, but instead the tear has occurred due to degenerative changes that have occurred to the cartilage tissue. Symptoms in these types of injury are less likely to be so acute and may only appear 24-48 hours later.

Signs and symptoms you might expect from a meniscal tear may include any or all of the following:

  • Pain when walking, squatting or jumping
  • Restriction of the knee joint with or without swelling
  • Knee joint locking or catching sensation
  • A popping or clicking sensation (often following an episode of locking/catching)
  • A feeling that the knee may give way (especially when stepping up/down stairs)
  • Tenderness around the line of the knee joint where the tear has occurred

If you have experienced pain around the knee after an accident or incident when playing sport, book an appointment to see one of our physiotherapist’s for a thorough and detailed assessment of the knee to ensure you are best placed to manage your injury safely, and return to your optimal level of function again!

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What is the Meniscus and why is it important?