Your knee meniscus is a fibrocartilage that separates thigh bone (femur) from your shin bone (tibia). It is commonly referred to as your “cartilage”. Each knee joint has a medial meniscus and a lateral meniscus. Your knee meniscus each have unique “wedged”, “kidney-like” shapes. Your meniscus act like a wedge to assist with the rotational stability created by the anterior cruciate ligament (ACL). The meniscus also acts as a shock absorber. As we walk, run, and jump the knee absorbs tremendous forces. Your meniscus helps to absorb these forces so that the bone surfaces are not damaged. The amount of force increases exponentially as the speed of movement increases from walking to running to jumping. Your meniscus helps to disperse the compressive forces over the entire knee rather than isolating them. In the younger population, your knee meniscus is usually torn traumatically, by a twisting on a slightly flexed knee. The traumatic type of meniscal injuries are most often sports-related. The meniscus can be torn anterior to posterior, radially (parrot beak), or can have a bucket handle appearance. In the older adult, the tear may be due to a natural age-related degeneration of the meniscus or a rough arthritic femoral bone surface tearing into the softer meniscus. In this case, surgery may be required to attend to both the meniscal repair and to repair the damaged joint surface. Depending on the type of meniscus tear, meniscus repair may be complicated. A large meniscus tear that is inadequately treated may cause premature degenerative bony (arthritis) changes. The history of a painful twist occurring on a slightly flexed knee will indicate the likelihood of a meniscus tear. You may also experience clicking, popping, or locking of the knee. These symptoms are usually accompanied by pain along the knee joint line and a joint swelling. Clinical examination may reveal tenderness along the knee joint line. You will usually notice it is painful to squat. Your physical therapist will use McMurray’s test and other clinical tests to confirm a meniscus tear diagnosis. A MRI scan is the most accurate non-invasive test to confirm a meniscus tear. X-rays do not show a meniscus tear. A small meniscus tear, or a tear in the red zone, will usually respond quickly to treatment. One of the major roles of your meniscus is shock-absorption. Luckily, the other vital shock absorbers around your knee are your muscles. Researchers have proven that if you strengthening your leg muscles, your bone stresses will reduce as your muscle strength improves and your knee becomes more dynamically stable. Your treatment will aim to reduce pain and inflammation, normalize joint range of motion, and strengthen your knee. Muscles of greatest influence include the quadriceps (especially the Vastus Medialis Oblique or VMO) and hamstrings. Similarly, strengthening your calves, hip, and pelvis muscles have tremendous role in improving knee function especially as it relates to optimizing patello-femoral (knee cap) alignment. It is also essential to maintain adequate muscle and joint flexibility / elasticity. Proper training will also work to optimize proprioception and balance to improve your technique when walking, running, squatting, hopping and landing thereby minimizing your chances of re-injury. Meniscal injuries are commonly associated with other knee injuries, which need to be treated in conjunction with your meniscal tear.
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