WHAT IS A TORN MENISCUS?
Does your knee hurt when you walk? Does it click and feel like it might lock? Are you unable to squat? If you answered yes to these questions you may have a torn meniscus in the knee.
The knee is comprised of two joints: the joint between the thigh bone (femur) and the lower bone (tibia) called the tibiofemoral joint and the joint between the femur and the knee cap (Patella) called the patellofemoral joint. This article will focus on the tibiofemoral joint.
The tibiofemoral joint is held together by a soft tissue capsule which is reinforced by ligaments on the inside (medial collateral ligament) and outside (lateral collateral ligament). Within the joint are two ligaments which criss-cross (cruciates) and serve to prevent excessive gliding during movement. Lying on the tibia are the menisci, both the semicircular medial and the circular shaped lateral meniscus. The menisci function to increase joint congruency and dissipate the weight bearing forces. The menisci only have a blood supply on their peripheral edge. Therefore, tears in the inner two thirds of the menisci will likely not heal and often require arthroscopic surgery.
The mechanism of injury to the meniscus usually involves twisting of the knee while loaded. Sports such as football, soccer, and tennis where the foot is planted and the knee twists rapidly or gets hit by an opposing player can injure both the ligaments and the menisci.
The symptoms associated with a meniscal tear include swelling, limping on the affected leg, pain at the joint line, and reduced mobility of the knee and sometimes locking. Tears to the outer third of the meniscus can often heal with treatment due to a sufficient blood supply. Larger tears which extend into the inner two thirds of the meniscus often require surgery, especially if the tear flaps up and causes locking.
Physiotherapy treatment includes modalities to reduce pain and swelling, stretching, active and passive mobilization to improve mobility. It is important that full straightening (extension) of the knee be achieved since one can not ambulate correctly if knee extension is limited. This places more stress on the knee and other joints which can then break down. Physiotherapy aims to gain full pain free mobility and strength such that patients can function normally.
Written by Susan Reive,
Owner of Kilborn Physiotherapy Clinic