“OUCH! I was running and twisted my knee and it hurts!” A common phrase heard from patients with a meniscus injury. Meniscal tears often occur from deep squatting, twisting, or a jamming force that occurs to the knee. Most people that have meniscal pain experience it over the inside or outside joint line depending on whether the injury occurs to the medial (inside) or lateral (outside) meniscus. Some people can also have pain on the back side of the joint and may be able to feel a pocket of swelling. This is commonly referred to as a Baker’s cyst and occurs as a result of a meniscal event. The meniscus is like a brake pad inside the knee joint taking pressure and dispersing force through the joint when we walk, run, or perform any loading activity. A torn meniscus can be very painful with any activity that involves weight bearing through the joint.
- Common signs that someone has an injury to the Meniscus: they might feel a click or pop when they bend and straighten the knee as well as with walking or going up and down stairs. They may have difficulty straightening the knee fully or pain with any weight bearing/ pivoting activity. The most common mechanism of injury is twisting with a planted foot, squatting, or cutting while running to avoid something on a path.
- Ways to decrease pain initially include Rest, Icing in the initial injury phase for 10-15 minutes at a time, Compression, Elevation (RICE). Performing some non-weight bearing ROM activities may help to decrease swelling if any occurs. We will be putting out a video on our facebook page tomorrow showing some different activities that can be beneficial as well, so you’ll have a visual!
Initial management of the injury can be at home with RICE over the first 48-72 hours. Returning to your normal level of activity can be tricky following a meniscal injury. The “Catch 22” is that although you need to rest for the initial 72 hrs, the next few days need to involve low level weight bearing activities such as walking if it isn’t too painful. If you can’t walk normally without a limp, you can hopefully do some gentle range of motion activities in a pool or on a stationary bike. This is very important to prevent loss of strength and atrophy in your hip and thigh muscles which then creates a longer recovery time from the initial injury.
As we said, recovery from this injury can be tricky and there can be setbacks, but you’ll know you’re on the right track if you continue to make steady progress toward your return to your favorite activities or sport. The first good news is that most of the research has shown that meniscal tears with surgical intervention vs conservative intervention have remarkably similar outcomes and surgical intervention is only required in certain situations.
More good news! Most meniscus tears don’t interfere with normal joint function and by building appropriate supportive musculature while making sure that you aren’t developing any abnormal movement patterns, that meniscus may be able to continue functioning for you without becoming a bigger issue. Manual therapy and mobilizing the joint can be an important part of this process to improve activity levels safely and avoid abnormal movement patterns that can create further issues down the line.
As always, if you have any questions or need to have a quick assessment of your knee and your movement patterns to make sure that you are on the right track feel free to call us at (817) 923-9000. We will answer any questions you might have or if you prefer, we can schedule you for a free screen!