Medial And Lateral Meniscus Tear: Symptoms,Treatment

Medial And Lateral Meniscus Tear: Symptoms,Treatment

The medial meniscus and lateral meniscus are specialized structures within the knee. These crescent-shaped shock absorbers between the tibia and femur have an important role in the function and health of the knee. Once thought to be of little use, the menisci (plural) were routinely removed when torn. Now we know that the menisci contribute to a healthy knee because they play important roles in joint stability, force transmission, and lubrication. When possible, they are repaired if injured. There are even experimental attempts to replace a damaged meniscus, possibly an important advance in orthopaedic medicine. 

Lateral Meniscus Tear

Symptoms of Lateral Meniscus Tear

Symptoms of a lateral meniscus tear include tenderness and pain around the outside surface of the knee, particularly along the joint line. There is usually swelling which appears within 24 to 48 hours of the injury occurring. Pain will also be felt when bending the knee or squatting down. A doctor or athletic trainer will do a full knee assessment including McMurrays' test to confirm the diagnosis.

Treatment for Lateral Meniscus Tear

Treatment for a lateral meniscus tear would initially be conservative meaning the athlete would try the easy simple things first including rest. If this approach doesn't work then a doctor may recommend surgery.

What can the athlete do?

If there is swelling rice principles should be applied (rest, ice, compression and elevation). Gentle exercises to maintain quadriceps muscle strength in the thigh can be done, although care should be taken not to aggravate the symptoms. Wearing a knee support can help protect the joint while it heals. A glucosamine joint healing supplement may be beneficial for healing cartilage injuries.

What can a Sports Injury Professional do?

The first aim of the sports injury specialist will be to correctly diagnose the injury. They may do this by using specific tests for meniscal tears such as a 'McMurrays' test. Once  an accurate diagnosis is made the whether to treat conservatively meaning without knee surgery or whether surgical treatment is required.

Conservative meniscus tear treatment

This may be indicated in the case of a small tear or a degenerative meniscus and may involve:
Ice, compression and recommendation of NSAIDs e.g. Ibuprofen. Try wearing a knee support or brace if the knee feels unstable. Electrotherapy i.e ultrasound, laser therapy and TENS. Once pain has subsided, exercises to increase range of movement, balance and maintain quadriceps strength may be prescribed. These may include: squating, single calf raises and later, wobble-board techniques.

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Medial Meniscus Tear

Symptoms of Medial Meniscus Tear

A torn meniscus will usually have a history of trauma or twisting of the knee at the time of injury, although they can come on gradually through degeneration or overuse. Pain will be felt on the inner surface of the knee along the joint line. Swelling of the knee may occur within 48 hours of injury with the athlete being unable to fully bend knee. If the injury is severe the athlete may be unable to weight bear on the affected leg. The athlete may also complain of the knee locking or giving way.

McMurrays test and Apley's test may be used by a therapist to help diagnose a knee cartilage injury. McMurrays test involves rotating the leg with the knee bent. Any pain or clicking indicates a positive result. Apley's test involves compressing the cartilage meniscus with the athlete in a prone position, again pain indicates a positive result.

Treatment for Medial Meniscus Tear

Immediate treatment

Immediate treatment is to apply the price principles of protection, rest, ice, compression and elevation. Once a cartilage meniscus injury has been diagnosed then the decision to treat it conservatively, meaning without surgery or whether to operate is made.

This will depend on a number of factors including whether the pain is increasing over time, the knee joint locks, has restricted movement, or if there are any other associated injuries such as anterior cruciate ligament sprain. If the patient sees no improvement in symptoms after 3 weeks of conservative treatment then surgery may be a likely option.

Conservative treatment

Continue applying the price principles to reduce pain and swelling. A knee support will help protect the knee. In the first 24 to 48 hours when complete rest is advised a simple elastic knee sleeve is fine. Later a hinged knee brace is often recommended.

After the initial acute stage mobility exercises and isometric quadriceps exercises will help accelerate rehabilitation. A glucosamine or joint healing type supplement may be of benefit in the healing of cartilage injuries.

A doctor or sports injury professional can confirm the diagnosis and may refer for an MRI scan. NSAID's or anti inflammatory drugs such as Ibuprofen may be prescribed in the early stages to help with pain and swelling. Electrotherapy including ultrasound, laser therapy and TENS may also be beneficial.

Once the initial pain and swelling has gone down then a full rehabilitation program consisting of mobility, strengthening and balance exercises should be completed.

Reference: Knee Problems