Our meniscus are horse-shoe shaped cartilage structures which sit on top of our tibia (shin bone) and joined to it by a ligament called the Coronary ligament. The meniscus play a crucial role in shock absorption in the knee which helps to decrease the stress on the articular cartilage which covers the ends of our bones and keeps the joint moving fluidly.
Without our meniscus the articular cartilage that covers the bones ends of the top of our shin bone and the bottom of our thigh bine (Femur) would wear down a lot quicker in the knee and the onset of pain, swelling and stiffness associated with Osteoarthritis would be a lot quicker.
The meniscus are handy structures to have and the body was very well designed in that sense. But the meniscus themselves are a not bulletproof and can be susceptible to injury.
When the meniscus are injured there are symptoms which can tell a specialist therapist that they’re injured. The knee joint relies on the meniscus (amongst other structures) for stability quite a bit so if there is an injury to it then the knee can potentially give way with pain. The pain will be mostly be sharp and worsen with twisting and turning maneuvers. Like any cartilage injuries recurrent knee swelling will also be a tell-tale sign of what’s going on. So when someone tells you they have damaged/torn their cartilage in their knee they are talking about the meniscus.
In rare occasions with meniscus injuries a big give away symptom is that the knee will lock. If this is the case then part of the meniscus has partially torn away from the main body of cartilage causing it to sit up into the joint. As the knee bends and extends this bit of cartilage can get caught in the joint during movement and cause the knee to ‘lock’ temporarily.
So How Does The Meniscus Get Injured?
Again reminding you of the point of the meniscus being such a stable structure, it takes a high bout of load to injure it acutely. Usually done through sport after a quick and sharp change of direction movements in sports such as basketball or football, the rotational force placed on the meniscus could tear the cartilage.
Meniscus injuries are not just a sports injury though, for example, slipping and your foot sliding could also take your knee into that exact same rotation and forceful nature which is required to injure the meniscus.
The second way in which the meniscus can become injured is a "degenerative tear", which is a supposed 'weakness' in the meniscus due to age. The cartilage can either slowly wear away or a tear will occur due to the ‘weakness’, this can occur doing everyday activities like walking up or downstairs or getting in and out of the car.
With any cartilage injury, especially the meniscus it will put more ownership on the muscles to take the support of the joint once it’s injured. A specialist therapist with expert knowledge and skills will take such meniscus injuries through a gradual increase in loading and directional change, which is needed to return to daily activities and/or sport.
A typical meniscus injury will present to me in clinic with the following symptoms:
So if you have any of the above and are living with knee pain my best advice to you is to go and get yourself assessed by an specialist therapist to see what can be done to help.
Look out for my next article explaining why surgery isn't always the answer.