The menisci of the knee are two “c” shaped cartilage rings that act primarily as shock absorbers to cushion weight bearing, but also help to increase knee stability. The menisci are situated on the inside and outside of the knee.
Meniscus injuries are common especially in older or overweight individuals and individuals participating in a sport where a quick change of direction occurs. Meniscus injuries are characterized by a tear in the cartilage disc in the knee and are either acute or overuse in nature.
- Excessive weight bearing (obese patients who are still a lot on their feet)
- Twisting forces (suddenly changing direction) while the foot is planted as occurs in soccer, rugby, netball, hockey and various other sports
Gradual wear and tear that occurs due to
- Repetitive weight bearing or twisting forces, for example, with distance running
- Degenerative changes that can occur to knee joint due to ageing
Who is at risk?
Individuals who present with some of the following are more predisposed to developing meniscus injuries:
- muscle weakness (predominantly of the thigh and hip muscles)
- poor biomechanics (movement patterns)
- poor pelvic and core stability
- joint stiffness (especially the knee, excessive hip or ankle)
- inadequate rehabilitation following a previous knee injury
- inappropriate training and inadequate warm-up
- decreased fitness
Signs and Symptoms
This will depend on the size and site of the tear, but these mostly include:
- Pain on the inside or outside of the knee (joint line) and potentially behind the knee
- May hear an audible sound or tearing sensation at the time of injury, if acute
- Slight to moderate swelling that occurs 48 hours after injury (if acute)
- Tenderness on a firm touch of knee
- Pain with weight bearing, twisting, kneeling, squatting or climbing stairs
- Intermittent locking/catching of the knee
- Joint stiffness
- Knee feels unstable or that it will give way under body weight
A Biokineticist will assess your injury and refer you to a Doctor if necessary based on your signs/symptoms and medical history. Thereafter, a Doctor may perform a scan (usually MRI) or investigative scope to confirm the extent of the injury. This will constitute whether surgery or conservative treatment is recommended. Conservative treatment (rehabilitation) will usually follow regardless of whether surgery occurs, so as to speed up the healing process and ensure the best outcome possible. This will in most cases occur under the supervision of a Biokineticist.
Biokinetics treatment will focus on:
- Strengthening exercises to improve thigh muscle strength and imbalances
- Stability exercises to hip, knee and ankle joints, and pelvic/core stability
- Range of motion exercises
- Balance training
- Biomechanical (movement) correction and re-education
- Activity modification advice
- Weight loss advice where appropriate
- Gradual return to activity program
By doing so, the cause of injury will be addressed, thereby improving treatment outcome and reducing the chance of re-injury as best as possible.
Author: Sven Kirchner