What is a Knee Cartilage Tear (Meniscal Tear)?
There are two distinct types of knee cartilage tears that can occur in the knee – a traumatic tear, and a degenerative tear.
Traumatic tears tend to occur in the younger population in a sporting context, using by a twisting on a slightly flexed knee with a fixed foot. The meniscus can be torn from front to back, from inside to outside or around its perimeter – often called a “bucket handle” tear as it allows a free segment of the cartilage to flip up similar to the handle on a bucket.
Degenerative knee cartilage tears will occur in the older adult, due to a natural age-related degeneration of the meniscus or a rough arthritic femoral bone surface tearing into the softer meniscus. In this case, surgery may be required to attend to both the meniscal repair and to repair the damaged joint surface.
Depending on the type of knee cartilage tear, a meniscus repair may be contemplated. A large meniscus tear that is inadequately treated may cause premature degenerative bony (arthritis) changes.
How do I know if I have a Meniscal Tear?
When you visit a Leading Edge Physiotherapist about your knee cartilage tears, they will do a comprehensive assessment, including taking the history of your complaint and a detailed physical examination. One of the main things they will be looking for with your history is a painful twist occurring on a slightly flexed knee.
They will also ask you if you experience clicking, popping, or locking of the knee. They will look for pain along the knee joint line and a joint swelling as well as pain with squatting. These symptoms are all indicative of a knee cartilage tear.
If a knee cartilage tear is suspected you may be referred onto our network of GPs and Sports Physicians to get an MRI scan of your knee, which is effective in determining whether a meniscal tear is present or not.
Do Meniscal Tears heal?
The knee meniscus has relatively poor blood supply. There is an area near the outside ⅓ of the meniscus that has some limited blood supply and is known as the “red zone”. This give tears isolated to this region the chance to heal either naturally or by being stitched back together.
The inside ⅔ of the meniscus (known as the “white zone”) has next to no blood flow and tears in this region therefore have no chance of healing. Tears in this region lead to an inflammatory reaction and often lead to arthroscopic surgery.
How do you treat Knee Cartilage (Meniscal) Tears?
Small meniscal tears, or tears in the “red zone” can respond well to conservative treatment, including physiotherapy.
One of the major roles of your meniscus is shock-absorption. Luckily, the other vital shock absorbers around your knee are your muscles. Research has shown that strengthening your leg muscles reduces the stress on your bone as your muscle strength improves and your knee becomes more dynamically stable.
Your physiotherapy treatment will aim to:
- Reduce pain and inflammation.
- Normalise the joints range of motion and muscle length
- Strengthen the muscles around your knee, including the quadriceps and hamstrings.
- Strengthen your lower leg muscles such as the calves, hip and pelvis muscles.
- Improve the alignment of the knee cap.
- Improve your balance
- Reduce the chance of re-injury
How long does it take for a Meniscal Tear to heal?
Your meniscal tear will commonly take up to six or eight weeks to fully heal. As mentioned previously, some meniscal tears will require surgery.
Your Leading Edge Physiotherapist will guide you as to what is the best course of action for your knee injury.
It is important to avoid activities and exercises that place excessive stress through your cartilage and further delay your healing. Everyone is different, so be guided by your physiotherapist.
Will I Need Surgery?
Most surgeons will recommend a period of physiotherapy treatment prior to contemplating surgery.
Pre-operative physiotherapy has two main benefits:
- Potentially improving your knee injury so there is no need for surgery.
- Improving the strength of your knee to better prepare you for your post-operative rehabilitation.
After surgery that only removes part of the torn meniscus, patients can normally be reasonably aggressively rehabilitated, targeting early return to function. Your Leading Edge physiotherapist will progress you through your rehabilitation as your pain and swelling allow. Most arthroscopic patients can return to normal function within 3 to 6 weeks.
Rehabilitation after a repair of a cartilage tear is usually different, due to the healing time required because the meniscus has been stitched. Most surgeons will have a non-weight bearing period before commencing weight-bearing exercises, allowing the repair to heal. This will delay return to sport, but should end in a better result for your knee, as the shock absorbing properties of the knee remain.
I think I have injured my knee cartilage, what do I do now?
As soon as possible, and for 72 hours after injury, use the RICE method:
- Rest - Take it easy and only move within your limit of pain.
- Ice - As soon as possible, and for 20 minutes every two hours, apply ice or a frozen gel pack wrapped in a damp towel. This helps to control bleeding and pain and reduces secondary tissue damage.
- Compression - Firmly bandage the injury. This helps to control swelling.
- Elevation - As much as possible, elevate your injury higher than the level of your heart to reduce swelling.