Author: Julie McGee, Doctor of Physiotherapy
WHAT IS THE MENISCUS?
The meniscus is a ring of cartilage located inside of your knee joint. Its main job is to help absorb shock, however, the meniscus can also provide some stability to the knee. The meniscus is positioned on top of your tibia (or shinbone) and is divided into two parts. The medial meniscus is located closer to your midline, while the lateral meniscus is located on the outer side of your knee.
HOW DOES IT BECOME IRRITATED?
The meniscus can become irritated either through trauma or over time through degeneration. Both types of meniscal irritations can occur due to a twisting, or pivoting movement at the knee. Meniscal tears fall into the category of meniscal irritation.
WHO IS AT RISK FOR MENISCAL IRRITATION?
Athletes performing activities which require cutting, and sudden changes in direction, as well as contact sports, are at risk for a traumatic meniscal irritation. Older adults are at risk for degenerative meniscal irritations as the meniscus can wear down over time. In this case, an awkward twisting movement of the knee such as with a fall, or pivoting on the knee to stand up when getting out of the car can irritate the meniscus.
WHAT ARE THE SYMPTOMS OF AN IRRITATED MENISCUS?
Symptoms of meniscal irritation can include pain, swelling, tenderness along the joint line, catching, locking, and pain with squatting. Sometimes a person may only have one or two of these symptoms.
WHAT OTHER CONDITIONS CAUSE SIMILAR SYMPTOMS?
Knee osteoarthritis is commonly associated with meniscal irritation, however, they are two different conditions. Meniscal irritation involves damage to the large pieces of knee shock absorber cartilage (fibrocartilage), while osteoarthritis is the wearing down of the thin cartilage (hyaline cartilage) covering the ends of the bones.
HOW CAN YOU TELL IF IT'S MENISCAL IRRITATION OR ARTHRITIS?
Differentiating between these two conditions can be difficult, as they often occur in tandem. But as a general rule, knee osteoarthritis is more prevalent in individuals over 50 years of age and tends to be particularly sensitive to sudden changes in the weather.
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WHAT CAN BE DONE IN TERMS OF TREATMENT?
Rest, ice, compression, and elevation are good forms of treatment immediately after the meniscus is irritated, or if there is still noticeable swelling and limitations in movement.
Once the swelling goes down, gentle range of motion exercises and stretching can help to restore normal movement to the knee. In addition, strengthening the muscles around the hip and the knee can help to provide additional stability to the knee so that it does not become irritated in the future. A physical therapist can help to guide you through exercises that are appropriate (see recommended exercise videos above.)
Depending on the extent of the meniscal injury, and the location of the tear a small percentage of cases may require surgery. In these cases, a medical doctor may order a MRI to help determine the next best steps.
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