A meniscus is a crescent shaped fibrocartilage that divides a joint. In the knee the menisci are C shaped and provide structural integrity to the knee when it undergoes stress. The knee menisci are commonly injured during twisting activities and during collisions involving inward or outward movements of the knee.
The lateral meniscus is less commonly injured than the medial meniscus. Small tear in the meniscus can and should be treated conservatively. A lateral meniscus tear presents as pain in the outside of the knee that is worse with twisting and especially going down stairs. Due to its connection to the lateral meniscus the popliteus muscle, located behind the knee, commonly causes posterior knee pain when the lateral meniscus is injured. A medial meniscus tear presents as pain in the inside of the knee that is worse with twisting and especially going up and down stairs.
Swelling and/or stiffness will appear in the knee when a tear is present. If the knee locks in extension or flexion and popping and clicking are present a more serious tear maybe present. An MRI with contrast maybe necessary to determine the extend of the tear.
Non-contact meniscus injuries occur due to lack of hip and ankle stability. When the foot and ankle can not control knee motion correctly increased stress is placed on the menisci. Eventually the stress overtakes the strength the joint and injury occurs.
Conservative treatment for meniscus injury starts with restoring proper joint motion loss whether flexion, extension or both. This can be accomplished with joint mobilization exercises and Active Release Technique. Once joint motion is restored and pain is under control, focus should begin on correcting the hip and/or ankle imbalances that predisposed the individual to the meniscus injury.
Yours in health,
Dr. Justin Hildebrand