How a Simple Twist Can Lead to Lasting Knee Pain and What You Can Do About It
One moment you’re moving smoothly, no hint of knee pain, and the next, a simple twist and an unmistakable pop changes everything. Suddenly, your knee swells, the pain sets in, and bending it becomes an ordeal.
You’ve just experienced a meniscus tear, a common but alarming injury that can occur in just a blink. It’s not just a concern for athletes—anyone can fall victim to this abrupt twist of fate.
Many people delay diagnosing a meniscus tear, not realising the severity of the injury until it’s too late. If not addressed promptly and managed properly, this common knee injury can lead to long-term implications such as accelerated arthritis and ultimately bring your sports and other activities to a firm halt.
Listen to Sophie’s story…
What are the symptoms of a Meniscus tear?
These symptoms can vary in intensity, and in some cases, the knee might still feel relatively normal. This is because the symptoms are dependant on the location, severity and type of meniscus tear you have sustained.
- Pain: Often felt in the knee or along the joint line. The pain may be more acute when twisting or squatting.
- Swelling: The knee may swell due to inflammation and location and volume of swelling will again be dependant on type, location and severity of tear.
- Stiffness: The knee might feel tight, and it may be difficult to fully straighten or bend the joint.
- Locking or Catching: The knee might lock up or catch during movement particularly if there is a bucket handle tear. This happens when a piece of the torn meniscus folds into the joint and gets stuck.
- Limited Motion: Difficulty moving the knee fully, especially in bending and straightening.
- Feeling of Instability: A sensation that the knee is giving way or not supporting your weight properly.
What causes a meniscus tear?
Meniscus tears are a common injury, especially prevalent in sports, where they can occur from both direct contact and non-contact mechanisms. In contact sports such as football or rugby, a player may sustain a meniscus tear as a result of a tackle where the knee is hit directly, forcing it to bend or twist unnaturally.
However, even in non-contact situations, athletes are at risk. Actions like twisting sharply while running, abruptly changing direction, or squatting can place significant stress on the knee joint, leading to a tear. These movements are integral to many sports, including football, netball, and cricket making participants in these activities particularly susceptible to meniscal injuries.
Outside of sport, everyday activities can also lead to meniscus tears.
Ordinary motions such as falling, slipping on a wet floor, or even stepping awkwardly off a curb can result in knee injuries. For many, a simple activity like kneeling or lifting heavy objects might be enough to cause a tear if the knee is positioned awkwardly or twists suddenly. This highlights that while athletes are at a higher risk, virtually anyone can suffer a meniscus tear.
As we age, the meniscus weakens and becomes more brittle, making it more susceptible to tearing even with minor stress. These are termed degenerative meniscus tears and are different from the acute tears sports people might experience through injury.
Degenerative tears occur gradually over time, often without a specific incident or injury. Symptoms may be less pronounced and develop slowly, making it less obvious that a significant injury has occurred.
How is it diagnosed?
The diagnosis of a meniscus tear typically begins with a clinical examination. Specific tests are performed to assess the stability, range of motion, and integrity of the knee joint. Tests such as the McMurray’s Test involve bending, straightening, and rotating the knee to elicit a response that may indicate a meniscus injury. This initial assessment is often sufficient to suspect a meniscus tear based on the symptoms and the mechanical response of the knee during these maneuvers.
While a clinical exam can strongly suggest the presence of a meniscus tear, further imaging is typically required to fully understand the specifics of the injury. An MRI scan is the most effective imaging technique for this purpose and allows for precise identification of the tear’s location, severity, and type (such as radial, horizontal, complex, or bucket-handle tears).
Once the MRI has confirmed the diagnosis and detailed the characteristics of the meniscus tear, treatment options can be tailored to the specific needs of the patient. Attempting to plan treatment for a suspected meniscus tear without an MRI scan can be risky, as it may lead to inappropriate management and exacerbate the injury.
What are the treatment options for a meniscus tear?
The treatment options for meniscus tears vary significantly based on the individual case. Decisions regarding the appropriate treatment are informed by a clinical assessment, MRI findings, and the insights of a knee consultant. These elements together provide a detailed picture of the nature of the tear and guide us in selecting the most effective treatment strategy.
For some, non-surgical treatment may suffice. This approach is typically considered when the tear is small and located on the outer edge of the meniscus where blood supply is better, aiding natural healing. Non-surgical treatment can include physiotherapy to strengthen the muscles around the knee, improve joint stability, and restore range of motion. However, a significant proportion of patients might require surgical intervention, particularly if the tear affects their quality of life or if the injury is large and in an area with poor blood supply.
Knee arthroscopy is a common surgical option where a small camera and surgical tools are inserted through tiny incisions around the knee. This procedure can be used to either repair the torn meniscus or resect (remove) the damaged part of the meniscus. The decision to repair or remove the meniscus depends largely on the type and location of the tear, as well as the patient’s overall health, age and activity goals. Repairing the meniscus is preferable to maintain long term knee health and delay degenerative changes, but not all tears are suitable for repair.
Post-surgery, physiotherapy plays a crucial role in recovery, helping to restore strength, balance, and power, and mapping out the patient’s return to sport or daily activities. Recovery time varies significantly between individuals and depends on the extent of the surgery. Generally, patients whose meniscus has been resected might recover quicker, often resuming light activities within a few weeks. In contrast, meniscus repair, which typically requires a bracing period to protect the healing tissue, may take several months before full activity can be resumed. This longer recovery period is necessary to ensure the integrity of the repair and to avoid re-injury.
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