Have you been diagnosed with a meniscal tear and are you wondering what kind of treatment options are out there and if walking might worsen the injury.
What can you do to speed up the healing process and reduce the discomfort
As a diagnostic radiographer, I will rely on medical studies to guide you.
Happy reading!😀
Any questions? remarks? Let’s meet in the comments section at the end of this article.🙏
Last updated: Dec 2024. Written by Juliet Semakula, a diagnostic.
Disclaimer: no affiliate links.
▶️What precisely is a meniscus tear?
A meniscus tear is a common type of damage to cartilage in the knee.
Our knee is composed of three types of cartilage, the hyaline, elastic and fibrocartilage. They help to reduce friction, they act as shock absorbs and support the knee joints.
The meniscus is made of the fibrocartilage that forms the articular surfaces of the bones.
It usually gets damaged when you have had an injury to your knee.
There are two main types of meniscal lesions.
1️⃣Traumatic lesions of the knee that can be caused by injury during twisting, bending or falling. You may feel sharp pain or aching that can feel close to the joint or deep inside the knee.
2️⃣Degenerative lesions are usually caused by several internal knee changes where there is a narrowing of the knee joint space and ‘wear and tear’ of the articular cartilage.
Meniscal tear can be caused by trauma or simple wear and tear to your knee.
Image: fromcentenoschultz.com
▶️So how do you know if it’s a meniscal tear and not something else?
Usually, their common extra-articular pathologies which are usually mistaken for a meniscal tear.
Such as:
🟤Iliotibial band syndrome.
🟤 Proximal tibiofibular joint instability.
🟤Snapping biceps femoris or popliteus tendons.
🟤 Peroneal nerve compression syndrome or neuritis.
Only a medical professional can diagnose your injury, when you go to the doctors a full examination of your knee will be carried out before any kind of imaging.
🟤 Your doctor will move your knee and leg in different positions, he will watch you walk and squat to assess your symptoms.
🟤 X-rays are usually not done for a meniscus tear because it won’t show, x-ray will only be done to rule out any other knee issues such as fracture.
🟤Magnetic resonance imaging (MRI) is usually performed to produce detailed images of both bone and soft tissues within the knee.
The symptoms and signs of a meniscal tear are similar to many other knee injuries. However, there are significant signs you may experience that may point to a potential meniscus tear.
Some patients I see with a ruptured meniscus, do not feel pain and swelling straight away, it might take 24 hours and more for you to start feeling pain.
▶️Some of the immediate symptoms.
♦knee pain or tenderness especially when twisting or rotating your knee.
♦Stiffness or swelling around your knee which may not start for a few hours or days.
♦Difficulty bending, straightening or moving your knee.
♦Your knee giving way when you try to stand and a feeling of being locked in place when trying to walk.
♦You may feel a crunching or clicking when you move your knee.
▶️What is the treatment for a meniscal tear?
Treatment and management of meniscal tears are determined by multiple factors:
♦One’s age.
♦The complexity of the tear.
♦Tissue quality and how severe your symptoms are.
Luvsannyam et al 2022
Treatment options.
1️⃣Non conservative management
If you have a simple meniscus tear, your doctor may advise you to rest your knee for 4-6 weeks combined with physical therapy.
This will determine if natural healing and return to the desired level of function will occur.
If you have severe pain and swollen knees with a suspected meniscus tear.
Your doctor will initially follow the R.I.C.E. (rest, ice, compression, elevation) principle.
You will be advised to
🟠Rest your knee.
🟠Apply ice on the knee
🟠Bracing or knee sleeves may be used for protection and compression.
🟠Try to elevate the injured knee.
Pain oral medication
Oral medication, such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), can also be prescribed to alleviate pain and swelling (Raj 2023)
2️⃣Operation options
Currently there are three main methods for the surgical management of meniscus tears.
🟠A meniscal resection (meniscectomy) can be done completely or partially via an open or arthroscopic approach.
🟠Meniscal repair can be performed open or arthroscopically.
🟠Meniscal reconstruction used to replace the partially or totally resected meniscus in symptomatic patients unresponsive to conservative management.
The main aims of surgical operations are to place safely a functional meniscus, to restore the knee, improve joint function and relieve pain
▶️Does walking worsen the meniscal tear or pain?
Walking will not worsen the meniscal tear or cause pain. Many people I have seen with a torn meniscus can walk, stand, sit and sleep without pain.
However, when walking you might feel a block to knee motion and have trouble extending your knee fully.
Unless the torn meniscus has locked the knee, then walking may be difficult, and you may feel more pain and stiffness.
It is important to see a doctor if you think you have got a meniscal tear because after several days, the knee can get progressively worse, becoming stiff, swollen, and painful.
Usually when you go to the doctor you will be advised to rest so that meniscus heals on its own. Resting will also reduce pain and swelling.
Whether you have been operated on or been directed to rest, resting does not mean doing nothing at all, you can use crutches to walk around.
Walking leaning on the leg where you have a meniscal tear will not worsen the tear.
You will need to find an easy way, duration and intensity that allows less pain when walking or you may seek professional opinion from a physiotherapist.
A study found that quadriceps-strengthening exercises 3 times a week for 10 weeks showed improved knee function by 35% in patients and did not increase meniscal tear symptoms.
Luvsannyam et al 2022
We can reasonably say, walking which is less demanding for meniscus than quadriceps strengthening does not worsen a meniscus tear.
▶️How to walk with a meniscal tear?
Walking on a torn meniscus will depend on the injury’s location and severity and perhaps also your own personal tolerance for pain.
There is no need to modify your way of walking when you have a meniscal tear. There is no right way of walking that will limit stress on the meniscus tear.
A slight tear might not feel so bad to you. You may very well be able to stand and walk on a leg that has a torn meniscus in the knee without increasing pain.
You may decide to use walking aids such as crutches to help you ease weight on the affected knee.
▶️Can you live a long time without problems with a meniscal tear?
A torn meniscus is certainly not life threatening. Once treated, the knee will usually function normally for many years
Of course! Meniscal tears are very common, over 40,28% of people who undergo knee MRI scan have a meniscal tear (Kaneko 2020)
So yes, you can certainly live a long time without problems with a meniscal tear.
In fact, in some people, it is said that this tear is asymptomatic: it is seen on MRI, but the person has no pain or discomfort!
▶️Can a meniscal tear heal on its own?
A meniscus tear can get better on its own without treatment, but it will take some time to heal.
You may need physiotherapy to help you with some exercises that will reduce pain and improve movement and strength in the knee.
However, if the injury to your knee is very severe, and all the conservative methods are not working for you, then an arthroscopy surgery to repair or remove the damaged cartilage will be performed.
An untreated torn meniscus can result in instability of the knee and lasting pain. It can also increase your risk of osteoarthritis.
▶️Can you exercise and run with a meniscal tear?
The objective of rehabilitation following meniscal repair is to promote healing by limiting stresses on repairs.
So, running or any sports that will place more stress on the knee. It is sometimes forbidden if you have a meniscal injury or tear.
Some people unknowingly can have a meniscal tear and practice running without any problem.
I have seen patients coming for MRI scans, only to discover they have a tear meniscal, yet they have been running.
It would be a good idea to limit as much stress to the injured knee as possible to allow healing. It’s up to you to weigh the pros and cons before you decide to run.
We have come to the end of this article, wishing you a quick recovery!🙋
📚Sources:
McCulloch PC, Jones HL, Hamilton K, Hogen MG, Gold JE, Noble PC. Does simulated walking cause gapping of meniscal repairs? J Exp Orthop. 2016 Dec;3(1):11. doi: 10.1186/s40634-016-0047-3. Epub 2016 Mar 15. PMID: 26979177; PMCID: PMC4792824.
Luvsannyam E, Jain MS, Leitao AR, Maikawa N, Leitao AE. Meniscus Tear: Pathology, Incidence, and Management. Cureus. 2022 May 18;14(5):e25121. doi: 10.7759/cureus.25121. PMID: 35733484; PMCID: PMC9205760.
Raj MA, Bubnis MA. Knee Meniscal Tears. 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 28613721.
Doral MN, Bilge O, Huri G, Turhan E, Verdonk R. Modern treatment of meniscal tears. EFORT Open Rev. 2018 May 21;3(5):260-268. doi: 10.1302/2058-5241.3.170067. PMID: 29951265; PMCID: PMC5994634.
Kaneko H, M. Ishijima, T. Aoki, Y. Negishi, L. Liu, H. Arita, M.Momoeda, A. Arepati, X. Ji, Y. Someya, Y. Tamura, Y. Watada, R. Kawamori, K. Kaneko,Prevalence and effect of medial meniscus tear in elderly persons -the bunkyo health study,Osteoarthritis and Cartilage,Volume 28, Supplement 1,2020,Pages S294-S295,ISSN 1063-4584,