How Do Doctors Diagnose A Meniscus Tear
The diagnosis of a knee injury begins with the history and physical examination. If there is an acute injury, the doctor will ask about the mechanism of that injury to help understand the stresses that were placed on the knee. With chronic knee complaints, the initial injury may not be remembered, but many patients who participate in athletic events or training can pinpoint the specific timing and details of the injury. Non-athletes may remember a twist or deep bend at work or doing chores around the house.
There is a true art to the physical examination of the knee. From inspecting , palpating , and applying specific diagnostic maneuvers, the doctor, trainer, or physical therapist may often make the diagnosis of a torn meniscus.
Physical examination often includes palpating the joint for warmth and areas of tenderness, assessing the stability of the ligaments, and testing the range of motion of the knee joint and the power of the quadriceps and hamstring muscles. There have been many tests described to assess the internal structures of the knee. The McMurray test, named after a British orthopedic surgeon, has been used for more than 100 years to make the clinical diagnosis of a torn meniscus. The health care professional flexes the knee and rotates the tibia while feeling along the joint. The test is positive for a potential tear if a click is felt.
Meniscus Tear Recovery Time
The expected recovery time for each knee injury will depend on the patient and the severity of the injury. After arthroscopic meniscus surgery, most individuals should expect the rehabilitation process to last roughly three months. With meniscectomies specifically, patients should anticipate a flexible recovery timetable of about one month. During this time, your doctor will prescribe a series of postsurgical knee exercises to help increase knee flexibility and also strengthen the surrounding tissues. Once weve designed a regimen and meniscus tear recovery strategy for you, these exercises can be performed at home in your spare time to better accommodate your schedule and lifestyle.
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Whats Behind The Knee
The back of the knee has complicated anatomy.
As well as the knee joint sitting in the middle, the thigh and calf muscles pass through this area. Firstly, the large hamstring muscles start from the pelvis and pass across the knee to attach to the lower leg bones. In addition, the large calf muscles begin at the bottom part of the thigh and cross the knee to form the large Achilles tendon.
Finally, vital nerves and blood vessels cross the back of the knee to supply the lower leg and foot.
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Athletes With A Torn Meniscus: Do We Treat It Differently
Generally, we believe that young athletes with a torn meniscus need surgery early. However, new findings question this thinking. Young athletes with a meniscal tear were randomised into immediate surgery or physiotherapy. After 12 months, there was no difference between groups for pain or return to sport. Also, only one in four athletes who had physiotherapy eventually required surgery. So, even for young athletes, we should consider a trial of physiotherapy in almost all cases.
What Does A Torn Meniscus Feel Like
Most meniscus tears lead to knee pain in the area of the tear, on the inside or outside of the knee. Swelling of the knee may also occur, as well as pain that can radiate down the leg. Occasionally, locking and catching of the knee occur when the meniscus gets wedged in between the bones of the knee. Pain and instability caused by the meniscus tear can also cause the knee to buckle or give way. Twisting activities usually worsen the symptoms.
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Symptoms Of Meniscus Tears
Acute meniscus tears often cause an audible popping sound or noticeable popping sensation at the time of injury. If your meniscus tear develops over time, it might not be so obvious at first.
Meniscus tears range in severity, but symptoms often include:
- Loss of mobility in knee
If you have a minor or partial meniscus tear, you may be able to bear weight on the affected knee, but it will feel unstable. More severe tears may make you unable to stand on the affected leg, and your knee will be painful to the touch.
Meniscus Tear Of The Knee
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Overview of a meniscus tear
The meniscus is a piece of cartilage that provides a cushion between your femur and tibia . There are two menisci in each knee joint.
They can be damaged or torn during activities that put pressure on or rotate the knee joint. Taking a hard tackle on the football field or a sudden pivot on the basketball court can result in a meniscus tear.
You dont have to be an athlete to get a meniscus tear, though. Simply getting up too quickly from a squatting position can also cause a meniscal tear. According to Boston Childrens Hospital, more than 500,000 meniscal tears take place in the United States each year.
Depending on the severity of your injury, treatment options can vary from at-home remedies to outpatient surgery. You can help prevent this injury by doing exercises thatll strengthen your leg muscles and using proper techniques during contact activities or sports.
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Surgery For Meniscus Tears
If you have a large meniscus tear, or youve tried physiotherapy on its own for at least three months and it hasnt helped, you may need to have an operation to repair it. Surgery may involve either repairing your torn meniscus, or removing the damaged part of your meniscus. Your surgeon will usually do the operation in a knee arthroscopy, which is a type of keyhole surgery. Youll need to have physiotherapy afterwards to get your knee back to normal, and working as it should.
Ask your doctor about the pros and cons of surgery, and how it might help you.
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Description Of Medial Meniscus Tear
The medial meniscus is an important shock absorber on the inside aspect of the knee joint. It absorbs about 50% of the shock of the medial compartment. Thus, when there is a medial knee injury such as a medial meniscus tear, it is very important to try to repair the tear, because if not repaired and is trimmed out there will be an increase to the load on the medial compartment, which ultimately leads to osteoarthritis.
A medial meniscus tear is more common than a lateral meniscus tear, because it is firmly attached to the deep medial collateral ligament and the joint capsule. In addition, the medial meniscus absorbs up to 50% of the shock of the medial compartment, making the medial meniscus susceptible to injury.
Symptoms Of A Meniscus Tear
A sudden meniscus tear usually happens during sports when you squat and twist the knee. A degenerative meniscus tear occurs in older people whose cartilage naturally thins and weakens over time. Either way, you may have knee pain, swelling, stiffness, or the feeling that your knee locks or gives out. If you have a severe tear, pieces of torn meniscus tissue may move into the joint space, making it hard for your knee to move and fully extend or fully flex.
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Can A Knee Injury Cause Sciatica Nerve Pain
In some cases, knee pain may be the result of a nerve or joint injury unrelated to sciatica, but it may feel like sciatic nerve pain.
The sciatic nerve runs from the lower back all the way down to the lower extremities. Abdominal pain, not knee injuries, may be the source of your chronic pain. Because the sciatic nerve is frequently associated with spinal nerve or spine conditions, further evaluation is required. The treatment of sciatica-related knee pain with physical therapy is a minimally invasive alternative to surgery. The patients treatment plan should be simple for the treatment of Sciatica if diagnosed immediately. Over-the-counter pain reliever medications, as well as physical therapy, can be used to treat knee pain. Although NSAIDs are the most commonly prescribed pain reliever, steroids, opioids, and antidepressants may also be considered. Chiropractor practice is concerned with correcting misalignments in the spine to relieve pain. If you have knee pain accompanied by other symptoms of sciatica, you may be unable to move around or perform everyday activities.
Do You Need Your Meniscus
It is always best to have your own normal meniscus. For this reason, every attempt is made to repair a meniscus tear that may heal. However, for tears that are torn beyond repair, it is best to remove the torn piece. The piece that is torn does not function like a normal meniscus, so removing that piece does not decrease the amount of functioning meniscus. Leaving a torn piece may irritate the knee joint and cause the tear to get larger. Only the portion of the meniscus that is torn or diseased is removed.
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Can A Meniscus Tear Cause Nerve Pain
Meniscus tears cause knee pain due to irritation of the lining or synovium. Because of the synoviums numerous nerves, it will experience pain and swelling if it is irritated.
Meniscus tears are the most common cause of knee pain. Why does the knee hurt? It can deteriorate and become damaged from repeated stress and tear. We now believe that there are many more tears that can be repaired than previously thought. Meniscus tears cause swelling in the knee as a result of damage to the lining or synovium. Most patients will be able to resume their normal activities within a few weeks of having their tear meniscus repaired. If tears continue to hurt with pivot or twisting and cause the knee to feel unstable, surgery may be required.
Typically, a patient with a meniscus tear is not bothered by pain by walking straight ahead or in one direction. Patients who have a certain meniscal tear will experience symptoms of pain while going upstairs. If you have instability or have a locked knee that will not move, or if your bucket handle or flap tear has developed, you should consult a physician.
Degeneration Of The Joint
Degeneration is a very significant cause of lateral meniscus tears over time, the edges of the meniscus become frayed, jagged, and thin. Any repetitive or frequent movement can place stress on the lateral meniscus over the years when evenually, all of a sudden, a meniscus tear happens. The knee joint itself suffers degenerative changes such as arthritis, osteoarthritis and/or cartilage thinning on the ends of the bones and this gradual wear and tear comes from overuse, repetitive knee movements, twisting or prolonged weight bearing activities. Degenerative changes to the knee happen slowly, so you may eventually suffer a torn lateral meniscus from a simple daily activity – the “hair that broke the camels back” if you will. Be aware that this injury can happen to anyone and is not just isolated to athletes.
Once injured, the meniscus is more susceptible to slowly wearing away with regular knee movements. When this happens more friction occurs against the articular cartilage and this cartilage wears away from the surface of the femur and tibia. With less protective covering, the joint begins to deteriorate. If your knee tissue begins to degenerate you have an increased risk of developing osteoarthritis over time.
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Why Do Meniscus Tears Hurt
Knee pain is very common. It can occur out of the blue, after a long tennis match, a long walk, or following a sports injury or an accident. One of the more common reasons for knee pain is a meniscus tear. Many more questions arise.
- Why does a meniscus or cartilage tear hurt?
- What motion makes a meniscus tear hurt?
- Can your symptoms or complaints determine what treatment might be necessary?
- When should I see a doctor for a meniscus tear?
What Do I Need To Do To Prepare For Torn Meniscus Surgery
Our staff will help to set up the surgery through your insurance company and will instruct you on any paperwork that may be necessary. If you are over the age of 50 or have significant health conditions, you may need an EKG and chest X-ray. You may also need to see your internist or family doctor to obtain a Letter of Medical Clearance. The day before the surgery, a member of the hospital or surgery center staff will contact you about what time to arrive for surgery. Do not eat or drink anything after midnight before your surgery.
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Do All Meniscus Tears Hurt
Yes, at some point in time most all meniscus tears will hurt. But that doesnt mean they will hurt for a long time. In many cases the pain from a meniscus tear will either improve significantly or go away without surgery. In cases where there was an injury which preceded the meniscus tear, you may have knee pain and swelling with virtually all activities. These acute meniscus tears usually occur in younger active individuals. The tear may cause mechanical pain such as popping, locking or even cause your knee to catch or feel unstable. Most people with acute, traumatic meniscus tears should consider surgery to repair the tear.
Acute traumatic meniscus tears are far less common than degenerative tears. Most of you probably felt the tear occur by kneeling, or twisting to pick something up. That is because the tear occurred through a degenerative or worn out meniscus. With a degenerative tear, rushing in for an MRI and rushing to schedule surgery isnt usually necessary since your knee pain has a good chance of settling down within 4-6 weeks. Tears that continue to hurt with pivoting or twisting and cause the knee to feel unstable might require surgery for a meniscus repair.
In general, there are many types of meniscus tears, and the type of tear you have will determine the type of pain you will have, and how long you will have it.
How Should I Care For My Knee After Surgery
Prior to your discharge, you will be given specific instructions on how to care for your knee. In general, you can expect the following:
Medication: You will be given a prescription for pain medication.
Showering: You may shower, but you should keep the dressing dry. After your dressing is removed, you may get your knee wet. You cannot take a bath until the wounds are completely sealed, which is usually 2-3 weeks after surgery.
Crutches: You will be instructed how to use crutches before the surgery. You should bring a set of crutches with you to the surgery. The longevity of crutches will depend on the type of surgery performed. Crutches are commonly required for a couple of days, unless you had a meniscus repair. In this case, the surgeon will let you know how long you should stay on your crutches to protect the repair.
Brace:If a meniscus repair is performed, you will receive a brace to restrict the motion of your knee. This is to protect the repair for the first 4-6 weeks and allow the area to heal.
Diet:Resume your regular diet as soon as tolerated. It is best to start with clear liquids before advancing to solid food.
Ice:You should apply ice over the dressing for 20-30 minutes every hour for several days. Do not use heat for the first 48-72 hours.
Suture removal: The stitches are absorbable so they do not need to be removed.
Exercise: You will be instructed on exercises you can begin immediately after the surgery. You will begin physical therapy 2-3 days post-op.
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Benefits Of Walking After A Meniscus Tear
After you have surgery to repair a meniscus tear, you may need to build up your strength in the muscles of your leg that support your knee.
Youll begin a graduated rehabilitation protocol that can vary depending on the surgeon who performs your surgery and the technique they used. Graduated rehabilitation exercises slowly increase in intensity and range of motion to avoid further injury.
A of studies spanning 21 years suggests that a faster rehabilitation with full weight bearing and early range of motion exercises might be a good path forward for many people.
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Causes Of A Meniscus Tear
The meniscus can be torn during activities that cause direct contact or pressure from a forced twist or rotation. A sudden pivot or turn, deep squatting, or heavy lifting can lead to injury. Many athletes are at risk for a meniscus tear.
Sports that require sudden turns and stops may put you at higher risk for meniscus tears. Some of these sports include:
According to Boston Childrens Hospital, meniscus tears are growing increasingly common in children. This is because children are participating in organized sports at an earlier age. Additionally, when focusing on just one sport, a child is more likely to experience a meniscus tear. The same is true for adolescents who participate in competitive sports.
The meniscus weakens with age. Tears are more common in people over the age of 30. Movements like squatting or stepping can lead to injury in someone with weak menisci.
If you have osteoarthritis, youre at higher risk of injuring your knee or tearing your meniscus. Osteoarthritis is a common joint disorder involving pain and stiffness in your joints caused by aging and wear and tear.
When an older person experiences a meniscus tear, its more likely to be related to degeneration. This is when the cartilage in the knee becomes weaker and thinner. As a result, its more prone to tear.
When a meniscus tear occurs, you may hear a popping sound around your knee joint. Afterward, you may experience:
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