Your knees do a lot of work every day, helping you walk, run, and stay active. But when something like a medial meniscus tear happens, it can make even simple tasks hard.
This injury affects the soft cartilage inside your knee, often caused by sports, aging, or a sudden twist. It’s a common problem, with about 61 out of 100,000 people experiencing it every year1.
If you’re struggling with knee pain, stiffness, or trouble moving, don’t worry—you’re not alone. Let’s go through what causes this injury, how to spot it, and what you can do to feel better. Let me know when you’re ready to start!
What is a Medial Meniscus Tear?
A medial meniscus tear happens when the soft, rubbery cartilage inside your knee is damaged. This cartilage acts as a cushion between your thigh bone (femur) and shin bone (tibia), helping to absorb shock and keep your knee stable. The medial meniscus is on the inside of your knee and works with the lateral meniscus to protect your knee joint.
Medial meniscus tears are very common, especially during sports or activities that involve twisting, squatting, or sudden direction changes. They can also happen as part of the natural aging process when the cartilage becomes weaker.
How Common Are Medial Meniscus Tears?
Medial meniscus tears are one of the most frequent knee injuries. Research shows that about 61 out of every 100,000 people experience this injury every year1.
Athletes and older adults are most affected. For younger people, the tears often happen during sports. For older adults, they are usually caused by wear and tear as the cartilage weakens over time2.
Who Is at Risk?
Athletes and Active People
Athletes in sports like soccer, basketball, or football are at high risk. These sports involve quick changes in direction, sudden stops, and jumps that put stress on the meniscus. About 12% of ACL (anterior cruciate ligament) injuries also include a meniscus tear3.
Older Adults
As people age, their knee cartilage becomes less flexible and more prone to tearing. This makes medial meniscus tear common in people over 50, even without an obvious injury. These tears are often linked to arthritis, which weakens the joint further4.
Extra Weight
Carrying extra weight increases the stress on your knees, making the meniscus more likely to tear. This risk is even higher for people who already have joint problems5.
Why Does It Happen?
The meniscus tears when it’s under too much pressure or when it weakens over time. This can happen during sudden twists, deep squats, heavy lifting, or even normal daily activities if the cartilage is already damaged or brittle.
The Role of the Meniscus in Your Knee
The medial meniscus is a C-shaped piece of cartilage inside your knee. It helps absorb shock, spreads out your body weight, and keeps your knee steady.
When this cartilage tears, it can’t do its job, which causes pain, swelling, and trouble moving1.
How Does a Tear Happen?
Sudden Injury
Many medial meniscus tears happen suddenly during activities like sports. Twisting your knee while your foot is planted, squatting too deeply, or landing awkwardly after a jump can tear the meniscus. This is more common in younger, active people. About 12% of ACL injuries also involve a medial meniscus tear3.
Gradual Wear and Tear
As you age, your meniscus becomes less flexible and more likely to tear. Small cracks can form over time, and even a simple twist while getting up can lead to a tear. This type of tear is more common in people over 50 and is often linked to arthritis4.
Why Does the Meniscus Become Weaker?
Aging
As you get older, the cartilage in your meniscus stiffens and loses strength, making it easier to get a medial meniscus tear4.
Joint Instability or Misalignment
If your knee isn’t aligned properly because of past injuries, arthritis, or natural differences, it puts extra pressure on the meniscus, making it more likely to tear6.
Common Signs and Symptoms of a Medial Meniscus Tear
- Pain on the Inside of the Knee: Usually felt along the inner side of the knee, especially during activities like walking, squatting, or twisting.
- Swelling Around the Knee: Often develops within the first 24–48 hours after the injury. It may feel puffy or tight around the joint.
- Stiffness or Difficulty Bending the Knee: Your knee might feel stiff, and bending or straightening it fully can be uncomfortable or impossible.
- Clicking or Popping Sensation: You may hear or feel a popping sound when the injury happens. Later, your knee might catch or lock during movement.
- Locking of the Knee: In some cases, the torn cartilage can get stuck in the joint, making it hard to straighten your leg.
- Weakness or Instability: Your knee might feel unstable, as if it could give way under your weight, especially when climbing stairs or turning quickly.
- Pain During Twisting Movements: Activities like playing sports or turning quickly can trigger sharp pain.
- Difficulty Bearing Weight: It might be uncomfortable or painful to put weight on the affected leg, especially immediately after the injury.
- Tenderness Along the Joint Line: Pressing along the inside edge of the knee joint might feel tender or sore.
- Gradual Worsening With Use: If the tear is degenerative, symptoms may worsen slowly over time instead of suddenly.
How Bad Can a Medial Meniscus Tear Be?
Grade 1: Mild Tear
A mild tear is the least serious. It affects only the outer layer of the meniscus and doesn’t go very deep. You might feel slight pain or stiffness, especially when twisting your knee or squatting, but it’s usually manageable.
These medial meniscus tear often heal on their own with active rest, ice, and light exercise to keep your knee moving.
Grade 2: Moderate Tear
A moderate tear goes deeper into the cartilage, causing more pain and swelling. You might feel catching or clicking in your knee when you move, and activities like climbing stairs can become uncomfortable. Treatment typically includes physiotherapy to strengthen the knee and reduce swelling, though surgery might be considered if symptoms don’t improve.
Grade 3: Severe Tear
A severe tear cuts all the way through the meniscus, and a piece may even move into the joint, causing your knee to lock. You’ll likely have severe pain, swelling, and difficulty straightening or using your leg. Surgery is often needed to repair or remove the torn part of the meniscus and restore knee function.
What Other Conditions Could It Be?
Knee osteoarthritis develops gradually as cartilage wears down. Pain worsens with activity and often comes with stiffness after rest. Unlike a meniscus tear, osteoarthritis pain builds over time and doesn’t cause locking2.
Patellofemoral Pain Syndrome
This condition causes pain around or behind the kneecap, often triggered by activities like climbing stairs or prolonged sitting. Unlike a meniscus tear, it doesn’t cause locking or swelling and is more generalized7.
Ligament Injuries (ACL or MCL)
Tears in the ACL or MCL are common sports injuries. They cause immediate swelling, instability, and a “giving way” feeling rather than locking, which is typical of meniscus tears3.
Bursitis
Inflamed bursae, such as the prepatellar, infrapatellar, or pes anserine bursae, cause localized swelling and tenderness. Unlike a meniscus tear, bursitis doesn’t lock the knee or cause catching sensations.
Tendonitis
Patellar or quadriceps tendonitis causes pain near the kneecap, often from overuse. The pain is sharp and focused on the tendons, unlike the joint-line pain or locking seen with a meniscus tear.
Common Mistakes When Treating a Medial Meniscus Tear
Ignoring the Pain
Trying to “tough it out” can worsen the medial meniscus tear and damage other parts of your knee. Pain is a sign that your knee needs attention.
Skipping a Proper Diagnosis
Avoiding a physiotherapist or doctor can lead to the wrong treatment. Without knowing the severity of your tear, recovery can take longer or fail completely.
Returning to Activity Too Quickly
Getting back to sports or heavy activity before your knee heals can worsen the tear or cause new injuries. Patience is key.
Avoiding Physiotherapy
Physiotherapy strengthens the muscles around your knee and improves stability. Skipping it can leave your knee weak and prone to re-injury of the medial meniscus tear.
Relying Solely on Painkillers
Painkillers mask symptoms but don’t address the injury. This can lead to overuse of your knee and further damage.
Types of Scans
MRI (Magnetic Resonance Imaging)
An MRI is the best scan for spotting a medial meniscus tear. It gives a clear image of the soft tissues in your knee, including the cartilage and ligaments. With this scan, we’re looking for any visible tears in the meniscus, swelling, or other signs of damage. It’s non-invasive and doesn’t involve radiation, making it a safe and accurate option.
X-Ray
While an X-ray doesn’t show the medial meniscus tear itself, it’s often used to rule out other problems, like broken bones or signs of arthritis. We’d look for joint space narrowing or bone changes that could explain your knee pain if it’s not a tear.
Ultrasound
An ultrasound can help us see some soft tissue issues in the knee, like swelling or fluid buildup around the joint. While it’s not as detailed as an MRI for a medial meniscus tear, it can be useful if we suspect other knee problems.
Is Surgery Needed?
Surgery for a medial meniscus tear is usually only needed if the tear is large, causing severe pain, locking, or instability, and doesn’t improve with non-surgical treatment. It’s also more common in active people who need full knee function for sports or daily life.
Types of Surgery
Meniscus Repair
The medial meniscus tear is stitched back together to keep the meniscus intact. This is ideal for younger, active individuals to prevent arthritis.
Partial Meniscectomy
Only the damaged part of the meniscus is removed, leaving as much healthy tissue as possible for cushioning.
Meniscus Replacement
In rare cases, the meniscus is replaced with donor tissue, typically for severe damage in younger patients.
How Physiotherapy Helps After Surgery
Physiotherapy is key to recovery. It rebuilds strength, restores movement, and stabilizes the knee. A tailored program helps you return to daily activities and sports while reducing pain and swelling. Combining surgery with physiotherapy leads to the best results.
Treatment Options
Exercise Therapy
Targeted exercises strengthen the muscles around your knee, improving stability and reducing stress on the meniscus. Exercises might include low-impact movements like cycling or walking in a pool. Neuromuscular training can also help retrain your balance and coordination.
Myofascial Release
This hands-on technique releases tightness in the soft tissues around your knee. It helps reduce stiffness and improves flexibility, making it easier to move your knee without pain.
Orthopedic Manual Therapy
Gentle joint mobilizations can help improve knee range of motion and decrease pain. This hands-on approach can also help reduce swelling by improving fluid drainage in the joint after medial meniscus tear.
Laser Therapy
Laser therapy uses light energy to reduce inflammation and promote healing in the meniscus. It’s painless and can speed up recovery by increasing blood flow to the injured area.
Dry Needling
This technique uses thin needles to target tight muscles and trigger points around the knee. It helps relieve pain, improve movement, and support muscle recovery.
Strapping and Taping
Taping the knee can provide additional support, reduce swelling, and improve stability during movement. This is especially helpful during early recovery or physical activities.
Conclusion
A medial meniscus tear doesn’t have to hold you back. With the right treatment and patience, you can reduce pain, regain strength, and return to what you love.
Recovery takes small, consistent steps like following your exercises, therapy, and rest. Progress may feel slow, but every step moves you closer to healing.
You’re not alone in this journey. I’m here to guide and support you. Let’s get started on your recovery together.
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References
- Fox, A. J. S., Wanivenhaus, F., Burge, A. J., Warren, R. F., & Rodeo, S. A. (2015). The human meniscus: A review of anatomy, function, injury, and advances in treatment. Clinical Anatomy, 28(2), 269–287. https://doi.org/10.1002/ca.22456
- Ahmed, M. E., Alshammari, D. A. S., Alenezy, N. G. J., Alanazi, A. M. M., Alenezi, S. A. D., Almotrafi, S. K. M., Alanazi, R. M. D., & Eid, S. M. T. (2024). Updates in prevalence and management of medial meniscal injury among adolescents and young adults in Saudi Arabia: Systematic review. International Journal of Medicine in Developing Countries, 8(1), 371–378. https://doi.org/10.24911/IJMDC.51-1700329341
- Feucht, M. J., Kühle, J., & Salzmann, G. M. (2014). Posterior root tears of the lateral meniscus: Clinical and biomechanical evaluation. Sports Medicine Research Journal, 22(4), 356–364. https://doi.org/10.1007/s00167-013-2731-3
- Tsujii, A., Nakamura, N., & Horibe, S. (2017). Age-related changes in the knee meniscus. Journal of Orthopaedic Science, 22(1), 30–37. https://doi.org/10.1016/j.jos.2016.09.006
- Dzidzishvili, D., Allende, C., & Hayes, R. (2024). Increased posterior tibial slope is associated with increased risk of meniscal root tears. Orthopedic Science Review, 18(2), 112–119. https://doi.org/10.1016/j.osr.2023.101234
- Papalia, R., Vasta, S., & Zampogna, B. (2013). Meniscal root tears: From basic science to ultimate surgery. Orthopedic Reviews, 5(1), e9. https://doi.org/10.4081/or.2013.e9
- Thorlund, J. B., Juhl, C. B., & Roos, E. M. (2018). Risk factors, diagnosis, and nonsurgical treatment for patellofemoral pain syndrome. Sports Medicine Journal, 12(4), 213–220. https://doi.org/10.1007/s40279-017-0797-5
- Hayashi, K., Koga, H., & Yamaguchi, Y. (2023). Effectiveness of rehabilitation for knee osteoarthritis associated with isolated meniscus injury. Rehabilitation Journal, 15(5), 210–225. https://doi.org/10.1016/j.rehab.2023.03.004
- Kim, J., Lee, C. H., & Park, Y. (2022). Rehabilitation after repair of medial meniscus posterior root tears: A systematic approach. Clinical Rehabilitation Review, 10(3), 345–352. https://doi.org/10.1177/02692155211062345
- Sari, E., & Kurniawati, D. (2022). Physiotherapy management in meniscus injury: An overview of clinical effectiveness. Physiotherapy Practice Review, 29(1), 78–85. https://doi.org/10.1080/09593985.2021.1956789
- Vaquero, J., & Forriol, F. (2016). Meniscus tear surgery and meniscus replacement. European Journal of Orthopaedic Surgery & Traumatology, 26(2), 199–210. https://doi.org/10.1007/s00590-015-1740-4
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