Coping with a Meniscus Tear

Meniscus tear, or meniscus lesion

A meniscus tear, or meniscus lesion, is wear-related or accident-related damage to the outer and/or inner meniscus in the knee joint.

How does a meniscus tear happen?

The meniscus acts as a shock absorber in the knee joint and is also responsible for controlling and stabilising the joint. It's usually damaged by movements in which the femur presses on the meniscus and pinches it. Depending on how the femur acts on it, many different kinds of tears can result. The inner meniscus is most often affected, as it's fused to the medial ligament and the capsule and therefore has almost no room to move out of the way.

There are at least 10 different manual tests for meniscus lesions. None of them is really reliable, though. That's why an MRI is now often used to confirm a suspected tear. However, an MRI can also show meniscus damage that isn't yet causing any pain or loss of function, which makes diagnosis even harder.

Symptoms of a meniscus tear

Depending on how severe the damage is, an injured meniscus can partially or even completely block the knee. In many cases, a shifting pain also occurs in the knee joint at the level of the joint line. Sometimes audible and noticeable crackling sounds occur too (when parts of the meniscus come loose and get caught between the joint surfaces).

Treatment for a meniscus tear

In principle, two treatment methods are used.

Partial meniscectomy:

The damaged part of the meniscus is cut out. From a medical point of view, the patient may bear weight straight away.

Meniscus refixation:

The meniscus is stitched back together using titanium darts, a suture or anchors. The fixation can't bear much load, and meniscus tissue heals only slowly. The load should therefore be increased gradually. After a meniscus refixation, knee flexion is limited to a maximum of 60° for the first 6 weeks. During this time, walking is only allowed with crutches.

Exercise after a partial meniscectomy:

It's advisable to take the weight off the knee for 3 days (using crutches if necessary), then to load it only lightly during the first week (no sport). During this time, the joint fluid can regenerate better and the knee can get used to functioning with less stability.

In the second week, cycling, jogging on the treadmill and strength training can be resumed. Loading within the limits of the symptoms is allowed. Exercises with strong knee flexion (over 90°) should be avoided for 6 weeks.

Exercise after a refixation:

You need to wait at least 6 weeks before doing knee bends up to 90°. Deep knee bends below 90° may only be done after 3 months. Jogging on the treadmill at the earliest 8 weeks after surgery.

Important exercises:

• Cycling, Two-legged calf raises
• Leg press up to 60°
• Knee joint flexion
• Abduction
• Adduction

What to keep in mind with a meniscus tear:

With any knee problem, swelling is an important indicator of how much load it can bear. If the swelling increases, you need to reduce the load straight away.

Our coaches are happy to support you with advice and hands-on help for the best possible training after an injury.