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Meniscal injuries

The meniscus refers to an important structure of the knee that is commonly injured. It is made from two menisci which are a combination of connective tissue and cartilage and act as shock absorbers for the joint. It is a crescent or horse shoe in shape and sits between the knee joint. Menisci are present in other joints, yet most commonly affected in the knee.

Injuries to the menisci commonly occur during high trauma of a younger person or degeneration/low grade trauma in older patients.

Mechanism: Twisting injury typically on a flexed knee in weightbearing.

Common symptoms include:

  • Delayed onset of swelling (Over the course of the day/night > Instant swelling)
  • Joint line tenderness (tenderness around the sides of your knee)
  • Pain on weightbearing, especially in flexed positions (Squatting etc)
  • Pain on twisting/changing direction
  • Pain on deep flexion or hyperextension
  • A deep "toothache" like pain.

If you have injured your knee and are getting locking episodes where you can't move your knee or  your knee is giving way, seek medical advice ASAP.

DID YOU KNOW? Meniscal tears are even common in the unsymptomatic knee, meaning many people will have tears to this structure without any pain or limitations. It is for this reason that not all knee injuries will have investigations or scans as patients may have abnormal findings on MRI which were not causing them any issue. This often muddies the waters and could lead to inappropriate management or interventions (Treatment).


Where menisci injuries are causing problems a conservative management programme can improve symptoms just as well, and often better, than surgery, with the latter only being required in specific circumstances.

For management of an old/more degenerative menisci injuries; consider looking at the advice here (Link in process of being created) as most advice will carry over to you.

Early management phase

  • Protect (Knee support/crutches if necessary)
  • Relative rest - Can continue pain free exercise/activity but limit painful activity.
  • Ice
  • Compression - Compression garments/stockings can often help with swelling
  • Elevation

Often the above is enough to calm down any swelling and inflammation of the knee.

Subacute phase

When the swelling has started to subside, it is recommended to start to strengthen the surrounding joint to help control and dissipate (spread and absorb) forces more efficiently and provide more of a chance for the menisci to heal. Unfortunately, this healing can often take onwards of 3-6 months + as the majority of the menisci have a bad blood supply. Cycling or hydrotherapy based exercise is recommended to promote circulation and healing. Additionally, strengthening exercises starting at 8-12 repetitions and 3-4 sets are recommended on whichever exercise is suitably difficult and tolerable within the pain limits of your knee. Patients tend to prefer exercises where no weight is going through the knee to start (Knee extension machine etc) however can do weight bearing exercises (squatting etc) if permitted by pain and reaction (In swelling/function).

Your physiotherapist is there to help you with exercise selection and load management.

Return to play

If you are looking to return to sport following this type of injury, consider looking here: Return to sport

3-6+ months, strong yet pain the same? This is where steroid injections may be indicated to help recovery.

Any questions? Contact us



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