You might have heard of meniscus tears among athletes, but they can affect anyone.
What is a Meniscus?
The menisci are the two C-shaped pieces of cartilage within the knee. Their job is to help to stabilise the hinge joint of the knee by cupping the end of the thigh bone.
As with osteoarthritis, this can be a slow-healing problem as cartilage has a poor blood supply. It relies on compression and decompression (like a sponge) to flush out waste and bring in nutrients. If your knee is painful, you might not be moving it as much as you should, so it can be really tough to get on top of the injury without assistance.
Common Methods of Injury
We often hear about these injuries among footballers, which makes a lot of sense. Menisci are there for stability and cushioning, but they are not good at twisting. When a foot is planted and a rotation force passes through the knee, a meniscus may tear. For footballers, this is not an uncommon movement. It could also be caused by a fall from a bike or horse when the foot is anchored on the pedal or stirrup.
Not all tears are the same, there are a number of shapes that a tear can take. One important shape is the bucket-handle tear. Here the cartilage tears longitudinally, making a flap that looks like a bucket handle. This might be asymptomatic when in place, but if a movement causes it to flip over, it can become painful and affect movement. Intermittent locking or giving way can be a key symptom in identifying this. It can be particularly frustrating to experience, as it seems to come out of nowhere and can be hard to reproduce. Other tears may be more consistently symptomatic.
Identifying the exact shape of the tear is typically not necessary, but may be done by X-ray or ultrasound if it looks like surgery is the most appropriate treatment for you.
Diagnosis and Management of Meniscus Tears
It may be possible to diagnose your injury from the history alone. There are tests we can perform in clinic to further rule the injury in or out. It is worth noting that sometimes a meniscus is only part of the problem, as with the “unhappy triad“. This is when the ACL, MCL, and medial meniscus are injured together, and may be the result of a tackle to the knee.
Treatment involves caring for the cartilage by encouraging movement during the appointment and with exercises. We also look elsewhere for new compensatory patterns to prevent secondary issues from arising. Your osteopath may also recommend heat or ice, depending on the details of your case.
Sometimes a case does not respond well to osteopathy alone, in which case we can refer you back to your GP. Guidelines often suggest that a patient should try conservative treatments before they are referred for imaging or further therapies- we can write a letter to support you through to the next stage if needed.
