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Fast Facts:
MCL: Runs from the femur to the tibia on the inside of
the knee.
ACL: Sits inside the knee joint and stabilizes the femur
and tibia from moving forward and backward
Gastrocnemius: The large muscle in your calf.
MRI: Magnetic Resonance Imaging
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Meniscal
Tear
By Kristin Camm, MAT, ATC. Kristin is an Athletic Trainer here at
Stockton. She completed her Bachelors Degree in Athletic Training
at West Chester University and her Masters of Arts in Teaching Degree
at Montclair State University. |
What is it?
The menisci are two oval shaped pieces of cartilage that sit in
the knee joint and cushion any stress placed on the joint. It also
keeps your femur (thighbone) and tibia (shinbone) from grinding
against each other. The "Medial Meniscus" sits on the inside of
the knee and the "Lateral Meniscus" sits on the outside. The medial
meniscus is C-shaped and the lateral meniscus is an O-shape. The
outer 1/3 of the menisci have a good blood supply, but as you go
to the inside, the blood supply becomes less. Depending on the mechanism
of injury, the type and placement of the tear will be different.
It hurts where?
If you tear your meniscus, your pain will be in the area of the
tear. It will be along of the knee joint line, which is where the
femur and the tibia come together. The tear can be in the front
of the knee, the back or even the sides but it is always located
at the joint line.
How does it happen?
A meniscus tear may be caused by twisting the knee, pivoting, cutting
or decelerating. In athletes, meniscal tears often happen in combination
with other injuries such as a torn ACL (anterior cruciate ligament)
or MCL (medial collateral ligament). A meniscal tear is usually
a non-contact injury.
Injury Progression
A meniscal tear will usually present with a pocket of swelling directly
where the tear occurred. If you continue to play without treatment,
the entire knee joint may swell or a fragment of the meniscus may
loosen and drift into the joint, causing it to slip, pop or lock-your
knee gets stuck, often at a 45-degree angle, until you manually
move or otherwise manipulate it to unlock. At this point, surgery
is the most likely option to get you back to play.
Similar injuries
Meniscal tears can be confused with a few different things. One
is a gastrocnemius tear at its origin at the back of the knee. Another
is a hamstring tendon strain also at the back of the knee where
the hamstring tendons cross right before they attach below the knee
joint. Ligament tears may also be confused with a meniscal tear
or may be associated with one. It is not uncommon to tear the medial
meniscus when you tear your MCL or ACL or even both.
Treatment
The treatment of a meniscal tear will begin with ice, electric stimulation
and rest. A visit to the orthopedist usually happens next with an
MRI being prescribed. If there is a tear, it will show up on the
films, in most cases. If the tear cannot heal on its own, surgery
may be the best option. Rehabilitation exercises will help strengthen
the musculature and help stabilize the knee. A very small percentage
of meniscal injuries can be treated through rehab and without surgery
for athletes. Occasionally, an athlete can postpone the surgery
until the season is completed, depending on the severity of the
tear.
Participation Status
Most people cannot participate at the varsity athletic level with
a meniscal tear. Some people are able to if the tear is small and
there is little swelling associate with it. Many people experience
a popping, clicking and/or locking sensation that is painful or
too irritating to continue to play. Once the tear has been fixed
or removed it will take 3-6 weeks of rehab to get back into play,
it is not necessarily a "season ending injury." |
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