How to Mend Your Meniscus Injury
A meniscus injury (also known as a cartilage tear, medial meniscus tear, lateral meniscus tear, acute meniscal tear, and discoid meniscus) is one of the most common knee injuries and the menisci tend to get injured during movements that forcefully twist your knee while bearing weight. The menisci also tend to grow weaker with age and can tear as a result of minor injuries or movements.
Other Common Knee Injuries
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- How to Mend Your Medial Collateral Ligament (MCL) Injury
The medial collateral ligament (MCL) is one of 4 major ligaments in the knee and is located on the inside of the knee. This ligament joins the end of the femur (thigh bone) with the top of the tibia (shin bone).
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- How to Mend Your Patellar Tendinitis (Jumper's Knee)
Patellar Tendinitis, also known as Jumper's Knee, is a painful condition affecting the patellar tendon; which is a tendon that connects the kneecap (also known as the patella) to the shin bone. This particular tendon aids your knee and leg in extendi
What are the Menisci & How Do They Function?
The menisci in your knee are crescent shaped wedges that are similar to shock absorbers and are located under the medial and lateral condyles of the femur - or the bumpy knobs at the bottom of your thigh bone. The menisci serve as cushions between your femur (thigh bone) and tibia (shin bone) to decrease stress caused by weight bearing and forces on the knees. As weight is applied to the meniscus they are compressed and are forced to extend out from between the femur and tibia.
The menisci essentially aid in distributing the weight of your body across the knee joint as you walk, run and jump. They also lubricate and protect the articular cartilage in your knee from wear and tear, stabilize your knee when you slide and turn, and limit extreme knee flexion and extension.
There are 2 menisci in your knee joint - the medial meniscus which is located on the inside of your knee and the lateral meniscus which is located on the outside of your knee.
The medial meniscus is c-shaped and approximately 3.5cm in length. It is not directly connected to a muscle, but helps your anterior cruciate ligament (ACL) and medial collateral ligament (MCL) stabilize your knee and absorb 50% of the load applied to the inside of your knee. The medial meniscus is quite inflexible and does not move freely in the joint; therefore it is typically torn more frequently than the lateral meniscus.
The lateral meniscus is o-shaped and covers a large portion of the tibia. This meniscus is much more mobile and does have a muscular connection to a tendon in your knee. It typically moves freely in the joint and absorbs 80% of the load applied to the outside of your knee. This meniscus is less likely to be injured and/or torn due to force because it can move freely and change shape.
What Symptoms Should You Expect?
When a meniscus in your knee is damaged and/or torn it will start to move abnormally inside of your joint which may cause it to become caught between your femur and tibia. As a result of this you will experience a significant amount of pain. You may also experience some swelling either immediately after the meniscus has been injured or you may develop swelling over time as a result of synovial fluid filling the joint cavity (this is also called "water on the knee").
Stiffness, buckling or weakness in your knee as well as grinding, clicking, popping or locking of the joint are also very common symptoms of this injury.
You may experience additional symptoms depending on the type of meniscus injury that you have:
Minor Tear or Deterioration
You will often experience pain and slight swelling within the first 12 hours of noticing the discomfort. These symptoms may decrease or disappear after 2 to 3 weeks.
You may have pain near the location of your meniscus tear (usually in the center or at the side of your knee). Swelling will generally increase over 2 to 3 days and your injury will feel stiff which will result in a limited range of motion (ROM) when moving your knee. Symptoms will eventually disappear but are likely to recur due to minor twisting or overuse.
Fragments of torn meniscus may move into the space in your joint and lead to a locking of your knee that is also swollen, stiff and painful. These symptoms usually come on quite quickly. Bruising, swelling and severe pain will occur within minutes of the injury which indicates a tear of your ligament as well as a tear of your meniscus.
This is a result of wear and tear over an extended period of time and does not occur due to a particular injury. You may not recall when or how your symptoms started. Pain and minimal swelling are usually the only symptoms you will experience which typically last indefinitely. You may also have some knee grinding or catching depending on the extent of the degeneration.
The medial meniscus is injured more often than the lateral meniscus!
What Causes a Meniscus Injury?
The 2 most common causes of meniscus injuries are acute trauma to the knee and degeneration of the knee joint. If the meniscus has torn and become loose it may move around in your joint interfering with your normal knee movement and function. Some meniscus injuries may also be caused by a Discoid Meniscus.
A forceful blow to the knee can result in an acute trauma of the meniscus. Movement of your knee beyond its normal range of motion can damage the mensici. Tthis is referred to as hyper flexion or hyperextension of the knee. Sports like rugby, football, baseball, soccer, or basketball can easily result in hyper flexion or hyperextension damaging the menisci. Acute trauma of this tissue can also occur during an accident of some kind or during other low-impact activities if your knee is unstable.
Degeneration of the Fibrocartilage
When you're young your meniscus is brand new and very flexible, but over time the menisci tissue weakens and becomes less flexible, more brittle and develops small cracks in it. Conditions like osteoarthritis place additional stress on your meniscus. Osteoarthritis can happen from normal wear and tear on the knee tissue and results in destructive chemical substances that release in the joint cavity that further breaks down the collagen fibers. As the menisci degenerate they are more susceptible to tears which can lead to a meniscus tearing without any associated injury.
As menisci develop in the body they begin to form as flat disc shapes rather than the familiar crescent shaped wedges most people are used to. For some people the meniscus does not develop into a cresent shape, and this condition is referred to as discoid mensicus. Discoid meniscus occurs most frequently in the lateral meniscus and in individuals of Asian descent. Children less than 11 years of age will generally have a discoid meniscus. This condition will often change over time and children will grow out of this as a c-shaped meniscus will form with maturity.
Symptoms of a discoid meniscus can vary but usually do not occur unless there is a tear in the meniscus. Symptoms that can be expected with a tear include, but are not limited to, clicking, snapping, buckling and/or locking of the knee joint, decreased range of motion, joint pain and tenderness, and atrophied quadriceps (muscles wasting away) may be experienced. Discoid mensicus has also been referred to as "snapping knee syndrome".
How do You Know if You Have a Meniscus Injury?
There are many tests that can be performed when diagnosing a meniscus injury. Your medical professional may perform a physical examination of your knee or order a test via x-ray, CAT scan, or MRI.
A medical professional will perform a physical examination by visually assessing and feeling the bones and soft tissue in your knee. They will also assess the symmetry of your knee to identify any areas of inflammation, bone deformity or atrophied muscles. Leg movements will also help the medical professional in determining causes and symptoms of your condition. Through movement the medical professional will be able to witness any pain, weakness, instability, catching, popping, or locking.
You may have the medical professional perform additional physical examinations such as McMurray's Test, Joint Line Tenderness, or Ege's test. Each test will involve the medical professional feeling your knee while laying down or standing in a certain position.
Diagnostic testing can obtain more detailed information, and assess the amount and/or type of damage in your knee. There are a variety of different tests available to analyse the damage in your knee, however recommendations will differ based on the degree of your injury and the opinion of your medical professional.
An X-ray identifies abnormal bone shapes, fractures, arthritis, and degeneration (wear and tear) within the knee. It can also identify a discoid meniscus, or loose bones and bone abnormalities that may mimic a torn meniscus.
A CAT (or CT) scan is used to provide a 3-dimensional assessment of the bones and soft tissues in and around your knee and may be used to find a meniscus tear.
An MRI can evaluate the soft tissues in and around your knee (muscles, tendons, ligaments, menisci, other connective tissues). It can identify ligament and meniscal damage, and help to determine the extent of your injury, the displacement and degree of your tear, fluid on your knee, a discoid meniscus, ACL or MCL tear, and/or other associated conditions.
Degree of Severity
How do You Determine the Severity of Your Meniscal Injury?
Two major factors that influence the degree of severity of your injury include: the location of the tear, and the shape of the tear.
Menisci are composed of a dense tissue called fibrocartilage which is a tougher connective tissue than articular cartilage. The amount of blood vessels in the fibrocartilage throughout the meniscus varies. The outer 1/3 of the meniscus is vascular which means there is an abundance of blood vessels to allow blood to the area. Meniscus injuries can be difficult to heal because of the limited blood supply available.
There are two "zones" within each meniscus; the "red zone" and the "white zone". The "red zone" is located on the outermost edge of the meniscus and this area receives the most blood flow. Conversely, the "white zone" is located in the inner portion of the meniscus and receives very little blood supply. Tears that are either wholly or in part located within the "red zone" will have a better chance of healing completely and at a quicker rate. Tears that occur in the "white zone" will be much more difficult to treat. Each injured site can benefit from stimulation from a heating device (ultrasound unit or heat wrap) to increase blood flow.
The shape and size of your meniscus tear will determine the treatability of your injury. There are three main shapes for meniscus tears: longitudinal, horizontal and radial. You may also have a "complex" tear, which is a combination of more than one shape.
Longitudinal tears extend along the length of your meniscus, but do not penetrate through your meniscus. This particular tear does not touch the rim of the meniscus and typically results from repeated movements.
Bucket Handle tears are longitudinal and completely penetrate the entire meniscus. Approximately 10% of individuals with meniscus injuries will have a bucket handle tear and may also experience an ACL injury. If you have a bucket handle tear you may also experience locking of your knee while in flexion.
Horizontal tears (also known as cleavage tears) slice your meniscus horizontally (like a bun) and are often not visible. Although these particular tears are rare, they occur more frequently in the lateral meniscus.
Horizontal Flap tears usually develop if a horizontal tear is left untreated. This tear occurs horizontally on the surface of the meniscus and will create a flap that moves around as you move your knee. If you have a horizontal flap tear you are at risk of developing a complex tear or a meniscal cyst (a mass that develops from a collection of synovial fluid along the outside rim of the meniscus).
Radial tears (also know as free-edge transverse tears) usually start as a split located on the inner edge of your meniscus. This tear occurs frequently in the lateral meniscus.
Parrot's Beak tears occur when a radial tear increases in size and becomes a complete tear. This tear is typically the result of an acute injury or repetitive tasks. You may experience locking or catching of the meniscus in your knee as this tear grows larger.
Easy At-Home Treatments to Avoid Surgery
What Treatments are Available to Mend Your Meniscus Injury?
It is important that you receive adequate treatment for your meniscus injury because once your meniscus is torn you have an increased risk in developing arthritis in your knee. You should consult a medical professional to obtain a proper diagnosis and receive a tailored treatment plan. Meniscus injuries can be difficult to heal because the blood supply in your knee is often limited to the outer edge of the menisci. Proper blood flow is essential when healing a meniscus injury.
As soon as your meniscus is injured your body triggers natural events that isolate damaged tissue and prepare it for healing. The main symptoms you will immediately feel after injury - the swelling, redness (rubor), heat (calor), pain (dolor), and loss of function - are really just signs that your body is starting to heal.
Unfortunately when your torn meniscus is swollen and inflamed the damaged tissue is blocking vital blood flow from coming into to continue the natural healing process. When your blood flow is blocked, the other healthy tissue in your knee is starved of oxygen, nutrients and antibodies needed for your healthy tissue to thrive and for your injured meniscus to heal. This is why it's never good to let a new meniscus injury stay untreated for too long.
Using cold compression immediately following a meniscus tear, re-injury (which is common due to instability of the knee), or surgery reduces pain and swelling and reduces the tissue damage that occurs with soft tissue injuries.
Blood Flow Stimulation Therapy
What can be done for your meniscus when the swelling is gone, but the pain is still there? Once the swelling is gone our bodies are starving for the naturally occurring oxygen, nutrients, antibodies and energy available in our blood. Blood flow is like the life force of our bodies, and the healing process really takes off only when injured meniscus tissue receives proper blood flow.
If you want to heal quickly you need to keep your blood flow moving constantly, but you also need to make sure your body is actively getting rid of cellular waste and toxins. This is where BFST® comes in, but what exactly is BFST® and how can it help to accelerate healing?
BFST® is exactly what it seems - it's a therapy that substantially increases the flow of blood to your knee without the need to exercise your already damaged meniscus.
Think about your injured knee as if it is a sponge that has dried out. Your damaged meniscus is waiting there ready to absorb all of the benefits of increased blood flow but your body is unable to keep up with the demand of what your meniscus needs. BFST® boosts your body's natural blood flow, delivering oxygen, nutrients, antibodies and energy directly to the source of your pain. Once you start receiving all of the benefits BFST® has to offer your injured knee becomes like a sponge that now has enough blood flow within reach to soak up everything good that is in your blood flow. Increased blood flow through BFST® also acts as a cleanser for your tissue, whisking away all toxins and cellular waste.
Treating Your Meniscus
Products available on Amazon to help with your Meniscus Injury!
How to Use the Knee Freezie and Inferno Wraps
When is Surgery an Option & What Surgical Prodcedures Mend Meniscus Injuries?
You may be a candidate for surgery is your have injured your meniscus and you experience disabling symptoms that interfere with your daily routine after 2 to 3 months, have a larger more complex or displaced tear, or have major instability in your knee.
You may undergo Arthroscopic Surgery in order for your surgeon to develop a proper diagnosis of your injury. This procedure involves inserting a fiber optic camera through a small incision on the outside of the knee. At this point the surgeon will look inside of your joint to assess all damage caused to your soft tissues and bones.
Repairing a torn meniscus is one of the most common knee surgeries and there are 3 different types of meniscus surgeries that may be recommended to repair your injury: Menisectomy, a Meniscal Repair, or a Meniscal Replacement.
A Partial Menisectomy or Resection is the most common meniscus surgery and involves removal of the torn or damaged portion of your meniscus. This surgery is generally used for either degenerative or horizontal tears located in the innermost portion of your meniscus. This location typically has a poor healing rate because it receives little or no blood supply, and therefore in this case it is best to remove the damaged part rather than try to fix it. Recovery time for this type of surgery is typically 6 weeks.
A Complete Menisectomy or Resection may be required if degenerative damage has caused a complete collapse of the meniscus. This commonly occurs to the lateral meniscus rather than the medial meniscus. This surgery involves the removal of the meniscus however if a Complete Meniscectomy or Resection is performed, your joint may become overloaded as the contact pressure increases by 200% to 300%. This type of surgery is only performed if it is absolutely necessary as an individual may become bow-legged upon removal of the medial meniscus, or knock-kneed upon removal of the lateral meniscus.
This surgery fixes any damage and helps prevent future deterioration of your meniscus. Although a Meniscal Repair is generally preferred over a Menisectomy, a Meniscal Repair is a more complex surgery and recovery time is much longer. There are two different techniques that may be used to repair a meniscus tear, and the method that works best for you will depend on the size and shape of the tear. Trenpanation is an abrasion technique used for longitudinal tears or bucket handle tears that will require the surgeon to make small holes or shave the torn edges of the meniscus to promote bleeding thus enhancing healing. Suturing is a technique used for radial split tears or parrot's beak tears and the surgeon will use stitches or other devices that the body will absorb to reconnect the tear, repair the damage, and save your meniscus. Recovery time for this type of surgery is typically 3 to 4 months.
A surgeon will implant a new meniscus into your knee during a Meniscal Replacement. There are two different types of implants: Allograft and Collagen Implant. An allograft is the transplant of a meniscus from a donor and this surgery is rarely done as it is not an effective long term solution. Collagen implants are placed in your knee to promote growth of a new meniscus, however results from this surgery are questionable and it is not FDA approved.
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