Meniscal Issues

This page has been designed to provide you with the right information about meniscal injuries and how to manage them from a physiotherapy point of view. It also contains the right information if you have had surgery to address your meniscal issue.

If you have had, or are planning to have, a meniscal surgery, you can jump straight to this information by clicking on the text below.

Go to Meniscal Surgery page

What is a meniscus and what does it do?

A meniscus is a structure in your knee that has many roles, but its main one is to help with the cushioning between your femur (thigh) and your tibia (shin). You have two menisci in your knee, with one on the inside and one on the outside of your knee joint. Most people will know their meniscus by a different name, that name being ‘cartilage’. The menisici are a type of cartilage but for consistency, this information page will use the name meniscus.

Are they strong?

Yes, your knees in general are unbelievably strong as they are designed to run, jump and kick. Your menisci are also incredibly strong as they are designed to help the knee manage all that running, jumping and kicking without too many issues.

Can you injure a meniscus?

Like any body part, you can injure it and menisci are no different. Just like any normal sprains and strains, you can have a mild issue where the meniscus might be grumpy and a bit upset, all the way up to a meniscus that has actually undergone some trauma.

How would you upset a meniscus?

As mentioned above, your menisci are very strong and are designed to be worked hard, but can be upset if too much stress is put through them. Commonly, kneeling or squatting down for a long time (especially if you’re not used to it) can irritate your knee and possibly the meniscus. Menisci can be injured more extensively with a bending, twisting action of the knee, like changing direction on the sporting field.

What are the symptoms of a meniscal problem?

The most common symptoms include localised knee pain (possibly to the back of the knee) and tenderness around the knee joint itself. Often meniscal issues will be most sore with your knee fully bent (squatting/crouching or kneeling), or if you stand on your feet for a long time or with standing/ twisting movements. Sometimes, a clicking or popping feeling or locking (sticking) sensation can be felt and these may indicate a meniscal tear.

What should I do to help my knee?

If you have recently upset your knee, try not to worry.

Follow the new way of managing acute (early) muscle and joint injuries using the POLICE principle.

This means looking after the injured body part by stopping playing or taking some weight off it.

This means working the body part within what is comfortable. This would include walking on it or moving it as much or as far as is comfortable/ manageable.

Ice can act as a good distraction and therefore is good as pain relief in the early stages of an injury.

Applying a Tubigrip or bandaging the area may help with the swelling, in the early stages. It will also reassure you that the body part feels suitably supported.

Gravity can help with fluid drainage and as such can help with swelling as long as your heel is above the height of your knee.

I’ve heard the term “meniscal tear”, what does that mean?

A torn meniscus is when the actual structure of the meniscus has undergone some damage. As detailed above, sometimes this happens due to accidents (see above), but sometimes they can exist without you even knowing (or causing any issues). Horga et al. (2020) found that 30% of people who had an MRI of their knees showed meniscal issues, including tears. The interesting thing is that these people had NO pain in their knees, which suggests you can have a meniscal tear in your knee and live quite normally with no symptoms.

Why do some meniscal tears need surgery then?

Good question - there’s lots of ways to answer this and ultimately, it’s complicated. We are all different and so are meniscal tears. Where the tear is, how big is it, how long it’s been there, how fit you are, how strong you are and how much you understand about your knee all affect how well you can manage any knee problem.

Often, if the tear is causing locking of the knee (when the knee actually gets stuck) and it is not settling, then it might be that surgery is considered.

So can meniscal issues be managed without surgery?

In short, yes. If your meniscus is irritated, it can calm down and there are some easy ways to do this.

Any type of pain, no matter where it is, is unpleasant and can sometimes become a bit concerning. We have designed this page specifically to give you the right information about meniscal issues and hopefully some reassurance that even if it’s really rather sore, your knee is an amazingly strong and robust piece of kit. Most meniscal issues are simply something that is irritated, rather than damaged, and can calm down with the right amount of time and a few things to help it along the way.

In order to help your knee start to settle, it is important to calm it down. What this means is, whilst your knee is sore, there are things that it might not like as much, such as walking too long, kneeling or the stairs. In order to calm your knee down, it is sensible to look at the things it doesn’t like at the moment and try to adapt or change that thing such as not walk as far, limit how long or often you kneel or go upstairs one at a time. You won’t have to do this forever, but whilst your knee is sore, think of it as it asking you to help it by not doing the things it doesn’t like in the same way you might have done them before.

To help you understand and really try the ‘calm it down’ principle, we have designed a whole page dedicated to the idea with some tips and hints to help you get started: Load Management

In many cases, when you are in pain you will find that you will do things differently. You may move differently, you may do your normal activities differently, you may even think differently because of the pain. As such, the pain will mean the work going through your leg will be different whilst it is sore. This is normal, but often what will happen is that the muscles in your leg will not be getting the same work as normal (when your knee isn’t sore) and they will eventually lose some strength.

By ‘calming things down’ first (see above) and then building some strength and confidence back into your knee when it’s ready, you are much more likely to make a good recovery (Sherman et al, 2020).

OK, I’ve got all that, but what exercises are good to build it back up as you say?

Remember, sometimes you have to ‘calm things down’ first before you can ‘build them back up again’. Make sure you have read and tried to put some of these ideas in place before jumping straight into the exercises.

The exercises below are all about getting the knee gently moving first and then progressing onto some strengthening when you feel ready.

Movement Exercises

All Knee Strengthening Exercises

Download our blank gym programme here.

Need more help? Refer yourself here.

Horga, L.M. , Hirschmann A.C., Henckel J., Fotiadou A., Di Laura, A., Torlasco C., De Silva, A., Sharma, S., Moon J.C., & Hart A.J. (2020). Prevalence of abnormal findings in 230 knees of asymptomatic adults using 3.0 T MRI. Skeletal Radiol. 2020; 49(7): 1099–1107. doi: 10.1007/s00256-020-03394-z

Sherman, S.L., DiPaolo, Z. J., Ray, T.E., Sachs, B.M. & Odaldeji, L.O. (2020). Meniscus injuries: a review of rehabilitation and return to play. Clinics in Sport Medicine. 39(1), 165-183.