What is a Meniscus Tear

Meniscus tear is a knee injury in which a piece of the meniscus is torn. The meniscus is a thick, rubbery, wedge-shaped cartilage in the knee. Two menisci are located in each knee.

They sit between the upper bone (femur) and lower bone (tibia) that make up the knee joint. Each meniscus acts as a shock absorber for the knee.

A torn meniscus is one of the most common types of knee injuries. This injury can range from mild to severe. Surgery may be needed for a severe tear.

What are the causes?

This injury may be caused by any squatting, twisting, or pivoting movement. Sports-related injuries are the most common cause. These often occur from:

• Running and stopping suddenly.
• Changing direction.
• Being tackled or knocked off your feet.

As people get older, their meniscus gets thinner and weaker. In these people, tears can happen more easily, such as from climbing stairs.

What increases the risk?

This injury is more likely to happen to:

• People who play contact sports.
• Males.
• People who are 30‒40 years of age.

What are the signs or symptoms?

Symptoms of this injury include:

• Knee pain, especially at the side of the knee joint. You may feel pain when the injury occurs, or you may only hear a pop and feel pain later.
• A feeling that your knee is clicking, catching, locking, or giving way.
• Not being able to fully bend or extend your knee.
• Bruising or swelling in your knee.

How is this diagnosed?

This injury may be diagnosed based on your symptoms and a physical exam. The physical exam may include:

• Moving your knee in different ways.
• Feeling for tenderness.
• Listening for a clicking sound.
• Checking if your knee locks or catches.

You may also have tests, such as:

• X-rays.
• MRI.
• A procedure to look inside your knee with a narrow surgical telescope (arthroscopy).

You may be referred to a knee specialist (orthopedic surgeon).

How is this treated?

Treatment for this injury depends on the severity of the tear. Treatment for a mild tear may include:

• Rest.
• Medicine to reduce pain and swelling. This is usually a nonsteroidal anti-inflammatory drug (NSAID).
• A knee brace or an elastic sleeve or wrap.
• Using crutches or a walker to keep weight off your knee and to help you walk.
• Exercises to strengthen your knee (physical therapy).

You may need surgery if you have a severe tear or if other treatments are not working.

Follow these instructions at home:

Managing pain and swelling

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If directed, apply ice to the injured area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times per day.
• Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

Activity

• Do not use the injured limb to support your body weight until your health care provider says that you can. Use crutches or a walker as told by your health care provider.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Perform range-of-motion exercises only as told by your health care provider.
• Begin doing exercises to strengthen your knee and leg muscles only as told by your health care provider. After you recover, your health care provider may recommend these exercises to help prevent another injury.

General instructions

• Use a knee brace or elastic wrap as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever.
• Your knee becomes red, tender, or swollen.
• Your pain medicine is not helping.
• Your symptoms get worse or do not improve after 2 weeks of home care.

Meniscus Tear, Phase I Rehab

Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed. It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse. Do not begin these exercises until told by your health care provider.

Stretching and range of motion exercises

These exercises warm up your muscles and joints and improve the movement and flexibility of your knee. These exercises also help to relieve pain and stiffness.

Exercise A: Knee flexion, active

1. Lie on your back with both knees straight. If this causes back discomfort, bend your uninjured knee so your foot is flat on the floor.
2. Slowly slide your left / right heel back toward your buttocks until you feel a gentle stretch in the front of your knee or thigh. Stop if you have pain.
3. Hold for __________ seconds.
4. Slowly slide your left / right heel back to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise B: Knee extension, sitting

1. Sit with your left / right heel propped on a chair, a coffee table, or a footstool. Do not have anything under your knee to support it.
2. Allow your leg muscles to relax, letting gravity straighten out your knee. You should feel a stretch behind your left / right knee.
3. If told by your health care provider, deepen the stretch by placing a __________ weight on your thigh, just above your kneecap.
4. Hold this position for __________ seconds.

Repeat __________ times. Complete this stretch __________ times a day.

Strengthening exercises

These exercises build strength and endurance in your knee. Endurance is the ability to use your muscles for a long time, even after they get tired.

Exercise C: Quadriceps, isometric

1. Lie on your back with your left / right leg extended and your other knee bent. Put a rolled towel or small pillow under your right/left knee if told by your health care provider.
2. Slowly tense the muscles in the front of your left / right thigh by pushing the back of your knee down. You should see your knee cap slide up toward your hip or see increased dimpling just above the knee.
3. For __________ seconds, keep the muscle as tight as you can without increasing your pain.
4. Relax the muscles slowly and completely.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise D: Straight leg raises (quadriceps)

1. Lie on your back with your left / right leg extended and your other knee bent.
2. Tense the muscles in the front of your left / right thigh. You should see your kneecap slide up or see increased dimpling just above the knee.
3. Keep these muscles tight as you raise your leg 4–6 inches (10–15 cm) off the floor.
4. Hold this position for __________ seconds.
5. Keep these muscles tense as you lower your leg.
6. Relax the muscles slowly and completely.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise E: Hamstring curls

1. On the floor or a bed, lie on your abdomen with your legs straight. Put a folded towel or small pillow under your left / right thigh, just above your kneecap.
2. Slowly bend your left / right knee as far as you can without pain. Keep your hips flat against the floor or bed.
3. Hold this position for __________ seconds.
4. Slowly lower your leg to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Meniscus Tear, Phase I Rehab After Surgery

Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed. It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse. Do not begin these exercises until told by your health care provider. If told by your health care provider, wear your brace while you do these exercises.

Stretching and range of motion exercises

These exercises warm up your muscles and joints and improve the movement and flexibility of your knee. These exercises also help to relieve pain and stiffness.

Exercise A: Knee flexion, passive (supine)

1. Start this exercise in one of these positions:
   1. Lying on the floor in front of an open doorway, with your left / right heel and foot lightly touching the wall.
   1. Lying on a bed with both of your feet on the wall or headboard.
2. Without using any effort, allow gravity to slide your foot down the wall slowly until you feel a gentle stretch in the front of your left / right knee, or until your knee reaches the angle that your health care provider tells you.
3. Hold this stretch for __________ seconds.
4. Return your leg to the starting position, using your healthy leg to do the work or to help if needed.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise B: Knee extension, passive (sitting)

1. Sit with your left / right heel propped up on a chair, a coffee table, or a footstool. Do not have anything under your knee to support it.
2. Allow your leg muscles to relax, letting gravity straighten out your knee. You should feel a stretch behind your left / right knee.
3. If told by your health care provider, deepen the stretch by placing a __________ weight on your thigh, just above your kneecap.
4. Hold this position for __________ seconds.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise C: Gastrocnemius stretch, passive

1. Sit on the floor with your left / right leg extended.
2. Loop a belt or towel around the ball of your left / right foot. The ball of your foot is on the walking surface, right under your toes.
3. Keep your left / right ankle and foot relaxed and keep your knee straight while you use the belt or towel to pull your foot and ankle toward you. You should feel a gentle stretch in your calf or behind your knee.
4. Hold this position for __________ seconds.

Repeat __________ times. Complete this exercise __________ times a day.

Strengthening exercises

These exercises build strength and endurance in your knee. Endurance is the ability to use your muscles for a long time, even after they get tired.

Exercise D: Quadriceps, isometric

1. Lie on your back with your left / right leg extended and your opposite knee bent.
2. Slowly tense the muscles in the front of your left / right thigh. You should see your kneecap slide up toward your hip or see increased dimpling just above the knee. This motion will push the back of the knee toward the ground.
3. Hold the muscle as tight as you can without increasing your pain for __________ seconds.
4. Relax the muscles slowly and completely.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise E: Straight leg raises (quadriceps)

1. Lie on your back with your left / right leg extended and your other knee bent.
2. Tense the muscles in the front of your left / right thigh.
3. Keep these muscles tight as you raise your leg 4–6 inches (10–15 cm) off the floor. Do not let your knee bend.
4. Hold for __________ seconds.
5. Keep these muscles tense as you lower your leg.
6. Relax these muscles slowly and completely.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise F: Straight leg raises (hip abductors)

1. Lie on your side with your left / right leg in the top position. Lie so your head, shoulder, knee, and hip line up. You may bend your lower knee to help with your balance.
2. Lift your top leg 4–6 inches (10–15 cm), keeping your toes pointed straight ahead.
3. Hold this position for __________ seconds.
4. Slowly lower your leg to the starting position.
5. Allow your muscles to relax completely.

Repeat __________ times. Complete this exercise __________ times a day.

Meniscus Tear, Phase II Rehab

These exercises are more advanced than phase I exercises. Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed. It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse. Do not begin these exercises until told by your health care provider.

Stretching exercises

These exercises warm up your muscles and joints and improve the movement and flexibility of your knee. These exercises also help to relieve pain and stiffness.

Exercise A: Quadriceps, prone

1. Lie on your abdomen on a firm surface, such as a bed or padded floor.
2. Bend your left / right knee and hold your ankle. If you cannot reach your ankle or pant leg, loop a belt around your foot and grab the belt instead.
3. Gently pull your heel toward your buttocks. Your knee should not slide out to the side. You should feel a stretch in the front of your thigh and knee.
4. Hold this position for __________ seconds.

Repeat __________ times. Complete this stretch __________ times a day.

Exercise B: Hamstring, doorway

1. Lie on your back in front of a doorway with your left / right leg resting against the wall and your other leg flat on the floor in the doorway. There should be a slight bend in your left / right knee.
2. Straighten your left / right knee. You should feel a stretch behind your knee or thigh. If you do not feel that stretch, scoot your buttocks closer to the door.
3. Hold this position for __________ seconds.

Repeat __________ times. Complete this stretch __________ times a day.

Strengthening exercises

These exercises build strength and endurance in your knee and leg muscles. Endurance is the ability to use your muscles for a long time, even after they get tired.

Exercise C: Step-ups (quadriceps)

1. Stand in front of a step, a thick book, or a step stool that is __________ tall.
2. Slowly step up with your left / right foot, keeping your knee in line with your hip and foot. Do not let your knee bend so far that you cannot see your toes. Hold a wall or a counter for balance, but do not use it for support.
3. Slowly unlock your knee and lower yourself to the starting position using gravity, not your muscles.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise D: Wall slides (quadriceps)

1. Lean your back against a smooth wall or door, and walk your feet out 18–24 inches (45–61 cm) from it.
2. Place your feet hip-width apart.
3. Slowly slide down the wall or door until your knees bend __________ degrees. Keep your knees over your heels, not over your toes. Keep your knees in line with your hips.
4. Hold for __________ seconds.
5. Stand up to rest for __________ seconds.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise E: Bridge (hip extensors)

1. Lie on your back on a firm surface with your knees bent and your feet flat on the floor.
2. Tighten your buttocks muscles and lift your bottom off the floor until your trunk is level with your thighs.
   1. Do not arch your back.
   1. You should feel the muscles working in your buttocks and the back of your thighs.
3. Hold this position for __________ seconds.
4. Slowly lower your hips to the starting position.
5. Let your buttocks muscles relax completely between repetitions.

Repeat __________ times. Complete this exercise __________ times a day.

Balance exercises

This exercise improves or maintains your balance. Balance is important in preventing falls.

Exercise F: Single leg stand

1. Without shoes, stand near a railing or in a doorway. You may hold onto the railing or door frame as needed.
2. Stand on your left / right foot. Keep your knee slightly bent and keep your big toe down on the floor.
3. If this exercise is too easy, you can try doing it with your eyes closed or while standing on a pillow.
4. Hold this position for __________ seconds.

Repeat __________ times. Complete this exercise __________ times a day.

Meniscus Tear, Phase II Rehab After Surgery

These exercises are more advanced than phase I exercises. Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed. It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse. Do not begin these exercises until told by your health care provider.

Stretching and range of motion exercises

These exercises warm up your muscles and joints and improve the movement and flexibility of your knee. These exercises also help to relieve pain and stiffness.

Exercise A: Quadriceps stretch, prone

1. Lie on your abdomen on a firm surface, such as a bed or padded floor.
2. Bend your left / right knee and hold your ankle. If you cannot reach your ankle or pant leg, loop a belt around your foot and grab the belt instead.
3. Gently pull your heel toward your buttocks. Your knee should not slide out to the side. You should feel a stretch in the front of your thigh and knee.
4. Hold this position for __________ seconds.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise B: Hamstring stretch, doorway

1. Lie on your back in front of a doorway with your left / right leg resting against the wall and your other leg flat on the floor in the doorway. There should be a slight bend in your left / right knee.
2. Straighten your left / right knee. You should feel a stretch behind your knee or thigh. If you do not, scoot your bottom closer to the doorway.
3. Hold this position for __________ seconds.

Repeat __________ times. Complete this exercise __________ times a day.

Strengthening exercises

These exercises build strength and endurance in your knee. Endurance is the ability to use your muscles for a long time, even after they get tired. If told by your health care provider, wear your brace while you do these exercises.

Exercise C: Long arcs (quadriceps)

If told by your health care provider, do this exercise while wearing ankle weights. Begin with __________ ankle weights. Then increase the weight by 1 1b (0.5 kg) increments. Do not wear ankle weights that are more than __________.

1. Sit in a chair. Start with both feet on the floor.
2. Slowly straighten your left / right knee and bring your foot out in front of you. Keep your thighs on the chair.
3. Hold this position for __________ seconds.
4. Slowly return your knee to the bent position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise D: Wall slides (quadriceps)

1. Lean your back against a smooth wall or door while you walk your feet out 18–24 inches (46–61 cm) from it.
2. Place your feet hip-width apart.
3. Slowly slide down the wall or door until your knees bend __________ degrees. Keep your knees over your heels, not over your toes. Keep your knees in line with your hips.
4. Hold this position for __________ seconds.
5. Push through your heels to stand up to rest for __________ seconds after each repetition.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise E: Standing heel raise (plantar flexors)

1. Stand with your feet shoulder-width apart.
2. Keep your weight spread evenly over the width of your feet while you rise up on your toes. Use a wall or table to steady yourself, but try not to use it for support.
3. Hold this position for __________ seconds.
4. Slowly lower yourself down to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise F: Hamstring curls

If told by your health care provider, do this exercise while wearing ankle weights. Begin with __________ weights. Then increase the weight by 1 lb (0.5 kg) increments. Do not wear ankle weights that are more than __________.

1. Lie on your abdomen with your legs extended. Put a folded towel under your left / right thigh.
2. Bend your left / right knee up to 90 degrees to make the shape of a letter “L.” Keep your hips flat against the surface that is under them.
3. Hold this position for __________ seconds.
4. Slowly lower your leg to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.