Meniscal Tears
Damage to the knee meniscus causing pain, swelling, and mechanical joint symptoms
Meniscal tears are a common knee injury affecting the meniscus, a type of cartilage that acts as a shock absorber and stabiliser within the joint. Each knee has two menisci, positioned between the thigh bone (femur) and shin bone (tibia), helping to distribute load and support smooth movement.
A tear can occur suddenly following a twisting injury or trauma, or develop gradually over time due to degenerative changes within the cartilage. When the meniscus is damaged, it can lead to pain, swelling, stiffness, and changes in how the knee moves.
In some cases, a torn meniscus may also cause mechanical symptoms, such as catching, clicking, or locking of the knee, which can affect your ability to move comfortably or stay active.
The severity of a meniscal tear can vary, ranging from small, stable tears to more complex injuries that affect joint function.
Early assessment is important to determine the type and extent of the tear, helping guide appropriate management and support long-term knee health and function.
What is a meniscal tear?
A meniscal tear is an injury to the meniscus, a type of cartilage in the knee that acts as a shock absorber and stabiliser between the thigh bone (femur) and shin bone (tibia).
Each knee has two menisci:
- The medial meniscus on the inner side of the knee
- The lateral meniscus on the outer side
These structures help distribute load across the joint, absorb impact, and support smooth movement during activities such as walking, running, and bending.
A tear can occur when the meniscus is subjected to twisting, pivoting, or excessive force, or it may develop gradually over time as the cartilage becomes weakened or worn. Meniscal tears can vary in type and severity. Some tears are small and stable, while others may be larger or more complex, affecting how the knee moves. In certain cases, a fragment of the meniscus may interfere with joint movement, leading to catching or locking symptoms.
Because the meniscus plays an important role in protecting the joint, damage to this structure can affect knee stability, movement, and long-term joint health.
Common causes of meniscal tears
Meniscal tears can occur due to sudden injury or gradual wear over time, often depending on your activity level and the condition of the cartilage. In younger or more active individuals, meniscal tears are commonly caused by traumatic events, particularly during activities that involve:
- Twisting or pivoting movements, especially with the foot planted
- Sudden changes in direction or deceleration
- Deep bending or squatting under load
- Direct impact or sporting collisions
These movements can place significant stress on the meniscus, leading to a tear.
In other cases, meniscal tears develop more gradually due to degenerative changes. Over time, the cartilage can become weakened and less resilient, making it more prone to tearing with relatively minor movements.
Common causes of degenerative tears include:
- Age-related wear and tear of the cartilage
- Repetitive stress from daily activities or occupational demands
- Underlying knee conditions, such as osteoarthritis
- Previous knee injury, which may affect joint mechanics
In some individuals, a meniscal tear may occur without a single clear injury, particularly when the cartilage has already been weakened.
Symptoms of meniscal tears
Symptoms of meniscal tears can vary depending on the size, location, and type of tear, and whether the injury occurred suddenly or developed over time. At the time of injury, some people experience a sharp pain in the knee, particularly with twisting or bending movements. Swelling may develop over the following hours or days.
Common symptoms include:
- Knee pain, often localised to the inner or outer side of the joint
- Swelling, which may come and go depending on activity levels
- Stiffness, particularly after periods of rest
- Reduced range of motion, making it difficult to fully bend or straighten the knee
- A sensation of clicking or catching within the joint
In some cases, particularly with larger or unstable tears, you may experience:
- Locking, where the knee feels stuck or unable to move fully
- A feeling of the knee giving way or not functioning normally
Symptoms can fluctuate, often worsening with activity and improving with rest. Degenerative tears may present more gradually, with persistent discomfort and swelling rather than a sudden injury.
Risk factors for meniscal tears
Common risk factors include:
- Participation in sport, especially activities involving twisting, pivoting, or sudden changes in direction such as football, netball, basketball, or skiing
- Increasing age, as the meniscus can become more degenerative and less resilient over time
- Previous knee injury, which may alter joint mechanics and increase stress on the meniscus
- Repetitive squatting, kneeling, or heavy lifting, often associated with certain occupations or training routines
- Underlying knee conditions, such as osteoarthritis, which can weaken the cartilage
Additional contributing factors may include:
- Muscle weakness or imbalance, particularly in the quadriceps and surrounding hip muscles
- Poor movement patterns, such as uncontrolled twisting or deep knee loading
- Joint instability, which can place uneven stress on the meniscus
In many cases, meniscal tears develop due to a combination of these factors rather than a single event.
Treatment options for meniscal tears
Management of meniscal tears is guided by your symptoms, the type and location of the tear, and your activity goals. Treatment may be non-surgical or surgical, depending on how the knee is functioning and the nature of the injury. Non-surgical treatment options are often appropriate for smaller or stable tears, particularly when symptoms are manageable.
These may include:
- Activity modification, reducing movements that aggravate the knee
- Physiotherapy, focusing on restoring strength, movement, and joint control
- Pain relief medications and anti-inflammatory treatments
- A structured rehabilitation program to support recovery and function
Some meniscal tears, particularly degenerative tears, may be managed effectively without surgery. If symptoms persist, or if the tear is larger, unstable, or causing mechanical symptoms, surgical treatment may be considered.
This may include:
- Arthroscopic meniscal repair, where the torn meniscus is sutured to allow it to heal
- Partial meniscectomy, where the damaged portion of the meniscus is trimmed while preserving as much healthy tissue as possible
The choice of procedure depends on factors such as the location of the tear, blood supply to the area, and overall knee health. Meniscal repair is generally preferred where appropriate, as preserving the meniscus helps support long-term joint function and load distribution.
When to seek medical advice for meniscal tears
It is important to seek medical advice if you are experiencing persistent knee pain, swelling, or changes in how your knee moves, particularly after a twisting injury or increase in activity.
You may benefit from an assessment if you notice:
- Ongoing knee pain, especially with bending, squatting, or twisting movements
- Swelling that develops after activity or does not settle with rest
- A sensation of clicking, catching, or grinding within the joint
- Reduced range of motion, making it difficult to fully bend or straighten the knee
- Symptoms that are not improving with rest or physiotherapy
It is particularly important to seek review if you experience:
- Locking of the knee, where it becomes stuck or unable to move fully
- A feeling of the knee giving way or not functioning normally
- Difficulty weight-bearing or returning to normal activity
Even if symptoms appear mild, underlying meniscal damage can still affect joint function and long-term knee health. Early assessment can help determine the type and extent of the tear and guide appropriate management.
Dr Scott Tulloch will perform a comprehensive assessment, which may include imaging such as MRI, to evaluate the meniscus and discuss the most appropriate treatment options based on your individual needs.