What is a Meniscus Injury?

A meniscus injury is one of the most common knee problems, affecting people of all ages, from weekend warriors to professional athletes. The meniscus is a piece of cartilage that acts as a cushion between your thigh bone (femur) and shin bone (tibia). It helps absorb shock, stabilise the knee joint, and distribute weight evenly when you move.

Meniscus injuries usually occur when you twist or pivot suddenly. Alternatively, if your knee over bends suddenly, this can often compress and damage the meniscus at the back of your knee. Whereas if the knee hyper extends or straightens suddenly, the meniscus at the front of your knee becomes compressed and possibly damanged. The mechanisms of injury can occur during sports like soccer, netball, or skiing. However, they can also develop gradually due to wear and tear, particularly as we age.

Signs and Symptoms

If you’ve hurt your meniscus, you may experience:

How is a Meniscus Injury Diagnosed?

A physiotherapist can often diagnose a meniscus injury based on your mechanism of injury, symptoms and a series of clinical tests. These may involve bending, straightening, and rotating your knee to see if it reproduces your pain. In some cases, an MRI may be needed to confirm the diagnosis and assess the severity of the tear.

Can a Meniscus Heal on Its Own?

It depends on where the tear is located. The outer third of the meniscus has a good blood supply, meaning it has a better chance of healing naturally. However, the inner two-thirds have limited blood flow, making it harder for the body to repair the damage. Even if the tear doesn’t fully heal, many people can manage their symptoms effectively with physiotherapy and avoid surgery altogether.

Physiotherapy Treatment for Meniscus Injuries

1. Reducing Pain and Swelling

In the early stages, managing pain and inflammation is a priority. This may involve:

2. Restoring Knee Movement

A stiff knee can make daily activities difficult. Gentle exercises and hands-on therapy help restore flexibility and prevent long-term movement restrictions. This should be replicated at home with a home exercise program that is taught by your physiotherapist.

3. Strengthening the Knee

This is where physiotherapy makes the biggest impact. Strengthening the muscles around the knee, particularly the quadriceps and hamstrings, provides better support and stability to the joint. Below is an example of a structured 16-week strength program:

Weeks 1-4: Foundation Phase (Bodyweight and Low Resistance)

Weeks 5-8: Progression Phase (Introducing Resistance)

Weeks 9-12: Strength Phase (Moderate to Heavy Resistance Training)

Weeks 13-16: Advanced Strength & Plyometrics Phase

Leg Press
Leg Press

4. Improving Proprioception and Stability

Your knee relies on tiny receptors to sense movement and position. After a meniscus injury, these receptors can be affected, increasing the risk of re-injury. Balance exercises, such as single-leg stands and wobble board drills, help retrain these receptors.

5. Gradual Return to Sport or Activity

Once strength and stability improve, we gradually reintroduce sport-specific movements to ensure you can return safely without risking further injury. For instance, if you played soccer, we would get you on a soccer pitch and attempt to create various drills that mimic a game of soccer to best prepare you before returning to training with your team.

Case Study: How Strength Training Kept the Knee Stable

A recent patient at our clinic, 42-year-old Peter, came in with persistent knee pain after a hiking trip. An MRI showed a degenerative meniscus tear. Initially, Peter struggled with pain and swelling, making it difficult to squat or climb stairs. He was worried that surgery was the only option.

With a structured physiotherapy program, Peter saw gradual improvements. We focused on:

After three months of consistent rehab, Peter noticed a huge improvement. He was able to return to hiking with minimal discomfort. However, the biggest game-changer was introducing strength training at our gym. Peter now trains regularly, and he’s found that keeping up with his strength program is the only thing keeping his knee symptoms stable. Without it, his pain starts creeping back.

Meniscus
Meniscus

Do You Need Surgery for a Meniscus Tear?

Surgery isn’t always necessary. In fact, research suggests that many people with meniscus injuries recover just as well with physiotherapy compared to surgery (Katz et al., 2013). Surgery may be needed if:

For most people, strengthening the knee and managing symptoms conservatively leads to great long-term outcomes.

Key Takeaways

If you’re struggling with knee pain and suspect a meniscus injury, book an appointment with our physiotherapists today. We can assess your condition and create a personalised rehab plan to get you back to doing what you love! Give us a call at XPhysio on (02) 9806 3077.

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