Meniscus Tear:

As we all get older, knee problems are almost inevitable for many of us. There are some kinds of knee injuries that are harder to overcome than others and as your body ages it doesn't recover as well as it once did. I recently got a big scare thrown into my life when my knee suddenly started hurting and feeling very tender when it was fully stretched. I have played tennis, basketball, and golf for the last 20 years and never even had a knee ache before so I naturally assumed something else must have caused it. I have a 3 year old son and I first noticed the pain when I would kneel on the floor to play with him. At first, the area just below my left kneecap and to the left felt sore and so I tried to avoid putting any pressure on it. Then, after a few more days went by, I realized that just pulling my knee upwards to put on pants or pajamas was pretty painful. I knew I had to go to the doctor and get a professional opinion and diagnosis.

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The doctor immediately told me I had probably tore my meniscus and he would know more once he did some basic movement tests on my knee. Sure enough, I had torn the meniscus in my left knee and at least it appeared to be minimal damage. He told me we could do an MRI to see how bad the damage was, but first let's do some treatment exercises to try and see if it will heal a bit on it's own. The problem when you tear your meniscus is that is doesn't heal very well. If you are a professional athlete they go into your knee via athroscopic surgery and trim off the tear so that the irritation is gone. Sometimes, with basic exercise like riding a bike or swimming, the bone in your knee will grind down the torn meniscus and eliminate the pain as well. That was my decision, to do some simple exercises over a month and then check back with the doctor. The pain stuck around for a while but I must say the knee did feel better after some time and although it is not pain free, I can once again kneel on the ground and bend my knee to put on pants. I continue to play tennis and golf without bother, so perhaps I am one of the lucky few that will not need a surgery. What is the meniscus and what is its function within the knee? How do you know that you have a tear of your meniscus? The meniscus sits between your tibia and femur bones in your leg where the knee is. The meniscus is made out of cartilage and protects the knee joint. If there is damage to the menisci, you could see longer term effects like arthritis in the knee joint. The meniscus is C-shaped and can tear in several different places which can cause a variety of symptoms. Most people suffer from swelling and pain around the knee as well as severe tenderness when you put pressure on the meniscus. I found this one out when I would kneel and flex my knee and then I could feel a tremendous amount of tenderness from the meniscus. A more severe symptom could be locking of the knee joint which dramatically limits your range of motion.

Do you need surgery?:

The severity of the meniscus tear really dictates if you will need surgery. Another factor is, what do you do for a living. Professional athletes almost always get minor surgery to repair a torn meniscus and it's a fairly routine operation. That way they can get healed and back on the court or field in no time. For the 'average joe', getting a surgery and potentially having to cover the cost yourself is not worth it unless the tear is really bad. Much like my situation, there are some alternatives to surgery that you can try first before going under the knife. I would have had surgery had my knee not gotten better on its own. To not be able to kneel down or get down on the floor with my kids would have ruined it for me. The weird part was that I could play tennis or run and not feel any pain at all, during or after the exercise. It was only when I went to bend the knee all the way could I really feel the tenderness and pain. My only hopes are that I don't reinjure it playing sports in the future, but my gut feeling tells me that once it's been torn it could tear again because it has been weakened. Surgery can run about $4000, unless your insurance covers it. It's an outpatient procedure with local anethesia given or in some cases an epidural is administered to numb the legs so the surgeon can perform the surgery. Only a certified knee doctor (orthopaedic) can give you a proper diagnosis and often they need to do an MRI to see the extend of the injury before making an educated decision on surgery. You can start with your general practitioner but eventually you will get referred to an orthopaedic since they are the specialist.

Healing a meniscus tear:

The problem with healing your torn meniscus is that blood flow to this cartilage area is not very good and often the region will not heal even with time. There are some basic exercises that I mentioned above that could help "break down" the area that has torn, but that is no guarantee. Often, the pain is not that bad so people live somewhat normal lives. I was totally surprised to find that I feel on pain whatsoever when I play tennis, basketball, or golf so that is the good news. My bigger concern is long term athritis in my knee joint considering I'm only 37 years old and would like to stay active into my 70's and 80'. The other option is surgery which is broken into two categories. Repairing the meniscus is a surgery that requires a long recovery and isn't right for everyone. The long term results for the knee are better with a meniscus repair compared to a meniscectomy. Doctors perform meniscectomies much more often and they essentially remove the section that has been torn off the meniscus. Recovery is rather rapid which is what most patients like to hear. Repair and rehab options vary from patient to patient, so ask your doctor where you fall into the spectrum.

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