Meniscal Tears

Meniscal tears are a common cause of knee pain. Typically, athletes who play contact sports, are most at risk for meniscal tears. However, anyone at any age can suffer from a torn meniscus. In fact, about one-third of people over 50 will suffer a torn meniscus, with meniscal tears being more common in men than in women. Men are around two and a half to four times more likely than women to develop a torn meniscus.

A meniscus can become damaged after a lone event (acute) or it may gradually break down over a period of time due to aging (degenerative). Acute injuries to the meniscus tend to most frequently occur during sporting activities or while engaged in heavy lifting. Actions that include quickly twisting or turning the foot, while the knee is bent and the foot is firmly planted, frequently lead to tearing of the menisci. Common sports during which pivoting and knee flexion together can lead to meniscal damage include football, soccer, basketball, wrestling, gymnastics, and skiing. For the older population, whose knee joints may be suffering the effects of wear and tear, injury to a meniscus can occur much more easily. This article will help you to understand meniscus tear symptoms and treatment and also the options for meniscus tear treatment without surgery.

So, What Exactly is the Meniscus?

In the anatomy of the leg, the thigh bone (femur) and the shin bone (tibia) meet at the knee joint, where two rounded discs of cartilage, called the menisci, reside. The menisci – plural form of meniscus – are flexible, crescent-shaped bands of thick cartilage that cushion the knee. The meniscus located at the outer edge of the knee is known as the lateral meniscus and the meniscus found at the inner edge of the knee is known as the medial meniscus. The menisci act as shock absorbers, cushioning the impact of the leg bones during weight-bearing activities. Much of the load placed on the inner side of the knee is absorbed by the medial meniscus, while the lateral meniscus bears most of the load that is applied to the outer knee. The menisci are there to protect the knee from the stresses of normal daily activities like walking, running, and climbing.

The severity of a meniscal tear must be diagnosed by your healthcare provider. A tear may be ranked as minor, moderate, or severe, depending on the level of damage. The medial meniscus is more commonly torn than the lateral meniscus. The most usual location of a meniscal tear in the knee is at the posterior horn of the medial meniscus. This posterior horn of the medial meniscus is located in the back, inner side of the knee. This area is not only the usual site for acute tears, but also for degenerative tears of the meniscus, where the meniscal tissue has been worn out – this is one common cause of knee pain seen in runners.

Symptoms of Meniscal Tears

As mentioned above, medial meniscal tears are the more common types of tears when compared to lateral injuries. This is true irrespective of age or type of activity. Pain and swelling are the most highly reported symptoms, and these may occur either immediately after injury or they may gradually develop. A more severe meniscal tear tends to present with popping or locking of the knee and difficulty with straightening the joint/leg. When it comes to a severe tear, symptoms are generally attributed to fragments of torn meniscal tissue that have become lodged within the joint space.

Generally, the presence of the following symptoms indicates the likelihood of a meniscal tear:

• Pain or difficulty with walking or running
• A popping sound from the knee
• Swelling or a tight feeling in the knee
• Buckling and giving way of the knee, potentially leading to falls
• Inability to straighten the knee, due to its locking in place

Diagnosis of Meniscal Tears

A full assessment by a healthcare provider is necessary for the diagnosis of a meniscal tear. When a torn meniscus is suspected, it is imperative that the opinion of a healthcare provider be sought. Delaying diagnosis and treatment of meniscal tears is not recommended, as prompt care can promote proper healing and help you to avoid the long-term impacts of delayed treatment. Your healthcare provider will perform a thorough history and physical examination, which may include diagnostic testing through use of X-ray or Magnetic Resonance Imaging (MRI) technology. The MRI is done to provide non-invasive imaging of the muscles, ligaments, tendons, cartilage, and bones around the knee joint. These steps will help the healthcare professional to determine an accurate diagnosis and to come up with a personalized treatment plan and whether meniscus tear treatment without surgery is possible.

Treatment of Meniscal Tears

Here at New York Dynamic Neuromuscular Rehabilitation, we are prepared with the educated staff and modern technology that will help you to reach a goal of a full recovery from your torn meniscus. Once you have been diagnosed with having a meniscal tear, non-operative or operative approaches can be considered. While some severe tears may require surgery, meniscus tear treatment without surgery has been found to be quite effective for less severe injuries. Our non-operative methods include, gait (walking) retraining , computer assisted rehabilitation environment (C.A.R.E.N), vibration therapy, gravity reduced treadmill (AlterG), and extracorporeal shockwave therapy (ESWT). Please use the available links to learn more about our treatment methods.

Treatment for medial meniscus tear injuries may begin with following the RICE method. RICE is the acronym for Rest, Ice, Compression, Elevation and is best utilized in the first 72 hours after injury. During this period in time, over the counter anti-inflammatory medications, like Ibuprofen, may be used as needed for pain relief. Once the initial inflammation has subsided, our Physical Therapists will work with you to develop a plan of exercises to strengthen the leg muscles both at home and in our center. At this time, avoidance strategies will also be introduced to decrease the amount of harmful movements of the affected knee. Conservative treatment with the use of meniscus tear treatment exercises is generally sufficient for the healing of minor tears and for proper knee function to be restored.

Posterior horn medial meniscus tear treatment will be geared towards the goal of rehabilitation, with a return of normal strength and range of motion to your knee. During the rehabilitative period, crutches or a knee brace may temporarily be prescribed as a part of the medial meniscus posterior horn tear treatment. Our skilled professionals at NY Dynamic Neuromuscular Rehabilitation are here to assist you with any questions you may have regarding torn meniscus treatment

Here at New York Dynamic Neuromuscular Rehabilitation, we strive to offer the most advanced and comprehensive treatment for medial meniscus tear injuries. Knowing that every patient is different, we make sure that the meniscus tear symptoms and treatments are unique to each individual case. Call us today to schedule an appointment.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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