Degenerative Meniscal Tear
What is a Degenerative Meniscal Tear?
In answering this question we should probably start by posing another question; what is a meniscus?
If this sentence sounds familiar to you, you have probably already read the section on Meniscal Tears. If you have, you can skip down a few paragraphs to the asterisk (*). Don’t stop reading though; there be gold in these pages!
A meniscus (singular) is a type of cartilage that exists within your knee joint. As with most joints in the body the knee has cartilage within its structure. Unlike most this takes two different forms. As well as the common smooth type of cartilage that is seen in most joints and is attached to the ends of the bones (articular cartilage), we also have a more fibrous type of cartilage, one on each side of the knee, that we call menisci (pleural). The one on the inside of your knee is the medial one; on the outside is our lateral.
As with all aspects of the body these are affected by age, not just old age, but simply the process of getting older. Up to our twenties the menisci are often healthy, with a good blood supply. At this stage in life if you are to tear your menisci you would expect to do this with a reasonable amount of force; a loaded, twisting movement. It is not uncommon that these are sustained during sporting activity such as football, hockey or skiing.
As we move through our 30’s, 40’s and 50’s we tend to find that our menisci can be somewhat more worn, but still remain well functioning and pain free. However we do sometimes see that increasingly small amounts of force are needed to elicit a tear.
* Degenerative meniscal tears are different from purely traumatic meniscal tears due to the reason why they exist. Degenerative meniscal tears exist because the degenerative process has led them to tear. This can sometimes be helped along by trauma, but this is trauma through an already tired meniscus. 50% of people over 50 years old have meniscal tear. Most of which will not even know it.
What are the symptoms of degenerative meniscal tear?
Symptoms of degenerative meniscal tear can include:
- Pain, often localized to a specific aspect of the joint. This can often be characterized as sharp and catching, made worse with twisting and turn manoeuvres.
- Recurrent joint swelling
- Giving associated with pain.
These symptoms can start with very little in the way of provocation. They can be due to incidents leading to a twisting of the knee but it is not uncommon to see onset of symptoms when the force involved is not too great.
What can I do for myself?
In treating a degenerative joint it is absolutely key that you pay particular attention to the features of life that maintain good joint health. The piece here explains how best to help yourself. It is also key to manage your activity levels appropriately. Degenerative joints don’t tend to like big surprises so planning activity is important. You should:
- Maintain a level of regular activity to maintain good joint function.
- Plan increases in activity methodically. For example if you are planning a walking holiday, make sure that you have walked the distances you intend to cover before hand. If not train yourself.
Of cause this is not going to be helpful if you are currently in considerable pain and need help quickly. In this case the information below might be of help.
Early Management - You should treat your knee using the acute soft tissue advice here. When you have undertaken the acute soft tissue treatment you should try to regain your range of motion, the ability to full straighten and fully bend your knee, while maintaining as much muscle function as possible. These exercises may be of help. It would be fair to suggest that early good quality injury management means that you should improve as quickly as possible. This is a service we are able to offer.
Recovery phase – Once you have noticed your knee starting to feel somewhat easier with the early management it is a good idea to start to think about recovery:
- Regaining full flexibility
- Regaining full strength
- Returning to previous levels of activity
As well as these flexibility exercises, you should also start to work your muscles. These simple exercises may be of use at the beginning.
Once you start this journey how far you continue depends on what you wish to get back to doing. If you have a specific sport or hobby that you wish to return to then gaining the help of a rehabilitation specialist would be advised. This is something we would be able to help you with.
What other treatments are available?
A physiotherapy session with one of our knee specialists at Cycloform Physiotherapy will include a bespoke assessment, diagnosis and then identification of your treatment needs. This may include
- Manual therapy (manipulation),
- Strength and conditioning exercise.
- Advice. You will be able to draw on our experts many years of treatment experience to help you regain control of your symptoms.
We are aware that people can read pages on the internet as much as they like, but there is nothing quite so reassuring as a specialist diagnosis and treatment plan. If you need our help you can book here.
Corticosteroid is a very effective anti-inflammatory. In an acute flare up of a degenerative meniscal tear it is sometimes helpful to treat the inflammation within the joint. This is delivered directly into the knee joint.
It can also however sometimes be ineffective. Whether this is something that could be of benefit is usually decided based upon a number of interacting factors. A specialist best undertakes this.
These injections and the evaluation of your potential for benefit can be undertaken by our knee specialists here at Cycloform Physiotherapy. To find more information about booking click here.
In some situations people may respond well to arthroscopy (key hole operation) of the knee joint. A surgeon can take away the unstable meniscal tear, which will hopefully lead to an improvement in symptoms.
In degenerative presentations such as this whether or not you would benefit from arthroscopy can sometimes be exceptionally complicated decision. People can be stuck in a situation where their healthcare practitioner is cautious and avoids suggesting surgery, thus delaying a helpful treatment. Or they can be given surgery, which is not as effective as they wish without a simple low risk strategy that might alleviate symptoms being undertaken first.
At Cycloform Physiotherapy our knee specialists have many years of experience of working along side specialist knee surgeons here in York. Our excellent working relationships based on years of mutual respect and many hours working closely in clinics together mean we are well placed to be able to give you help with making a decision. Week in week out we help people through this decision while possessing the expert skills to undertake conservative treatment that is require.