Meniscus Injuries

A meniscus injury involves damage to one of the two C-shaped pieces of cartilage in the knee that act as shock absorbers between the thigh bone and shin bone. Each knee has a medial meniscus on the inside and a lateral meniscus on the outside. These structures play a critical role in distributing weight, stabilizing the joint, and allowing smooth movement during walking, running, and pivoting. When the meniscus is torn or worn down, the knee loses some of its ability to absorb impact and maintain stability.

Meniscus injuries can vary widely in severity. Some tears are small and cause minimal symptoms, while others are more complex and can significantly disrupt knee function. The location of the tear also matters. Areas of the meniscus with a better blood supply have a greater ability to heal, while tears in areas with limited circulation often do not heal on their own.

What are the symptoms of a meniscus injury?

The symptoms of a meniscus injury depend on the size, type, and location of the tear, but there are several patterns that are commonly seen.

• Pain is usually the first symptom. It is often felt along the joint line – the space between the thigh bone and the shin bone, either on the inside or outside of the knee, depending on which meniscus is involved. The pain may develop suddenly after an injury or gradually over time with wear and tear.
• Swelling is another frequent symptom. It may occur within a few hours of the injury or develop more slowly over the next day. In some cases, swelling is mild and intermittent, especially with smaller tears.
• A catching or locking sensation in the knee. This occurs when a fragment of the torn meniscus interferes with normal joint motion. In more severe cases, the knee may actually become stuck in a bent position and cannot fully straighten.
• Stiffness and a limited range of motion are also common. The knee may feel tight, especially after periods of inactivity or after increased use. Activities such as squatting, kneeling, or twisting may become difficult or painful.
• A feeling of instability or the knee “giving way” can occur, particularly with larger or more complex tears. This symptom reflects the loss of normal joint mechanics and support.

What are the causes of a meniscus injury?

Meniscus injuries typically occur in two primary ways: acute injury or degenerative wear.

• Acute meniscus tears are most often seen in active individuals and athletes. These injuries usually happen during movements that involve twisting or pivoting the knee while the foot is planted. Sudden changes in direction, deep squatting, or direct contact to the knee can place excessive stress on the meniscus. Sports such as soccer, basketball, football, and skiing are common settings for these injuries.
• Degenerative meniscus tears develop over time as the cartilage weakens and becomes less resilient. This type of injury is more common in older adults. Normal daily activities, such as stepping down from a curb or turning while walking, can be enough to cause a tear when the meniscus has already been compromised by age-related changes.

In many cases, degenerative tears occur without a specific injury event. Patients may notice a gradual onset of knee pain, stiffness, or swelling without being able to identify a clear cause.

How is a meniscus tear diagnosed?

Diagnosing a meniscus tear involves a combination of medical history, physical examination, and imaging when needed.

Dr. Faucett will discuss how how symptoms began. A sudden twist or pivot often points to an acute tear, while gradual pain without a clear injury suggests a degenerative tear. Swelling that develops over several hours rather than immediately is common with meniscus injuries.

He will examine the knee testing for pain, swelling, tenderness, and range of motion. Pain along the joint line is a key finding. Limited motion, especially difficulty fully straightening the knee, may indicate a more significant tear. The goal of evaluation is to determine the type of tear, its location, and how it is affecting knee function. This allows for a treatment plan that is tailored to the individual, focusing on restoring stability, reducing pain, and preserving as much of the natural meniscus as possible.

Specific tests such as the McMurray and Thessaly maneuvers are used to reproduce symptoms. Pain, clicking, or catching during these movements increases suspicion for a tear.

X-rays are often obtained first to rule out arthritis or bone-related issues, but they do not show the meniscus. An MRI is the most useful test to confirm a meniscus tear and define its size, location, and pattern.

In many cases, the combination of history and physical exam strongly suggests a meniscus tear. MRI is used to confirm the diagnosis and guide treatment decisions, especially when symptoms are persistent or unclear.

Early recognition of symptoms and an accurate diagnosis are critical. Not all meniscus tears require surgery, but untreated or poorly managed injuries can lead to persistent pain, reduced mobility, and long-term joint damage.

Meniscus injuries are common, but they are not all the same. Understanding the differences in how they occur and present is essential to making informed decisions about care and maintaining long-term knee health.

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Scott C. Faucett MD, MS is a board-certified and fellowship-trained sports medicine orthopaedic surgeon. His goal is helping active people with ankle, hip and knee injuries back to their active lifestyles. Contact him at his DC office to schedule a consultation to receive expert care for the hips, knees and ankles.

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Dr. Scott Faucett

• Internationally Recognized Orthopedic Surgeon
• Voted Washingtonian Top Doctor
• Ivy League Educated & Fellowship-Trained
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