Symptoms
- ■ Pain along the inner or outer knee joint line, often sharp and specific to palpation
- ■ Swelling that develops gradually (hours) after injury, unlike the immediate swelling of ACL tears
- ■ Clicking, locking, or giving-way sensation within the knee joint
- ■ Difficulty fully extending or flexing the knee, often painful at end range
- ■ Increased pain when squatting, twisting, or climbing stairs
Causes
- ■ Sudden twisting or pivoting of the knee during sport with foot planted on the ground
- ■ Deep squatting with combined loading and rotation in occupational or sporting contexts
- ■ Degenerative tearing from accumulated wear in patients over 40 years without acute trauma
- ■ Contact injury to the side of the knee during collision sports
- ■ Hyperflexion or hyperextension forces applied to the knee
Diagnosis
- ■ McMurray Test and Thessaly Test for meniscal tear provocation
- ■ Joint line palpation to locate medial or lateral meniscal tenderness
- ■ Knee range of motion and functional squat assessment
- ■ MRI of the knee: gold standard for characterizing tear pattern, location, and severity
* Evidence-Based Interventions
Clinical
Approaches
Swelling Control & Range Restoration
Ice, compression, elevation, and gentle flexion/extension mobilization in the early phase.
Quadriceps Activation
Quad sets, SLR, and mini-squats to rebuild protective muscle function around the joint.
Neuromuscular Training
Single-leg balance and proprioceptive drills to restore joint stability and dynamic control.
Progressive Return-to-Sport Loading
Jogging, running, cutting, and sport-specific drills with objective return criteria.
🏠 Home Exercises Guide
Strengthen your recovery. Perform these exercises strictly under pain-free limits:
📋 Execution Blueprint: Quad Sets and Short Arc Quads
- 1Lie flat on your back with the affected leg straight and a rolled towel under the knee.
- 2Tighten the quadriceps muscle firmly and press the back of the knee into the towel.
- 3Lift the heel 6 inches off the floor, maintaining the contraction at the top.
- 4Hold for 3 seconds, then lower slowly.
- 5Perform 15 repetitions three times daily to safely rebuild quadriceps strength.
* FAQs
Common Questions
No. Over 50% of meniscus tears, particularly degenerative tears in older patients and horizontal or partial tears in younger patients, can be successfully treated with conservative physiotherapy without surgery.
After partial meniscectomy (removal), most patients walk without aids in 1-2 weeks and return to sport in 6-8 weeks. Meniscal repair (stitching) requires 4-6 months due to the avascular nature of the inner meniscus.
Low-impact exercise (swimming, cycling) is generally safe. High-impact, pivoting, or deep squatting activities should be avoided until assessed. Physiotherapy guides a safe activity modification plan.
A locked knee occurs when a torn fragment of meniscus flips into the joint, mechanically blocking full extension. This is a surgical emergency requiring prompt arthroscopic intervention.
Meniscus tears typically cause joint line pain and swelling over hours. ACL ligament tears cause immediate massive swelling (hemarthrosis) and instability. Both can coexist in the same injury.
Significant meniscal loss (after total meniscectomy) does increase the risk of knee osteoarthritis over time. However, preserving as much meniscus as possible through repair or conservative management and building muscle protection significantly reduces this risk.
Return-to-sport criteria include: full knee range of motion, quadriceps strength within 90% of the unaffected side, single-leg hop test symmetry, and sport-specific movement competency. This typically takes 3-6 months depending on surgery.
Medial meniscus tears cause pain on the inner (medial) knee joint line; lateral tears cause pain on the outer (lateral) knee. McMurray test and Thessaly test provoke pain specific to the torn side.
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Verified Author Protocol
Dr. Karolin Rockson, PT (BPT), Ex. CMC - Vellore
Board: Indian Association of Physiotherapists (IAP)
Reg No: PT-84729