How Meniscus Tears Affect an Athlete’s Performance

Acting as a shock-absorber between the femur and tibia in the knee joint, the meniscus is a C-shaped fibrocartilage that is composed of the anterior horn, the posterior horn and the body.

The meniscus is an important structure in the knee joint; it is responsible for shock absorption, providing stability to the joint, facilitating load sharing and transmission and lubricating the articular cartilage.

Most athletes engaged in contact sports such as football or rugby are familiar with meniscal injuries; any direct impact such as a hard tackle by an opponent or sudden movements involving quick twists/turns of the knee can potentially cause micro or major tears in the meniscus.

A meniscal tear could occur in either the medial or lateral meniscus.

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The medial meniscus is crescent-shaped and located on the inside of the knee. It is attached to the medial collateral ligament, making it more prone to injury; cartilage injuries are usually associated with injuries to the ligaments surrounding the knee. 

The lateral meniscus is more circular in shape and found in the outer region of the knee where it covers more tibial articular surface than the medial meniscus.

Meniscal tears are classified on the basis of their location and tear patterns; some of the more common ones are bucket-handle, radial, vertical longitudinal and flap.

In case more than one tear pattern exists, it is considered to be a complex tear.

The cartilage in the meniscus can also weaken over time, thinning out as the years progress. This sort of gradual degeneration places older patients at a greater risk of developing this condition.

In some cases, patients complain of the knee “giving way” or the knee getting locked in a particular position for a long time.

An athlete with a meniscal injury would find it difficult to perform any side weight-bearing movements such as squats or side lunges.

A physical examination is performed in conjunction with diagnostic tests to determine the extent of injury and to devise an appropriate treatment plan. This includes gathering information on the history of injury, checking for joint line tenderness and performing the McMurray test.

Radiographs are useful in detecting fractures, osteochondral injuries, or any intra-articular loose body.

Magnetic Resonance Imaging (MRI) is the preferred radiographic procedure of choice because of its high accuracy rate in identifying meniscal tears.

With a diagnosis in place, a treatment modality must be developed in conformity with the severity of injury; for smaller tears with a stable knee, nonsurgical treatment in the form of avoiding activities that could further injure the knee, application of ice packs wrapped in towels on the site of injury and wearing elastic compression bandages to prevent swelling, can be undertaken.

The inclusion of a customised orthotic intervention such as MASS4D® in an active rehabilitation programme would benefit the patient in the long-term as a means of preventing re-injuries; this is achieved by supporting the foot in its optimal posture, thereby facilitating the correct re-alignment of ligaments, muscles and joints in the leg and the whole body.

This ensures that less stress is imposed on the affected knee, whilst giving the torn meniscus sufficient time to heal and enabling the athlete to return back to the field.

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References:

1. Timothy Brindle, John Nyland, Darren L. Johnson (2001) The Meniscus: Review of Basic Principles With Application to Surgery and Rehabilitation. Journal of Athletic Training: April/June 2001, Vol. 36, No. 2, pp. 160-169
2. Fan R.S.P., Ryu R.K.N., Meniscal Lesions: Diagnosis and Treatment. MedGenMed 2(2), 2000 [formerly published in Medscape Orthopaedics & Sports Medicine eJournal 4(2), 2000]. Available at: http://www.medscape.com/viewarticle/408520
3. Richard Howell, Neil S. Kumar, Nimit Patel, James Tom (2014) Degenerative meniscus: Pathogenesis, diagnosis, and treatment options. World Journal of Orthopedics: November 18, 2014, Vol. 5, No. 5, pp. 597-602

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