What the meniscus does
Each knee has two menisci: the medial meniscus on the inner side and the lateral meniscus on the outer side. They sit between the thigh bone and the shin bone, spread the load across the joint, absorb shock and help the knee move smoothly and stay stable.
Only the outer part of the meniscus has a good blood supply. Tears in this outer zone can heal or be repaired, while tears in the inner part heal poorly.
Symptoms of a meniscus tear
- Pain along the inner or outer joint line, especially when twisting or squatting.
- Swelling and stiffness that develop over 24 to 48 hours; see joint effusion.
- Catching, clicking or a feeling that something is in the way.
- Locking: the knee gets stuck and cannot fully straighten.
- A feeling of the knee giving way.
- Difficulty kneeling, squatting or going down stairs.
Medial and lateral meniscus tears
Medial meniscus tears are more common, because the medial meniscus is more firmly attached and moves less. They cause pain on the inner side of the knee and are typical of degenerative tears.
Lateral meniscus tears cause pain on the outer side of the knee. They are often linked to sports injuries and happen together with anterior cruciate ligament tears. Tears are also described by shape, such as radial, horizontal, flap or bucket-handle; a bucket-handle tear is the one most likely to lock the knee.
How meniscus tears happen
- Acute tears: twisting or pivoting on a bent knee with the foot planted, often in football, basketball or skiing, sometimes with a pop.
- Deep squatting or kneeling while lifting heavy loads.
- Degenerative tears: from about age 40, the meniscus becomes weaker and can tear with minor movements, such as getting up from a squat.
- Degenerative tears often occur together with early knee arthritis and are commonly found on scans of people with no symptoms.
How it is diagnosed
A doctor or physiotherapist asks how the injury happened and examines the knee for joint line tenderness, swelling, range of movement and specific meniscus tests. They also check the ligaments, as combined injuries are common.
An MRI scan shows the meniscus well. It is useful when surgery is being considered, in young people after a significant injury, or when the knee locks. X-rays are used in older adults to look for arthritis.
Physiotherapy and exercise therapy
- Reducing swelling and pain with relative rest, ice, compression and elevation in the first days.
- Restoring full knee straightening and bending.
- Strengthening the quadriceps, hamstrings and hip muscles.
- Balance and control exercises to protect the knee during movement.
- Gradual return to running, jumping and twisting sports.
For degenerative tears, a structured exercise programme of around 8 to 12 weeks gives results similar to arthroscopic surgery for most people. See ice or heat for knee pain and KT tape for the knee.
When surgery is needed
- A knee that is locked and cannot fully straighten, as with a bucket-handle tear.
- A tear in the outer, well-supplied zone in a young, active person, which can often be repaired.
- Combined injuries, such as a meniscus tear with an ACL tear.
- Persistent mechanical symptoms after a good course of rehabilitation.
Surgeons try to preserve as much meniscus as possible, because removing it increases the risk of arthritis later. Options are repair with stitches or partial meniscectomy, which trims the damaged part.
Recovery time
- Non-surgical treatment: many people improve over 6 to 12 weeks.
- Partial meniscectomy: walking within days and return to sport in about 4 to 6 weeks.
- Meniscus repair: crutches and a brace for several weeks, with return to sport after 3 to 6 months.
Knee cartilage problems can occur together with meniscus tears; see knee cartilage damage.
Key points to remember
- Meniscus tears cause joint line pain, swelling and sometimes catching or locking.
- Acute tears follow twisting injuries; degenerative tears develop with age.
- Most degenerative tears are treated with exercise therapy first.
- A locked knee or a repairable tear in a young person may need surgery.
Questions about meniscus tears
These answers are general information and do not replace an examination or individual medical advice.
Can a meniscus tear heal on its own?
Small tears in the outer part can heal, and many other tears stop causing symptoms with exercise therapy, even if they remain on a scan.
Can you walk with a torn meniscus?
Usually yes, although it may be painful and the knee may swell. A locked knee needs prompt assessment.
What does a lateral meniscus tear feel like?
Pain on the outer side of the knee, swelling and discomfort when twisting or squatting, sometimes with clicking.
Is walking good for a torn meniscus?
Walking within comfort is generally fine and helps keep the knee moving. Avoid deep squats and twisting at first.
Will a torn meniscus cause arthritis?
Meniscus tears and removing meniscus tissue increase the long-term risk, which is why preserving it is preferred.
How long does a meniscus tear take to heal without surgery?
Many people improve within 6 to 12 weeks with a structured programme.
Sources
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.