Meniscus Injury Information

What is a Meniscus and What Causes it to Hurt?

The meniscus is important tissue in your knee that sit on the ends of both the thigh bone and shin bone of your leg. They act as bumpers, shock absorbers and as wear pads to prevent the two bones from damaging each other as your knee moves under your weight. The meniscus is living tissue. There are actually two separate pieces called the medial meniscus and lateral meniscus but we will treat them as one here. It doesn't matter which or if both are damaged, the result is still the same - debilitating pain. Meniscus is made of cartilage which is probably one of the toughest tissues your body makes. In order to understand how the healing of a meniscus happens, it helps to understand a bit more about the knee.

That space between the bones of your knee is a harsh environment. Your body seals off the harshest area in a capsule, your knee capsule or synovial capsule, to contain the space for its special needs. There is no blood in the knee capsule, blood would get destroyed in that environment. Instead, your body produces Synovial Fluid in that space to take the place of blood.

Synovial fluid carries oxygen and nutrients, and everything the living parts of your body need in the knee joint. It also removes waste and damage from the cells. Synovial fluid replaces the roll of blood in your knee and much more. It also plays a key roll in lubricating the joint to minimize wear and tear. And, it works as a kind of hydraulic shock absorber in your knee so the meniscus cartilage doesn't have to take all the abuse.

When your knee compresses and expands under the weight of your body the synovial fluid gets squeezed in and out of the area. To some degree, the surrounding tissue, gives away and to some degree the Synovial Fluid gets pushed into a special sac called a bursa. As you put weight on and off your knee, the synovial fluid pumps in and out of your knee a tiny bit, back and forth between the bursa and the knee capsule. The result is that it acts as a liquid shock absorber for your knee. This pumping action also causes the synovial fluid to flow through your knee so it can do the delivery work of the blood that isn't there. Synovial Fluid actually moves around in your joint as a function of your movement.

When your body detects an issue in your knee such as meniscus or ligament damage, it increases the production of synovial fluid. This provides more lubrication, more shock absorption, and more nutrition to protect and help heal the damaged tissue.

If the injury lasts for a very long time, the constant production of extra synovial fluid may end up with your bursa getting stretched. This is typical when you have only minor damage to the meniscus. When the initial meniscus injury is small, you don't notice it and don't rest your knee as a result, and the injury doesn't heal.

When any inner knee injury last for a very long time, it is common for the bursa to swell from all the extra fluid produced. That bursa is in the back of the knee, and when it swells it is referred to as a Bakers Cyst. A Bakers Cyst can be painful, but it is not bad in that it is a big reservoir of good synovial fluid for your knee to use.

Most meniscus injuries though, are more noticeable, and so painful that you don't drive through the pain long enough for a Bakers cyst to form.

Driving through the pain is the number 1 issue people have with healing meniscus injuries. Your knee is perfectly capable of healing itself, but giving it the rest it needs is very disruptive to our regular routines. Rest is the most important element of dealing with any meniscus issue.

What Causes a Meniscus Tear and Why Doesn't it Heal?

A lot of people with a meniscus injury know what caused it. Bad luck is the true answer. At some point you might recall moving a certain way, or doing a sudden motion, that caused a sudden shot of extreme pain in your knee joint. That was likely the moment. It may have been something you had done many times before, but for some reason, that one time, something went wrong. It's not your fault. It happens to so many people. As bad as it is, in these cases, the good news is that once you heal your injury completely, you are unlikely to be plagued by the issue again.

Sometimes though, we might not remember any particular event that caused the meniscus to tear. It is possible that it was a one time event but not enough that you noticed at the time. Since then though, your constant level of activity has caused the injury to get worse. It's hard to start a meniscus tear, but once it starts, it's vulnerable to tearing more with a little less strain. In these cases, people notice the pain intermittently at first, perhaps during an activity they do regularly. In other cases, they never notice until the Baker Cyst forms. Regardless, it probably isn't the case that the activity you are doing when you notice it now was what caused it in the first place. The first instance was probably just the bad luck, a one time event. But now that it's injured, the damage is likely getting worse during that regular activity where you feel the pain. So, this means you need to go easy on that activity for a while and others like it.

Another way you may have damaged your meniscus is through something called Isometric Strain. This is different than injuries that we discussed above that happen when you did something harsh. Isometric Strain is a method of hurting your knee when you aren't moving at all. This kind of injury happens when you keep your knee locked in a certain position for a long period of time. It may be locked straight, or bent, or maybe with a twist. But if you keep your knee pressed into any one position for an extended period of time, that tissue being squeezed can get damaged. Remember the synovial fluid shock absorber? Well, if you keep enough pressure in one place for long enough, the synovial fluid gets pushed out of place until there's nothing between the different tissues. After a while, the meniscus gets squeezed too. That meniscus tissue which is your knee padding, gets squished like a sponge, and with no lubricant or fluid buffer it's prone to damage. Then, if you move suddenly, maybe not even with a lot of effort, a tear is much more likely.

Isometric Strain happens more often than you realize. It's what happens to people who stand in one place for a long time with one or both knees 'locked'. Or think about crossing your legs for a long time when sitting - that torque on your knee is severe. Some people cross their ankles when they sleep. Doing so causes the knee of the top leg to hyper-extend for hours possibly, constantly pressing on one part of the meniscus. There are things that we do, that maybe you haven't thought about that cause isometric strain in different parts of your body. If you are unsure what caused your injury, think about this possibility as well. If this is the culprit then you may need to correct that habit, or you risk causing the injury over and over again. You will need to stop it for some time to at least let your torn meniscus heal.

Regardless of how your meniscus injury started, you need to go easy on your knee to let it heal. Once it's injured you may feel pain during lots of activities that would not have otherwise bothered your knee. If you feel pain doing any activity, that is a sign that your actions are tearing your meniscus further and you need to stop right away. Don't drive through the pain of a meniscus injury. Never.

What Doesn't Cause a Torn Meniscus?

Over use or Repetitive Strain. It's not the cause. It may be why you're not healing now, but it didn't start the problem. Your knee is designed to move. It's designed to take the regular abuse of walking and running and various exercise. That's not even abuse, that's just use.

Once the meniscus is torn, regular activity can keep retearing it, but regular activity won't likely hurt it in the first place. There are a few people who can go too far though... Still, when you do too much activity for you knee for a long time, it shows up as osteoarthritis, not a meniscus tear. If you have a diagnosis of arthritis and a meniscus tear, then you probably are doing too much for your knee regularly and you had bad luck one day.

If you have a torn meniscus, there is no reason you cannot have a very active lifestyle again one day. Just do what you need to do to heal your injury properly. Remember, though, once the pain goes away, you are not fully healed. When the pain goes away your meniscus is probably only 30% healed. So, however long it took to get rid of the pain, go twice that long with your treatment plan, and going easy on your knee. Most people need to go easy on their knee for several months after the pain is gone so the meniscus can heal completely.

What Else Can Make You More Prone to a Torn Meniscus?

• Antibiotics - Many Antibiotics will penetrate into the synovial space. That's good if you have an infection in your joint that the drugs need to treat. But antibiotics for other issues can also penetrate your knee and depending on the drug, it may put your joints at risk.
• Steroid Injections - These are commonly given to relieve pain in knees. It will often help the pain but they do nothing to heal the meniscus. In many, many cases, steroid injections lead to further meniscus damage and a much worse long term outcome. Never get steroid injections in your knee.
• Isometric Strain - You know about this now, so keep aware of it. Staying at 'rest' for a long time in any position other than a sitting position with your feet on the floor may cause damage you weren't expecting. People's sleeping positions are often silent contributors to isometric strain.
• Prior Injury - Once the pain goes away, you are not fully healed! The meniscus heals very slowly. Honestly, if it has been less than 2 years since you've had pain your meniscus can still be getting stronger even in the best cases. If it has only been a matter of months, you are still very vulnerable
• Orthotics - Orthotics are often sold to unsuspecting people as solutions to other issues. It's really just marketing. Orthotics do little to nothing to really help people with foot and leg issues. What people don't realize is that orthotics change your gait and when you do that, it can put unbalanced strain on other parts of your body. Many people buy orthotics for a foot issue only to develop other foot or knee issues as a result.

What You Should NOT Do With a Torn Meniscus?

The internet is full of bad advice about treating your knee. Here's a short list though: Don't use a tight band on your knee. Never get a Steroid injection. Draining a Bakers Cyst doesn't solve the underlying problem. Anti-inflammatories don't help - it's not that kind of swelling. Pain killers will probably make it worse. Driving through the pain will just make it worse.

What You Should Do when you have a Torn Meniscus

REST. For a little while - not forever - it is really helpful to give your knee a rest. In many cases, resting your knee for a few weeks will give it time to heal to a point that your body gets ahead of the healing / reinjury cycle. It's important to realize that once the pain goes away, your underlying injury may not be healed completely so take it easy and go back to regular life gradually once the pain and swelling are gone. If you want to be more proactive about healing the problem, you can click here to visit the Recommended Treatments page.

Rest & Use Conservative Treatments

If you want your meniscus tear to go away as quickly as possible, you need to rest the affected knee. Avoid any physical activities that could cause further injury to your knee. If your meniscus tear hurts during any activity, do your best to avoid the activity - at least for a little while. Consider using crutches to keep the weight off your injured knee and avoid re-injury.

Do regular ColdCure^® treatments to control the pain and swelling for 20-30 minutes at a time. The compression during each treatment helps gently move the synovial fluid back into your knee from the bursa sac.

You can also focus on healing your underlying knee injury with regular BFST^® treatments. This combination will work to finally move your healing process forward as quickly as possible.

Around the 4-6 week mark you can start doing some light stretching and strengthening exercises. Slowly work your way back to your regular level of activity. Continue doing BFST^® treatments long after the pain (and lump if you have one) disappear to maintain the healing you've done. Do a ColdCure^® treatment if you experience any flare-ups of pain and swelling and after any significant activity.

When to do Physiotherapy

Physiotherapists and doctors recommend stretching and strengthening exercises because it helps to promote blood flow through your injured knee. Remember, it's the motion in our knee that causes the synovial fluid to circulate. When we are injured though, we need to reduce our activity, and that leads to a weakening of the muscles called Atrophy. In the early days of recovery, it is only the motion that we need to pump the joint. We don't need to bear a lot of weight on the knee. Really, as long as you don't feel pain, whatever activity you are doing is probably okay. So in the early days of recovering, the early days of PT, the key is motion, not exercise.

Physiotherapy is also intended to help strengthen the surrounding muscles to rebuild that lost muscle once you are on the mend. But, it can be harmful if heavy stretching and exercises are started too early. Your injury first needs to stabilize, and in order to stabilize the injury you need to rest. If you still have significant injury, any physio you do should start off very light.

Our advice is, don't start Physical Therapy until your condition has stabilized. When you start, if you feel pain during or after PT, speak up! Your clinician can't feel what you feel, so it is very important to advocate for yourself during physio. Let them know how it feels at each stage so they can use that as a guide to treat you properly. PT is not supposed to hurt and if it does you may be re-injuring your knee. Never drive through the pain. If your physio recommends you work through the pain you should consider a different therapist.

At the beginning of your injury, even before the injury has had a chance to stabilize and long before you start physio, the ColdCure^® Wraps will help keep the pain and swelling under control. Cold compression is highly recommended to stabilize a fresh injury. And when you are active, invariably, you're going to aggravate your condition to some degree. If you're very active, you may aggravate it a lot! After any activity where you may have aggravated your injury, use cold compression to minimize the negative impact and stabilize your knee. Always use your ColdCure^® wrap after any heavy activity and after PT.

The KB Support Tape^™ should be applied every morning and worn all day long, including to PT, to help prevent re-injury. It protects you when you move. KB Tape is armor for your injury. For many people, King Brand^® products, used in the comfort of your own home, are all that is required without having to attend and pay for Physical Therapy appointments. Because you don't have to move to use them, the King Brand BFST^® and ColdCure^® Wraps can be started any time in your recovery process.

Surgery Should Be a Last Resort

You don't have to undergo surgery in order to fix your torn meniscus. You can heal your injury with conservative treatments. However, it's possible that your underlying knee condition or injury requires surgery. These are very rare cases. Very rare.

Meniscus surgery usually involves the removal of part of the meniscus and that is not what you want. That's a path to an eventual full knee replacement, it's just a temporary fix. You want to do everything you can to let your meniscus heal on its own.

Quite frankly, if you go see a surgeon, they will most likely recommend surgery. This is only because this is what they know. It's how they make their living. And 10 years from now they can do the full knee replacement, because that's usually what happens. Surgeons don't see the reams of people that heal without surgery because... well... those people just go away!

If you really want a surgical solution, absolutely get more than one opinion. 'Meniscus Repair Surgery' is often what they call a procedure where they just trim away the piece of meniscus that is bothering you. They don't sew it back together like it sounds, because stitches would never hold in that harsh environment. If you don't have that piece anymore, it isn't going to hurt. But if you don't have that piece anymore, your knee is even less protected than it was before. With that solution you will definitely be getting a full knee replacement sometime down the road.

Don't drain the cyst if one has developed. If it's an option, you want to keep the synovial fluid and just move it back into your knee joint where it belongs, where it can help. Periodic cold compression for 20 or 30 minutes at a time will help with this.

Bands that you wear constantly on your knee are more likely to cause you to develop ligament or tendon damage so don't go with a 'wear as you go' solution.

If surgery is your only option, make sure your post-surgery recovery goes as smoothly as possible by using BFST and ColdCure. Use a ColdCure^® Leg Wrap to reduce the inflammation and relieve the pain for the first few days following surgery. Once the inflammation has gone down, promote blood flow to the injured area using a BFST^® Knee Wrap. This will improve your circulation and help you heal faster.

If you have a cyst, there is also a possibility that the Baker's Cyst could rupture, causing fluid to move into the calf and result in further swelling and pain in the calf. A ruptured cyst isn't great, but it's not the worst situation either. Until the underlying injury is dealt with, in some circumstances, it becomes difficult for the ruptured bursa to heal. You want a functional bursa to keep capturing the synovial fluid and return it back into your knee. Symptoms of a ruptured Baker's Cyst are similar to those of a blood clot, so if you're not certain that your Baker's Cyst has ruptured, please see your doctor.

Dealing With Pain

Painkillers are BAD, Not Good

Painkillers mask the pain, causing you to continue to stress and injure your knee. This will only make your condition worse. It is understandable that people need relief from the pain, so if you have to take painkillers, restrict them to times when you are off your feet. You can use painkillers to help you sleep. Using them when you are active is a recipe for permanent damage. Your choice of pain killers is important. You can give us a call to discuss which ones are best.

A ColdCure^® Leg or Knee Wrap is designed to relieve the pain associated with a torn meniscus. This safe and effective pain reliever is also great at bringing down swelling and inflammation. The ColdCure^® Wrap is incredibly soothing and provides support and protection for your knee while you wear it. The painkilling element is incredibly powerful and it works instantly - there's no 20 minute wait like with pills.

A torn meniscus can be extremely painful and debilitating. Painkillers such as ASA or acetaminophen are often used to treat the pain but these drugs do nothing to treat the actual condition. In fact, most painkillers are known blood thinners that can have other side effects. Cortisone injections are used in extreme cases but these too are intended to address the pain. They do not promote healing of the injury itself and they put you at a very high risk of further injury.

Blood Flow is Essential for Healing

You don't have to wait for endless months in pain. You can heal much more quickly with the right treatment. For a knee injury, blood flow is the most critical element in rapid recovery. Blood Flow Stimulation Therapy^™ (BFST^®) gives your knee the blood flow it needs to heal quickly and completely.

BFST^® brings extra oxygen and nutrient-rich blood to the injured area - a requirement for the body to heal itself. But there's no blood in the meniscus, so how can blood flow help? Blood flow works hand in hand with the synovial fluid. The good that comes, and the bad that leaves, is exchanged between the synovial fluid and your blood supply, so yes, blood flow is an important catalyst to healing. Unfortunately, an injured knee at rest often has restricted blood flow, which extends your healing time and greatly increases the amount of scar tissue that develops. With a King Brand^® BFST^® Knee Wrap, blood flow can be stimulated in the area of injury while you are at rest. With improved blood flow and without physical activity and the risk of re-injury, you can recover from your knee injury at a surprisingly rapid rate.

King Brand^® Quality

King Brand^® soft tissue rehabilitation medical products are the #1 choice by top Athletic Therapists and Medical Practitioners worldwide. We provide guaranteed results and customer satisfaction. Like all King Brand^® products, there simply isn't a better performing option. All King Brand^® products come with a 100% satisfaction guarantee. Try our products and if you are not completely impressed, you can send them back for a full refund. We know you will love them though, because thousands of people already use them and rave about the results.

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King Brand^® BFST^® and ColdCure^® Wraps are FDA Registered medical devices. They are intended to prevent, treat and cure soft tissue injuries and chronic conditions. Part of being an FDA Registered company means that our products are made from high quality, biocompatible materials. These devices are manufactured and tested to the highest safety standards in the industry.

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