Causes Of Meniscal Tears
While being one of the most common knee injuries, meniscal tears can turn serious if not treated on time. Let's learn all about this cartilage injury and what could be its potential causes.
Written by Dr Sonia Bhatt
Last updated on 3rd Jul, 2025
A meniscal tear is a common knee injury that affects individuals of all ages—from athletes engaged in high-impact sports to older adults experiencing natural degeneration of the joint. The meniscus, a C-shaped piece of cartilage located in each knee, serves as a crucial cushion between the shin bone (tibia) and thigh bone (femur). This greatly impacts the stability of the knee joint, absorbing shock during movement. However, the meniscus is vulnerable to injury, particularly during sudden twists, rotations, or other impacts to the knee.
Let's dive into exploring the causes behind meniscal tears, shedding light on both traumatic injuries and age-related factors.
Anatomy and Function of the Meniscus
The meniscus is a crescent-shaped cartilage structure found in each knee joint. There are two distinct menisci in every knee—the medial meniscus on the inner side and the lateral meniscus on the outer side. These structures serve as crucial components in knee function and stability.
The medial meniscus is less mobile, anchored firmly to the joint capsule and ligaments, providing a more fixed role in supporting the knee. In contrast, the lateral meniscus is more flexible, allowing it to better accommodate the dynamic movements of the knee.
The menisci are critical in evenly distributing the body's weight across the knee joint. By increasing the contact area between the femur (thighbone) and tibia (shinbone), the menisci reduce stress on the cartilage and minimise the risk of joint damage. They absorb shock during various activities like walking, running, and jumping, protecting the knee from excessive wear and tear.
In addition to cushioning the joint, the menisci play a key role in enhancing stability by deepening the femoral and tibial articular surfaces. This helps to maintain proper alignment and prevent excessive movement of the knee. The medial meniscus, in particular, provides added stability during rotational motions, supporting the knee in maintaining its proper alignment.
Types of Meniscal Tears
Meniscal tears are broadly distinguished into two types-
1. Degenerative Tears
Degenerative tears are more commonly observed in older individuals, as the meniscus naturally weakens and loses its elasticity with age. These tears can occur even with minimal twisting or stress, often happening during routine activities such as walking or climbing stairs. Over time, the cartilage in the meniscus may deteriorate due to wear and tear, making it more susceptible to tears with minimal force.
2. Traumatic Tears
Acute traumatic tears are typically the result of sudden, forceful movements, most commonly caused by twisting injuries to the knee. These tears are often seen in athletes, particularly those involved in contact sports or activities that require abrupt changes in direction. This type of tear is usually more severe and may require immediate medical intervention.
Common Causes of Meniscal Tears
There are many reasons that can cause meniscal tears. Some common ones include-
Sports injuries: In sports like football or basketball, quick, high-impact movements such as twisting, pivoting, or jumping can strain the knee and lead to meniscal tears, especially under load or awkward positioning.
Age-related degeneration: As people age, the meniscus becomes less resilient, with the collagen fibres weakening and the cartilage thinning. This makes it more susceptible to tears.
Sudden twisting motions: Twisting the knee while the foot is planted, often during a sharp turn or sudden pivot, places excessive strain on the meniscus, potentially causing it to tear, particularly in athletes.
Heavy lifting or squatting: Improper lifting techniques or deep squats can place undue stress on the knee joint, particularly when combined with twisting or excessive force, increasing the risk of meniscal injury.
Risk Factors for Meniscal Tears
Here are some factors that may increase the risk of meniscal tears-
Age: As people age, the meniscus naturally weakens and becomes more prone to tears. Degenerative changes in the cartilage make it less resilient, increasing the likelihood of tears.
Physical activity level: People who engage in high-impact or sports-related activities, especially those requiring rapid twisting, pivoting, or jumping, have a greater risk of meniscal tears.
Previous knee injuries: A history of knee injuries, such as ligament tears or fractures, increases the risk of developing meniscal tears.
Symptoms of a Meniscal Tear
If an individual has torn their meniscus, symptoms may not appear immediately. It can take up to 24 hours or more for pain and swelling to develop. Here are some common ones-
Swelling or stiffness in the knee region
Pain is often experienced, especially when twisting or rotating the knee.
The knee may feel as though it is "locked" in place
The knee may feel unstable or weak
A torn meniscus may cause difficulty in fully extending or straightening the knee
Consult Top Doctors For Meniscal Tears
Diagnosis of Meniscal Tears
Here are a few methods through which meniscus tears can be diagnosed
1. Physical Examination
A torn meniscus is generally diagnosed with the help of physical assessments. During this exam, the doctor may handle the knee and leg into various positions, assess the patient's walking pattern, and even ask them to squat for better assessment.
2. Imaging Tests (MRI, X-rays)
X-rays: While a torn meniscus itself is not visible on X-rays as it’s made of cartilage, X-rays can be helpful in identifying other knee concerns that may reflect similar symptoms.
Magnetic Resonance Imaging (MRI): MRI uses a strong magnetic field to produce detailed images of hard/soft tissues in the knee. It is one of the most helpful imaging tests for diagnosing a meniscal tear.
Treatment
Treatment for a torn meniscus often starts conservatively, depending on the tear's type, size, and its exact location. Tears related to arthritis typically improve with arthritis treatment, making surgery unnecessary. Similarly, tears that don't cause knee locking or limit motion may become less painful over time, reducing the need for surgery.
Doctors often recommend:
Rest: Don’t take part in activities that can worsen knee pain, especially twisting or pivoting motions. Using crutches can help relieve some pressure.
Ice: Applying ice to the affected area can decrease pain and swelling. A cold pack or ice-filled towel should be used for a brief time every 4 to 6 hours during the first few days.
Medication: Pain relievers can help manage discomfort during recovery.
Prevention of Meniscal Tears
There are several steps individuals can take to reduce and prevent the risk of meniscal tears:
Strengthen knee muscles: Strengthening muscles around the knee, such as the quadriceps, hamstrings, glutes, and calves, helps stabilise the knee and reduce stress on the meniscus. Exercises like squats, lunges, hamstring curls, and leg presses are beneficial.
Warm up and stretch: Warming up and stretching before and after physical activity helps maintain flexibility and reduces the risk of injury.
Wear proper footwear: Wearing shoes that fit well and provide sufficient support for the activity can help prevent knee strain.
Take it slow: Gradually increasing the intensity of an exercise program allows the body to adapt safely and reduce the likelihood of injury.
Conclusion
A meniscal tear can occur due to various factors, including sports injuries, age-related degeneration, and sudden twisting movements. Understanding the anatomy, causes, symptoms, and risk factors associated with meniscal tears is essential for effective prevention and treatment.
While conservative treatments, such as rest, ice, and medication, can be effective, preventive measures, including strengthening the knee muscles, warming up, and wearing proper footwear, are helpful in reducing the risk of injury. With proper care and attention, individuals can safeguard their knee health and maintain an active lifestyle.
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Orthopaedician
42 Years • MBBS, MS Orthopedics
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7 Years • MBBS, Diploma in Orthopaedics, Fellowship in DFSI
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