Meniscus Tear: Symptoms, Treatment and When Surgery Is Needed

A twist on the football field, a deep squat that felt wrong, or a knee that simply started to ache and catch in your fifties: a meniscus tear is behind a large share of knee pain seen in orthopaedic clinics. The good news is that not every tear needs an operation, and knowing which ones do is what this guide is for.

What is the meniscus?

Each knee has two C-shaped pads of cartilage, the medial and lateral menisci, sitting between the thigh bone and shin bone. They absorb shock, spread load across the joint and add stability. When one tears, the knee loses some of that protection and the torn edge can catch inside the joint.

Symptoms of a meniscus tear

• Pain along the inner or outer joint line, worse on twisting or deep squatting
• Swelling that builds up over a day or so after injury (or slowly in degenerative tears)
• A catching, clicking or “something is stuck” sensation
• Locking: the knee will not fully straighten
• A feeling of the knee giving way

A knee that swells rapidly within hours after a twist should also be checked for a ligament injury; read our guide to ACL tear symptoms and recovery, as the two often occur together.

Two kinds of tear

Traumatic tears occur in younger, active people, usually after a twisting injury. Degenerative tears occur with age, when the cartilage has weakened over the years, and may develop after a minor movement or none at all. The distinction matters, because degenerative tears often respond well to non-surgical treatment.

How it is diagnosed

Your doctor will examine the joint line, test rotation and stability, and check for locking. An MRI confirms the tear pattern and location and shows any cartilage or ligament damage. X-rays are used to look at bone and early arthritis, since the two problems commonly coexist in older knees.

Treatment without surgery

For many stable or degenerative tears, a structured programme of physiotherapy, quadriceps and hip strengthening, activity modification and short-term anti-inflammatory medication is the first step. Improvement in pain and function over several weeks is a good sign that surgery can be avoided. Our physiotherapy and rehabilitation team designs these programmes.

When surgery is recommended

• The knee is locked and will not straighten
• A displaced fragment causes repeated catching or giving way
• Pain and mechanical symptoms persist after a proper trial of physiotherapy
• A young, active patient has a repairable tear, especially in the outer zone

Surgery is done with arthroscopy (keyhole surgery) through two or three small incisions. The surgeon either repairs the tear or trims the damaged part.

Preserving as much meniscus as possible is preferred where it is realistic, because losing meniscus tissue increases stress on the cartilage over time. For a detailed independent overview, see the American Academy of Orthopaedic Surgeons guide to meniscus tears.

Recovery and protecting your knee

Whatever the treatment, rehabilitation is what restores a strong, stable knee. Expect a phased plan: swelling control and movement first, then strength, balance and finally sport-specific work. Maintaining a healthy weight and strong thigh muscles lowers the load on the meniscus for the long term.

Can I keep exercising with a meniscus tear?

Usually yes, within limits. Low-impact activity such as cycling, swimming and straight-line walking generally keeps the knee moving and the muscles strong. Avoid deep squats, pivoting and twisting sports until your doctor is happy with the knee, and stop any activity that causes sharp pain or catching. A knee that is locked should not be forced.

Do not ignore these signs

• The knee is stuck and will not straighten fully
• Rapid swelling within hours of an injury, which may mean a ligament injury as well
• Repeated giving way that makes stairs or uneven ground unsafe
• Pain that is not easing after several weeks of sensible rest and exercise

Keeping your knees healthy afterwards

Strong quadriceps and hip muscles absorb load that would otherwise pass through the cartilage, so strengthening is the best long-term protection. Warm up before sport, use footwear suited to the surface, build training load gradually and keep your weight in a healthy range. If your knee has advanced arthritis rather than an isolated tear, see our guide on when knee replacement is necessary.

Knee care in Wakad, Pune

Dr. Nirmal Patil, MS (Ortho), has 16 years of experience in arthroscopic and joint surgery and consults at Precision Ortho Spine & Rehab Clinic in Wakad, Pune, for patients across Hinjewadi, Baner and Pimpri-Chinchwad. If your knee is catching, locking or painful after an injury, book an assessment.