Meniscal Tear

The menisci are two C-shaped pieces of cartilage sitting between the thigh bone and shin bone, acting as shock absorbers that cushion and stabilise the knee joint during weight-bearing and movement. A tear can occur suddenly, typically during a twisting movement while the foot is planted and the knee is bent — common in sports involving pivoting, changing direction or deep squatting — or it can develop gradually as part of age-related wear, particularly alongside osteoarthritis in the knee.

These two types of tear behave quite differently. A traumatic tear in a younger, active knee often occurs alongside other structures being strained, such as the ligaments, while a degenerative tear in an older knee may have been present for some time without symptoms before becoming painful, sometimes without any clear injury at all.

What causes a meniscal tear

Traumatic meniscal tears typically happen during sport or activity involving a sudden twist, pivot or deep bend of the knee while the foot stays fixed to the ground — a common mechanism in football, netball, tennis and skiing. Degenerative tears, by contrast, develop from cumulative wear of the meniscus tissue over years, making the cartilage more brittle and prone to tearing even with relatively minor movements like standing up from a low chair or twisting slightly while gardening. Both types can occur alongside general knee osteoarthritis, since a worn meniscus and worn joint surfaces often go hand in hand as the knee ages.

Symptoms

Common symptoms include pain along the joint line — often more noticeable on one side of the knee than the other — swelling that can develop over hours or a day or two after the injury, and a catching, clicking or locking sensation as the knee moves. Difficulty fully straightening or bending the knee is also common, and some people describe a sense of the knee “giving way” during certain movements, particularly twisting or descending stairs.

When to see a physiotherapist

Many meniscal tears, particularly smaller or degenerative tears, are well suited to physiotherapy assessment as a first step, since a large proportion respond well to conservative treatment without needing surgery. It’s worth having any suspected meniscal tear assessed reasonably promptly rather than continuing to load a knee that’s catching or locking, as this helps guide the right early management. See Andrew sooner rather than later if your knee is locking in a fixed position, repeatedly giving way, or significantly swollen following a specific twisting injury — these findings help determine whether imaging or an orthopaedic referral should run alongside physiotherapy rather than after a lengthy trial of treatment.

Physiotherapy treatment for a meniscal tear

Once your assessment has identified the likely location and severity of the tear, treatment is built around a staged exercise rehabilitation programme:

• Swelling and pain management in the early stage, including advice on activity modification and load management while the joint settles
• Restoring full range of motion, since a knee guarding against pain often loses the ability to fully straighten or bend, which needs to be regained before progressing to strength work
• Progressive strengthening, particularly of the quadriceps and hip muscles, which play a major role in offloading and stabilising the knee joint during everyday movement and sport
• Functional and sport-specific retraining for those returning to pivoting or twisting activities, focused on the control and strength needed to protect the knee under load

What to expect from treatment

Recovery timeframes vary considerably depending on the tear’s location, size and whether it’s traumatic or degenerative — some smaller tears improve meaningfully within a few weeks of appropriate treatment, while larger or more complex tears take longer and may need a staged approach alongside specialist input. Andrew will be upfront with you about which category your knee likely falls into and what a realistic timeframe looks like, rather than setting a generic expectation.

When surgery may be needed

Not every meniscal tear settles with physiotherapy alone. If your knee continues to lock, gives way repeatedly, or isn’t progressing despite a genuine trial of conservative treatment, Andrew will discuss whether imaging or a specialist referral is the appropriate next step. Even when surgery is required, physiotherapy still plays an important role — both in optimising strength beforehand and guiding rehabilitation afterward.