A meniscus tear is a common injury for both active and older persons

The two menisci of the knee (the white crescents) act as a cushion between the femur and tibia, so that the two bones don’t rub against one another. — Wikimedia Commons

I have been having trouble dancing. I like to do K-pop dancing in my gym, but ever since last week, I have been having difficulty going through the dance moves. There is a pain in my right knee. The doctor says I might have a meniscus tear, but what is a meniscus?

Your knee joint is made up primarily of two bones: the femur in your thigh and the tibia in your lower leg (shin).

There is also the kneecap, or patella, which sits in front of your knee to protect it from injuries that come from the front.

You can feel your kneecap in front of your knee, and you can even move or rock it slightly.

But your bones don’t rub against one another.

They are covered by two “C”- or crescent-shaped pieces of fibrocartilage.

These function as shock absorbers that protect the ends of the femur and tibia from being ground down through friction from our constant walking and moving around.

These pieces of fibrocartilage are called menisci (plural) or meniscus (singular).

They are rubbery to the touch (if you ever get to touch them).

There is the medial meniscus, which is located on the inner part of your knee, and the lateral menisci, which is located on the outer part of your knee.

The menisci stabilises your knee by transmitting the weight from one bone to the other when you are standing up, walking, running or making any other action while on your feet.

There are, of course, other structures in your knee such as ligaments.

Are the menisci easily injured?

Yes, if you are mostly the active sort or if you are older.

Your meniscus can tear from a traumatic injury.

This can occur during any sports, but especially contact ones like rugby, football, tennis and basketball.

I have met many tennis players who have had meniscus tears.

It can also occur when you pivot on your knee, such as during dancing or gymnastics.

Your meniscus tears more easily with age and degeneration.

For example, an older person with a degenerative meniscus can tear his meniscus by just getting up suddenly from a sitting position, especially if he already has osteoarthritis.

Sometimes, the meniscus can tear along with other structures in your knee, such as the anterior cruciate ligament.

How does the meniscus usually tear?

There are several main ways your meniscus can tear:

• Radial: The tear occurs at the centre of the “C”.
• Longitudinal: The tear occurs along the length of the meniscus.
• Flap: A part of the meniscus is torn, but remains attached to the rest of the meniscus.

  When this happens, the torn flap might “flap” around when you move, giving you a feeling as if it is “caught” in your knee.

• Horizontal flap: The same as the flap tear, but across the width of the “C”.
• Horizontal tear: The tear occurs across the width of the “C”.
• Bucket handle tear: A large type of horizontal tear.

  When this happens, your knee can actually become “stuck” because the torn part of your meniscus is blocking normal knee motion.

• Wear and tear: A tear that looks different from all the above.

Those are just the areas where the tear occurs. There are also:

• Incomplete or intrasubstance tear: This one occurs inside the cartilage of the meniscus itself, but does not manifest in a flap.

  It can usually heal on its own.

• Complex tear: This one involves combinations of the tear patterns listed above.

Oh boy. I am not sure which tear I have. I seem to only have pain when I am rotating my knee. I don’t have pain if I am not trying to move.

If your meniscus tear is small, it may take a whole day before the symptoms start to appear.

Most people will experience some pain with a meniscus tear, especially when you try to rotate or twist your knee.

This may be accompanied by swelling and stiffness.

It may be difficult for you to straighten your knee fully.

Some people complain of feeling a “popping” sensation in their knees, or that the knee is locked in place when they try to move it.

Some people also complain of the knee giving way.

Do I have to go for surgery?

It depends on many factors, such as what type of tear it is, your age and what you desire your future activity level to be.

You see, if you get a tear on the outer one-third part of your meniscus, it may heal on its own as it has a rich blood supply.

If not, then it can be repaired by surgery.

This is called the “red zone” in meniscus terminology.

But the inner two-thirds of your meniscus does not get a lot of blood supply. This is called the “white zone”.

Tears that occur in this region are very difficult to heal.

This is when the surgeon might just have to trim the torn parts away.

Not all meniscus tears have to have surgery, of course.

Your surgeon might just recommend rest, painkillers and ice.

Sometimes, they may inject a steroid into your knee.

If your symptoms still do not go away with these methods, the surgeon might perform an arthroscopy (i.e. looking inside your knee with a tiny scope).

Then the doctor will either repair the tear or trim what cannot be repaired away.

You will also need to go for rehabilitation, which can take up to six months to complete.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email [e-mail]. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.