What is Persistent Muscle Pain? How Is It Treated?

Meniscal injuries can be treated without surgery with natural therapy, additional treatment and medical exercise methods applied according to the degree and level of deformation.

What is Meniscus Tear? 

The menisci are C-shaped collagen structures located between the thigh and leg bones that form the knee joint, and they absorb the pressure and impacts on the knee and provide the knee's mobility thanks to their flexible structures. 

In some sudden movements, the menisci may not be able to adequately subsidize the external blows or they may lose their flexibility and strength due to age and become unstable. In such cases, the flexible C-shaped structure may wear off or break between the knee joints and prevent the knee from performing its functions. 

This deformation that occurs on the menisci is called meniscus tear. Although meniscus tear is commonly known as an athlete's disease, it is a disorder that can be encountered frequently in people of all ages and professions, depending on age, lifestyle and movement habits.

How Does a Meniscus Tear Occur?

The knee joint consists of 3 bones, the thigh, the leg bone and the knee cap bone in the front, and these bones are connected to each other by the soft cartilage meniscus tissue. The menisci are positioned in each knee in two ways, internal and external, and function as a shock absorber between the disc cushions and the joint, absorbing the sudden pressure and force on the knee. 

Meniscus tears occur as a result of sudden stop, rotation, sudden bending or twisting of the knee, and the pressure on the knee cannot be met by the menisci. During sudden movement, the menisci located in the articular cartilage may be exposed to more pressure than they can bear and may break as a result of excessive stretching, or they may break and get stuck between the joints or tissues. This condition is called meniscus tear.

What Are the Factors Triggering Meniscus Tear?

• Engaging in sports that put sudden and severe pressure on the kneecap and the knee, such as running fast, making sudden maneuvers, jumping, turning around, bending the knee, such as football, basketball, volleyball
• Making a habit of compelling knee movements such as sitting, crouching, kneeling by bending the knee
• Trying to lift a heavy object in the wrong position 
• Exercising with movements that are not suitable for physical condition 
• Inability to function properly as a result of age-related degenerative changes on the knee and wear and tear of the meniscus

Can Children Have Meniscus Tear?

Meniscus tear is an orthopedic disorder that can be seen at any age, and it can develop as a result of sudden or reverse movement or sports trauma, or it can be congenital. Congenital meniscus problems are called discoid meniscus, and menisci that should be C-shaped are circular in shape and have the potential to tear more easily than normal meniscus.

What Are the Symptoms of a Meniscus Tear?

Knee pain due to movement is among the most common symptoms of meniscus tear. Other symptoms include straining when bending the knee, mechanical noise, compression of the knee or locking that causes limitation of movement.

Common meniscus tear symptoms are listed as follows;

• Knee pain
• Knee stiffness and limitation of movement 
• Swelling and stiffness in the knee area
• Mechanical noises from inside the knee 

What are the Diagnostic Methods of Meniscus Tear?

Any patient presenting with knee pain can be evaluated for a potential meniscus tear. Before diagnosing a meniscus tear, the patient's history is listened to and a detailed physical examination called the McMurray test is performed. 

In some cases, knee pain can be a sign of different diseases, as well as anterior cruciate ligament or medial lateral ligament injury. For this reason, with the McMurray test, radiological MRI is requested from the patient to obtain a definitive diagnosis of the meniscus tear.

What is the McMurray Method in Diagnosing Meniscus Tear?

Meniscal tears may not always be apparent with MRI. In such cases, the McMurray test is used to evaluate whether there is a tear in the meniscus. The McMurray test must be performed by specialist physiotherapists, otherwise a possible disability may occur. 

In the McMurray test, while the patient is lying in the supine position, the physiotherapist performing the test slowly grasps the heel with one hand and the knee with the other hand and performs maneuvers slowly with various flexion and rotation positions. If a slipping sensation occurs in the joint or a mechanical crackling sound is heard during these maneuvers, the diagnosis and diagnosis of meniscus tear will be finalized. 

What is Non-Surgical Meniscus Tear Treatment?

The techniques applied in the treatment of meniscal tears generally vary depending on the size and location of the tear. In addition, dynamics such as the patient's age, weight, muscle structure and occupation are also the determining factors of the course and method of the treatment process, and most meniscus cases can be treated without surgery.

The outer part of the meniscus is called the red zone, and meniscus tears that occur in this area can often heal on their own since blood circulation is effectively provided. Tears that progress to the inner parts of the meniscus can be healed with physical therapy methods such as manual therapy.

How is Non-Surgical Meniscus Treatment Performed with Manual Therapy?

In the treatment of meniscus tear, based on ensuring a balanced and regular blood flow, the blood flow is regulated first by applying pressure to the degenerated meniscus area by hand. In order for the manual therapy method to be successful in the treatment of non-surgical meniscal tears, a medical exercise program should be applied in addition to the therapy.

By performing muscle strengthening exercises in the knee with medical exercise programs, the knee is helped to regain its old mobility and other muscles are provided to work as well. Medical exercises that help the meniscus to return to its former flexible structure are applied regularly during and after the recovery period, together with the healthy moving knee and strengthened knee muscles. 

What is Cold Compress in the Treatment of Non-Surgical Meniscus Tear?

In the treatment of meniscus tear, the most effective method used especially to reduce or relieve pain and swelling is the cold compress method. It is aimed to reduce the pain and relieve swelling by applying a cold water bag or ice compress to the damaged area of ​​the meniscus tissue every 3-4 hours a day. 

Depending on the recovery course of the swelling and the severity of the pain, cold compress application is applied for 3 or 4 days and the knee is bandaged and the pain caused by the movement of the knee is prevented. In the treatment of meniscus tear, a lifestyle away from movement is adopted in the first week, while regular meniscus exercises are started after the first week, aiming for a successful recovery process.

What Should Be Considered to Avoid Meniscus Tear?

Although the meniscus is popularly known as an athlete's disease, it is a common knee problem that can happen to many people. Considering the weakening and loss of flexibility of the menisci due to age, it is recommended that individuals over the age of 45 should stay away from a sedentary lifestyle.

To prevent meniscus tear, you can pay attention to the following items;

– Prepare your body for exercise with warm-up exercises before sports

– Try to rest your overtired muscles by taking short breaks between sports or exercise.

- Keep your weight control balanced by determining your ideal weight

– Avoid sudden movements that put pressure on the knee or force it

– Be careful not to bend your knee or sit on it for a long time while doing exercise or squatting in your daily movements.

– Take care to keep your knee muscles strong with regular exercises