Meniscus Tears
Meniscus tears are common knee injuries seen in both sport and everyday life. The meniscus is a piece of C-shaped cartilage inside the knee joint that helps with shock absorption, stability, and smooth movement. Each knee has two menisci — one on the inside and one on the outside of the joint.
Tears can happen suddenly during sport, or develop gradually over time as the cartilage becomes less resilient. Barnes commonly sees meniscus injuries in runners, footballers, gym-goers, and people whose jobs involve repeated squatting or twisting.
How Meniscus Tears Happen
A classic meniscus injury occurs when the foot is planted and the knee twists. This mechanism is common in sports that involve pivoting or sudden changes of direction, such as football, rugby, skiing, and tennis. In younger patients, the injury is often linked to a specific incident and may involve swelling shortly afterwards.
In older adults, the picture is often more gradual. Degenerative changes can weaken the cartilage over time, meaning relatively normal activities like kneeling, gardening, or standing awkwardly can trigger symptoms. In these cases, there may not be one memorable injury at all.
Meniscus tears are also more likely when other knee problems are already present. Reduced hip mobility, knee osteoarthritis, or previous ligament injuries can all alter the way forces move through the joint.
Symptoms of a Meniscus Tear
Symptoms vary depending on the size and location of the tear, but commonly include:
- pain along the joint line of the knee
- swelling or stiffness
- clicking or catching sensations
- pain when twisting or squatting
- difficulty fully straightening the knee
- a feeling that the knee might give way
Some tears can also cause “locking”, where the knee physically cannot move past a certain point. This can happen when part of the torn cartilage becomes trapped within the joint.
Not every clicking knee has a meniscus tear, and not every tear causes severe pain. Some smaller tears are surprisingly manageable, while others really affect day-to-day movement.
Different Types of Meniscus Tears
There are several recognised tear shapes, including longitudinal tears, radial tears, and “bucket handle” tears. The latter are more likely to cause locking symptoms because part of the cartilage folds into the joint space. However, they might have periods of minimal symptoms when the “handle” moves back into place.
The location of the tear also matters. The outer part of the meniscus has a better blood supply, meaning some tears here have greater healing potential. Deeper tears towards the centre are less likely to heal independently.
Adapting Sport and Exercise
Complete rest is rarely the goal, but continuing to repeatedly aggravate the knee can delay recovery. Barnes usually focuses on modifying activity rather than stopping movement altogether.
Twisting, pivoting, deep squatting, and impact-heavy exercise are often the biggest aggravators. Temporary changes might include reducing running mileage, altering gym exercises, or swapping to lower-impact training like cycling or swimming while symptoms settle.
The aim is to keep the knee moving and loading appropriately without repeatedly irritating the injured tissue.
Osteopathy for Meniscus Tears
Barnes takes a mechanical approach to knee pain. Rather than focusing solely on the painful area, he assesses how the hip, ankle, pelvis, and lower back may be influencing load through the knee joint.
Restrictions elsewhere in the chain can increase rotational stress through the knee and make symptoms harder to settle. It is common, for example, to find stiffness through the hip or upper back changing lower limb mechanics.
Treatment may involve:
- improving movement in surrounding joints
- reducing muscular tension around the knee
- supporting swelling reduction and circulation
- improving confidence in movement
- guiding rehabilitation and return to sport
If symptoms suggest a more significant injury — particularly true locking, major instability, or suspected ligament involvement — Barnes may recommend imaging or onward referral.
Recovery depends on the type of tear, activity levels, and the overall health of the joint. With appropriate management, many people return successfully to sport and exercise without surgery.
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