Complete Guide to Meniscal Tears

What is a Meniscal Tear?

A meniscal tear is a common injury seen in knees. It is when the cartilage in your knee that acts as a cushion and stabiliser between your thighbone and shinbone is damaged. Each knee has two menisci, one on the inside, known as the medial meniscus and one on the outside, known as the lateral meniscus. They act as shock absorbers, stabilising the joint and helping to distribute weight across the knee.

This C-shaped piece of cartilage can tear during activities that cause rotation in or put pressure on the knee joint.

What are the Types of Meniscal Tears?

Different patterns of meniscal tears include:

• Radial tear—A radial tear starts at the inner edge of the meniscus and cuts straight outward. It disrupts load distribution and often does not heal well on its own.
• Horizontal tear – A horizontal tear is a split between the top and bottom layers of the meniscus, usually caused by degeneration, and may lead to fluid-filled cysts.
• Longitudinal tear—A longitudinal tear is a vertical tear running along the curve of the meniscus. It is often caused by twisting injuries. If it occurs near the outer edge, it has greater healing potential. 
• Bucket-handle tear – A bucket-handle tear is a large longitudinal tear where part of the meniscus flips into the joint space. This injury often causes locking and, therefore, may require surgical repair.
• Complex/degenerative tear—A complex tear is a combination of tear patterns with frayed, worn tissue. It is usually seen in older adults and is linked with arthritis and degenerative changes. 
• Flap tear—With a flap tear, a small piece of the meniscus becomes detached, creating a flap. This flap can catch in the joint and cause pain or mechanical symptoms, and therefore, it may need surgical removal or repair. 

How Common are Meniscal Tears?

Meniscal tears are common. They are frequently seen in athletes and older adults following knee injuries. Access Ortho treats many patients with meniscal tears, helping them access rapid orthopaedic care following their injuries. 

• Meniscal tears occur in up to 60 per 100,000 people per year in the general population.
• The incidence is much higher in athletes, particularly those involved in pivoting sports (like football or netball). Meniscal injuries account for around 15% of all sports-related knee injuries.
• Degenerative meniscal tears are seen in over 30% of people over 50, even without significant trauma.

Symptoms and Causes of Meniscal Tears

What Causes Meniscal Tears?

Meniscal tears typically occur from:

Traumatic Injuries During Sports

• Sudden twisting, pivoting, or rapid changes in direction are typical causes of meniscal injuries. They are particularly common in sports like football, rugby, netball, and skiing.
• Meniscal tears frequently occur when the foot is planted, and the knee rotates.

Awkward Movements When Squatting or Lifting

• Deep squats, kneeling, or lifting heavy objects with poor form can place excessive strain on the meniscus, causing it to tear. 
• A quick twist while squatting can easily cause a tear, especially if combined with load-bearing. This action may occur while trying to lift or move heavy items. 

Degenerative Changes in Older Adults

• With age, the meniscus becomes less flexible and, therefore, more prone to fraying and tearing.
• In older adults, tears can occur with minimal or no trauma. Sometimes patients report they occur just from standing up or walking awkwardly.
• Degenerative tears are often associated with osteoarthritis, which is seen in the older population. 

Direct Blows to the Knee

• A hard impact, such as from a tackle or fall, can compress or shift the joint, tearing the meniscus. Meniscal tears are often seen in conjunction with ligament damage in these situations. 
• These types of injuries are commonly seen in contact sports or accidents like falls or car crashes.

Poor Knee Mechanics or Muscle Imbalance

• Patients with weak quadriceps, tight hamstrings, or poor hip control often find that their poor mechanics increase stress on the knee joint. Over time, this increased stress can contribute to wear and increase the risk of a meniscal injury.

Previous Knee Injuries or Surgery

• Prior knee surgery can alter joint mechanics, increasing the likelihood of meniscal tears. Proper rehabilitation after all surgery is essential. 

What are Meniscal Tear Risk Factors?

The following factors may increase a person’s risk of a meniscal tear: 

Age – Degenerative meniscal tears become more common with age. People over the age of 40 are more likely to sustain a meniscal tear due to natural wear and reduced cartilage elasticity.

Participation in Contact or Pivoting Sports – Sports like soccer, rugby, basketball, netball, and skiing increase the risk of meniscal tears due to frequent twisting and pivoting actions and direct knee contact injuries. 

Previous Knee Injuries—Past knee injuries, especially ACL tears or previous meniscal damage, can weaken the knee muscles and increase the chance of future tears.

What are the Complications of Meniscal Tears?

Obesity—Excess body weight increases the load on the knee joint. The extra strain on the knee contributes to faster degeneration and a higher risk of traumatic and degenerative meniscal injuries.

Occupations Requiring Frequent Squatting or Kneeling – Jobs like plumbing, tiling, carpentry, and gardening involve activities with deep knee bending. This squatting position places repetitive stress on the meniscus and can increase the chance of damage.

Poor Lower Limb Strength or Biomechanics—Weak quadriceps, poor hip control, or imbalanced muscle function can strain the meniscus during movement and increase the risk of meniscal tears.  

Inadequate Warm-Up or Flexibility—Tight hamstrings or quads or a poor warm-up before physical activity can reduce joint mobility, increasing the risk of injury.

Some common complications can occur following a meniscal tear. It is important that your treating medical team is aware of these and takes active steps to minimise complications. The team at Access Ortho are specialists in the care of meniscal tears and other knee injuries. Arranging a rapid appointment at Access Ortho will ensure an accurate and prompt diagnosis, and allow you to start treatment as soon as possible.

The following are complications that need to be considered: 

Chronic Knee Pain

Meniscal tears can lead to ongoing knee pain. This pain may be especially noticeable during weight-bearing activities like walking, running, or squatting. It may be sharp during movement or more of a dull ache at rest after an activity. If the tear is not treated correctly, this pain can become more persistent over time.

Limited Mobility

A torn meniscus can restrict knee movement. This restriction can be caused by swelling, pain, or a mechanical obstruction from the tear. Restricted movement may interfere with everyday tasks like climbing stairs, getting in and out of a car, or kneeling and can cause long-term limited range of movement if not treated early. 

Knee Instability

When the meniscus is damaged, it will no longer be adequately helping to stabilise the joint effectively. Due to the damage, you might experience a feeling of the knee “giving way” or instability. The instability may be particularly noticeable during activities that involve pivoting or changing direction.

Accelerated Osteoarthritis

The meniscus cushions and distributes load across the knee joint. When the meniscus is torn, it leads to increased stress on the cartilage. Over time, this can lead to osteoarthritis due to the breakdown of joint surfaces. The medial (inner) compartment of the knee is particularly susceptible to this.

Mechanical Symptoms (Catching or Locking)

Bucket-handle or flap tears may cause a piece of the meniscus to move into the joint space, disrupting smooth motion and leading to episodes of the knee catching, clicking, or locking in place. 

Diagnosis and Tests

How Are Meniscal Tears Diagnosed?

Diagnosis starts with taking a detailed medical history and a physical examination. Your medical provider will ask about how the injury occurred, any specific movements that cause pain, and whether you’ve experienced symptoms like locking, catching, or instability.

During the examination, your doctor will assess:

• Swelling or stiffness
• Tenderness along the joint line
• Reduced range of motion
• Signs of instability or mechanical symptoms

If a meniscal tear is suspected, specific clinical tests may be done to help confirm the diagnosis. Imaging may then be used to get a clearer view of the structures inside the knee.

Access Ortho medical staff are highly trained in assessing and caring for orthopaedic injuries. When you present to Access Ortho, you will receive a thorough assessment, and radiology will be arranged if required before making a diagnosis and formulating a treatment plan.

Which Tests Do Providers Use to Diagnose Meniscal Tears?

McMurray Test

• McMurray’s test is a clinical movement performed by the medical team where the knee is bent and then straightened while being rotated.
• A “click” or pain during the movement can indicate a meniscal tear. This test is often used to pick up a posterior horn tear.

Apley’s Compression Test

• This is a clinical test performed with the patient lying face down and the knee bent at 90 degrees. The medical practitioner applies downward pressure through the heel while rotating the leg. 
• Pain is indicative of possible meniscal damage.

Joint Line Tenderness

• The medical practitioner will press along the inner or outer joint line; this pressure may reproduce pain around the area of a tear.

MRI (Magnetic Resonance Imaging)

• An MRI may be ordered, as it is excellent for noninvasive imaging of soft tissues.  
• An MRI will show the location, size, and type of a meniscal tear and any associated injuries (e.g., ligament damage).

Arthroscopy

• Some patients may be referred for an Arthroscopy. 
• An arthroscopy is a minimally invasive procedure in which a small camera is inserted into the knee joint, allowing direct visualisation of the meniscus and other soft tissues.  
• An arthroscopy may be used for diagnosis or to treat the meniscal injury if a concern is found during the procedure.

Specific Considerations for Meniscal Tears

It is essential that your treating medical team understands the effects of different meniscal tears and that not all tears should be treated the same. The team at Access Ortho are specialists in orthopaedic injuries and offer rapid appointments for acute knee injuries. 

Medial vs. Lateral Meniscal Tears

The medial meniscus (on the inside of the knee) and lateral meniscus (on the outside of the knee) serve similar functions but differ in structure, mobility, and injury patterns:

• Medial Meniscal Tears
  • Medical tears are more common due to its firm attachment to the tibia and the medial collateral ligament (MCL). These attachments make it less mobile and more prone to injury during twisting or pivoting.
  • Often injured in association with other soft tissues, such as the ACL.
• Lateral Meniscal Tears
  • It is less commonly seen as an isolated injury. It typically occurs with other soft tissue damage. 
  • Later tears are frequent in athletes doing high-impact sports and are often seen in complex knee injuries.
  • The lateral meniscus is more mobile, making it less likely to get trapped during movement.
  • It may cause pain on the outer side of the knee and often presents with more subtle or vague symptoms.

 Acute vs. Degenerative Tears

• Acute Meniscal Tears
  • Caused by a sudden injury, such as twisting while the foot is planted.
  • Acute tears are more common in younger people or athletes.
  • Often present with sharp pain, swelling, and mechanical symptoms like locking or catching.
  • It may require surgical repair.
• Degenerative Meniscal Tears
  • Occur over time due to age-related wear and tear of the cartilage.
  • It is common in people over 40, particularly those with early signs of osteoarthritis.
  • Symptoms may include intermittent discomfort, stiffness, and joint swelling without a clear injury event.
  • It can usually be managed non-surgically with physiotherapy, weight management, and activity modification.

Red Zone vs. White Zone Tears

Different areas of the meniscus have varying levels of blood supply, which affects its healing potential:

• Red Zone (Outer Third)
  • Well-vascularised (receives good blood flow).
  • Tears in the red zone have a higher chance of healing naturally or, if surgically repaired, will heal faster.
  • A common site for longitudinal or peripheral tears.
• White Zone (Inner Third)
  • Poor blood supply or avascular.
  • Tears in this area generally do not heal on their own, even after repair attempts.
  • These injuries often require partial meniscectomy (removal of damaged tissue) if symptomatic.
• Red-White Zone (Middle Third)
  • The healing potential in this area depends on individual factors like age, tear size, and knee stability.

How Are Meniscal Tears Treated?

The chosen treatment for a meniscal tear depends on several factors, including:

• The type, size, and location of the tear
• Whether the tear is acute or degenerative
• The patient’s age, activity level, and overall knee health
• The presence of other injuries (like ACL tears or arthritis)

The Orthopaedic team at Access Ortho will recommend the best treatment pathway for your injury. 

RICE Protocol (Rest, Ice, Compression, Elevation)

• RICE is used in the early phase of treatment following a knee injury.
• It helps reduce swelling, pain, and inflammation.
• RICE should be combined with changes to activity to prevent stress on the injured knee.

Physiotherapy

• Physiotherapy plays a key role in conservative treatment and post-surgical rehab.
• The role of physiotherapy is to:
  • Restore range of motion
  • Strengthen the quadriceps, hamstrings, and glutes
  • Improve knee stability and function

Medication for Pain and Inflammation

• NSAIDs (e.g., ibuprofen or neurofen) are commonly used alongside other treatment modalities to reduce inflammation and manage discomfort.

Knee Bracing

• Some patients find knee bracing helpful to support the knee, especially in the early stages.
• Braces may assist by limiting rotation or bending to protect a healing tear or minimise pain. 
• Knee braces may also be used in sports following a meniscal tear.

Arthroscopic Surgery

Arthroscopic surgery is a procedure used when:

• Symptoms persist despite conservative treatment
• The tear is large, unstable, or causing mechanical symptoms (e.g., locking)

Surgical options include:

• Meniscal repair – The surgeon sutures the torn edges; preferred for younger patients and red zone tears.
• Partial meniscectomy: The surgeon trims and removes the damaged portion of the meniscus. This procedure is more common in degenerative or white zone tears.
• Total meniscectomy – This procedure is rarely done due to the high risk of long-term joint degeneration.

Rehabilitation Exercises

• Rehab is crucial following a meniscal tear, regardless of whether a patient needs surgery or conservative care.
• Rehab typically begins with gentle range of motion activities and progresses to strengthening and functional exercises.
• Full rehabilitation of a knee following a meniscus injury can take a few weeks to many months, depending on the treatment approach and tear type.

Prevention

How Can I Prevent Meniscal Tears?

The following techniques may assist in preventing meniscal tears. 

• Strengthen thigh muscles – Focus on the quadriceps and hamstrings for knee support.
• Maintain flexibility – Stretch regularly to reduce strain during movement.
• Use proper technique – Avoid twisting or overloading the knee during sports and exercise.
• Wear appropriate footwear – Supportive shoes reduce joint stress and improve stability.
• Maintain a healthy weight – Less pressure on the knee means a lower risk of injury.
• Avoid sudden activity changes – Increase intensity gradually when starting a new activity to protect your joints.

Outlook / Prognosis

What Can I Expect if I Have a Meniscal Tear?

The outlook for a meniscal tear depends on several factors, including:

• The type, size, and location of the tear
• Whether it’s an acute or degenerative injury
• Your age, activity level, and overall knee health
• The blood supply to the affected area (i.e., red vs. white zone)

The orthopaedic team at Access Ortho will guide you on your expected prognosis following a meniscal tear. 

General Expectations:

• Many small or degenerative tears improve with non-surgical treatment such as physiotherapy and activity modification.
• Surgically repaired tears—especially in younger, active individuals, can heal well with proper rehab.
• Tears in the white zone (poor blood supply) may not heal and could lead to ongoing symptoms or long-term cartilage wear. Therefore, they need to be managed appropriately. 
• If untreated or poorly managed, meniscal tears can contribute to knee instability, chronic pain, or early-onset osteoarthritis. Therefore, ensuring a rapid and accurate diagnosis and establishing a treatment plan early to minimise complications is essential.

What is the Recovery Time from a Meniscal Tear?

The following is a guide only. You must be guided by your treating team. 

Non-surgical treatment (e.g., RICE + physiotherapy):

• 6–8 weeks – For minor or degenerative tears, the focus during recovery should be on symptom relief and strengthening

Meniscal repair surgery:

3–6 months – Usually includes limited weight-bearing and a gradual return to sport

Partial meniscectomy (removal of damaged tissue):

4–6 weeks – A partial meniscectomy may carry a higher long-term risk of joint degeneration. Therefore, rehabilitation and monitoring are important. 

When Should I See a Specialist?

You should seek medical attention if you experience any of the following symptoms, especially after an injury or a sudden movement:

• Significant swelling, persistent pain
• Swelling that doesn’t go away, or ongoing pain and discomfort may indicate a more serious injury than a simple strain.
• Inability to straighten or bend your knee
•  Loss of range of motion can indicate a torn meniscus or another internal knee issue that needs assessment.
• A sensation of your knee “giving way” or feeling unstable
•  Instability could point to a meniscal tear or an associated ligament injury, such as an ACL tear.
• Locking or catching in the joint
•  If your knee gets “stuck” in one position or catches when you move, it may suggest a mechanical block, such as a displaced meniscus tear.
• Symptoms that don’t improve with rest and home care
•  If pain, swelling, or limited movement persists after a few days of RICE and activity modification, it’s best to get it checked.

Seeing a GP, sports physician, or orthopaedic specialist early can help confirm the diagnosis, prevent further damage, and guide the best treatment path. Access Ortho are specialists in orthopaedic injuries such as meniscal tears. The orthopaedic team will be able to give you clear advice on your injury and the best course of action. Access Ortho offers rapid appointments for acute limb injuries. 

What’s the Difference Between a Private Orthopaedic Clinic and a Fracture Clinic?

Both private orthopaedic clinics and fracture clinics, such as Access Ortho, specialise in treating bone, joint, and soft tissue injuries, but there are some key differences in focus, access, and patient experience.

Fracture Clinic

• Public Fracture clinics are found in public hospitals. They require a referral to attend, and frequently, there is a delay in getting an appointment. 
• Private Fracture clinics such as Access Ortho are in the community, and you do not require a referral to attend. Appointments can also be made rapidly for acute injuries.
• Focus on acute injuries like broken bones, dislocations, and severe sprains.
• Patients can attend a private fracture clinic like Access Ortho after a visit to the Emergency Department or GP or as a first point of contact.
• Access Ortho is able to fit casts, boots and splints. 
• Access Ortho offers rapid advice directly from an orthopaedic surgeon
• Access Ortho is affordable and provides cost-effective specialist care
• Private Fracture clinics such as Access Ortho specialise only in orthopaedics, unlike an ED or Urgent Care, which treat all illnesses and injuries. The team at Access Ortho will, therefore, provide expert advice on all orthopaedic injuries. 
• Access Ortho provides follow-up care appointments with orthopaedic surgeons without the delay of trying to get an appointment privately. 

Private Orthopaedic Clinic

• Offers access to specialist orthopaedic care; however, you must have a referral from your GP or emergency doctor. 
• Getting an appointment is often delayed due to the surgeon being booked weeks in advance.
• They may not have casting or bracing on site, so you will need to go elsewhere for this.
• Costs can be high, especially if you need ongoing clinical care
• Excellent for treating chronic orthopaedic concerns, it is harder to get an appointment for acute injuries, especially if it does not require surgery. 

Why Choose Access Ortho?

Access Ortho bridges the gap between a GP or Emergency department and a private orthopaedic surgeon. Access Ortho is a specialist-led fracture and injury clinic for patients of all ages.

• No long waitlists
• Rapid access to orthopaedic consultants and imaging
• Streamlined care for fractures, sprains, dislocations, tendon injuries, and more
• Suitable for adults and children
• Compassionate, efficient, affordable expert care from day one

Whether it’s a sports injury, a child’s fracture, a workplace injury, or any other acute orthopaedic concern, Access Ortho makes getting the right care simple and stress-free.

Frequently Asked Questions About Meniscal Tears

Is it possible for a meniscal tear to heal on its own?

Some small meniscal tears, particularly those in the outer “red zone” where there’s a good blood supply, may heal without surgery. Conservative treatment such as rest, physiotherapy, and careful activity modification can be successful. However, tears in the inner “white zone” are less likely to heal on their own.

Is surgery always necessary for a meniscal tear?

Surgery is not always needed for meniscal tears. Many degenerative or minor tears can be managed non-surgically with physiotherapy, anti-inflammatory medication, and activity changes. Surgery is considered if symptoms persist or the tear causes mechanical issues like locking.

How do I know if I tore my meniscus?

Common signs of a meniscal tear include pain along the joint line, swelling, clicking or locking, and difficulty completely bending or straightening the knee. A clinical examination and possibly an MRI are usually needed to confirm the diagnosis.

Can I still walk with a torn meniscus?

Many people can still walk following a meniscal tear, especially with minor or degenerative tears. However, walking may cause pain, swelling, or a catching sensation, particularly with uneven surfaces or turning movements.

Will a knee brace help with a meniscal tear?

A brace can support and stabilise your knee following a meniscal tear, especially during early recovery or when returning to sport. It may reduce symptoms but won’t heal the tear itself.

How long should I rest after a meniscal tear?

Rest in the first few days to weeks after a meniscal tear is essential to reduce swelling and pain. After that, gradual reintroduction of movement and strengthening exercises is important. It is helpful to do these under guidance from a physiotherapist.

What exercises should I avoid with a meniscal tear?

If you have had a meniscal tear, you should avoid deep squats, twisting motions, high-impact jumping, and pivoting activities, especially early on. These movements can worsen the tear and are likely to cause discomfort.

Can I return to sports after a meniscal tear?

Many people return to sports after a meniscal tear following a period of rehab or surgery. Recovery timelines will vary based on the type of tear and treatment, but gradual return with proper strengthening is important for long-term knee health.

Is a meniscal tear the same as a cartilage tear?

Yes and no — the meniscus is a type of cartilage, but “cartilage tear” can also refer to damage to the articular cartilage, which lines the joint surfaces. They are different structures with different healing properties. It is important to seek clarification about your injury if you are uncertain.

What’s the difference between a meniscal tear and an ACL tear?

A meniscal tear affects the cartilage that cushions and stabilises the knee. An ACL tear involves a key ligament that controls knee movement and stability. ACL injuries often cause more instability and swelling and usually require longer rehab or surgery.

Do meniscal tears always cause swelling?

Meniscal tears do not always cause swelling. Acute tears often cause swelling within hours to a day or two. Degenerative tears may cause minimal or intermittent swelling, especially after activity.

Can you prevent arthritis after a meniscal tear?

While a torn meniscus can increase the risk of osteoarthritis, good management, including early treatment, strengthening, weight control, and avoiding high-risk movements, can help the joint stay healthy over time.