Cartilage is a tough but flexible tissue found throughout the body. It covers the surface of joints acting as a both shock absorber and allows bones to slide over one another. In the knee the cartilage is known as the meniscus.
A meniscus injury/tear can occur through trauma following twisting action or develop over time known as a degenerative tear. Often pain is sharp and felt immediately, however swelling usually occurs / increases over 24 hours.
The most common symptoms of a cartilage injury are:
- Limited function in daily tasks
- Pain felt inside the knee
- Reduced movement of the knee joint due to pain when bending / straightening
- A dull ache at rest or at night
- Pain is worse during or after activity
- Stiffness worse with inactivity
- The knee may lock (get stuck in one position)
- The knee may give way (drop and cause you to fall)
Diagnosis is usually made from a consultation with your Health Care Professional, involving a detailed history of the onset of symptoms, current pattern of symptoms and your current functional ability.
An image/scan is generally not needed to confirm a cartilage injury. One may be performed if the Health Care Professional needs further information to finalise the diagnosis or if surgery is being considered.
The primary aim of treatment is to help manage your pain. This allows you to move more and help you return to normal activities sooner. Initial treatment therefore is aimed at pain control. This might involve pain medication, or the use of heat or cold treatments.
Once your pain is under control, working on the movement and strength of your knee is what will help long term.
You can help to reduce pain, ease stiffness, strengthen your muscles and improve overall general fitness by keeping active. Below are some basic exercises specific to your knee to get you started.
It is normal to experience some discomfort when doing exercises, and individuals may start at different points. Pain should not increase excessively during or immediately after the activity. Discomfort should return to pre-activity levels 24-48 hours after the activity has finished.
The number (reps) and frequency (sets) of exercises suggested here are a guide, and should be performed to your personal tolerable pain levels. This means repetitions will vary between individuals and you should only go as far as is reasonably comfortable for you.
Knee flexion & extension in sitting
Sit on a chair and slide your affected foot along the floor by bending the knee. Bring your foot under the chair and then extend it out as far as you can comfortably and return to the starting position and repeat as directed. You can place a towel under your foot to assist in performing this exercise if desired.
Static quadriceps
Sit upright on your bed or the floor, with your legs out straight in front of you. Point your toes directly up to the ceiling. Tighten your thigh muscle, pushing the back of your knee down into the floor. You should be able to see the muscle tensing. Relax and repeat.
Inner range quadriceps
Sit upright with your legs out in front of you. Place a yoga block under your affected knee. Slowly lift your heel up off the floor, straightening your knee while keeping the back of your leg on the towel. Hold this position, then control the movement as you lower the foot back down again.
Unless you have a serious injury or have sudden continuous severe pain, you can usually treat your knee pain without having to see your doctor. If after 2 weeks of treating yourself you feel the pain isn’t any better or is worsening, you should see a Health Care Professional
You should also see a Health Care Professional if you:
- Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help
- Have pain that has rapidly deteriorated or suddenly worsened despite self help
- Have pain, tingling, numbness or weakness in your legs and feet
- Develop sudden stiffness in the knee resulting in a complete loss of movement (also known as locking)
- Are noticing changes to your balance or walking pattern
- Are feeling clumsy or are falling more often
- Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection
- Feel unwell, have a fever, or unexplained weight loss
- Are experiencing significant and regular changes to your usual sleeping pattern
- Have a history of recent injury (e.g. from a road traffic accident or a fall) or a history of knee surgery
- Have a new and visible deformed or misshapen knee
- Notice your knee is giving way, causing you to fall.
If you do not have any of the above, you may be able to effectively self-manage your condition