If you have knee pain that just doesn't want to go away and you have a history of engaging in high impact sports involving the knee like football and basketball, you may have a meniscal tear. With sports being a favorite activity in San Ramon, there are many people at risk of developing chronic knee pain from meniscal tears.
The meniscus is a shallow bowl-shaped piece of cartilage that is attached to the lower leg bone, or tibia. The end of the femur (upper leg) bone has two protuberances called the femoral condyles, which rest on top of the meniscus. In the standing position, the meniscus bear the full weight of the body above the knee. They serve as a cushion and shock absorber and protect both of the ends of the tibia and the femur. As the knee bends, the femoral condyles glide over the meniscus.
The two basic types of tears are a radial tear and a vertical tear. Meniscal tears usually are caused by excessive pounding forces to the knee, which cause tiny fissures that eventually grow over time. Running on hard pavement, weight lifting, and playing basketball are activities that can do this. Sometimes small pieces break free and float loosely inside the knee space. This can cause the knee to swell and become stiff (difficult to fully bend).
Meniscal tears increase the chances of accelerated knee osteoarthritis, as “bone on bone” contact occurs between the ends of the femur and tibia. If this is allowed to occur for many years, you are on your way for knee replacement surgery down the road.
To avoid injuring your meniscus, consider doing functional exercises that combine cardio and strength instead of running. They strengthen the knee, making it more stable and decreasing risk of injury. Do mostly closed kinetic chain exercises where the foot is immobilized, usually on the ground. This includes squats and lunges. Intermittent jumping exercises are ok as long as they are controlled and are not the focus of an exercise session. Power jumps and related plyometric exercises fall into this category. The fitness trainers at Club Sport in San Ramon can recommend the appropriate exercises for your situation.
If you believed you have injured your meniscus, call your doctor, who should order an MRI. If there is a large tear, surgery will likely be recommended. If you have a small tear, or there are no signs of meniscal damage, you may have damaged the lining of the cartilage. Laser therapy can help accelerate the healing of these types of presentations. For more information on laser therapy, call us at (925) 855-5525.
Dan Perez, DC