Degenerative meniscus

The meniscus is a cartilage structure in our knees that serves to absorb shock, aid joint stability and provide lubrication. The meniscus is the most commonly injured structure in the knee joint. Unfortunately these areas have reduced blood circulation, hence healing is poor. As a result of this, rehabilitation is extremely important.

Injury to the meniscus usually implies a tear to the meniscus. As people get older the meniscus gets more fragile. As a result, tears become more common as you age.

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Causes and symptoms

What causes meniscal injuries?

Meniscal injuries can be divided into two common causes:

Degenerative meniscus
Acute meniscal injury

A degenerative meniscus is the term used to describe the normal process of wear and tear within the meniscus. An acute meniscal injury is a consequence of a trauma. In this case the meniscus is usually injured as part of an abnormal twisting knee movement.

What are the symptoms of meniscal injury?

Symptoms will progress over a period of months to years
You may not experience any symptoms
You may experience knee pain, clicking from within the knee and swelling of the knee
Occasionally the knee may lock or give way

Diagnosis of meniscal injury

The diagnosis of a meniscal injury is often made on the history of injury, the symptoms described and a healthcare professional’s examination of knee function.

Sometimes an x-ray will be taken. X-rays cannot visualise the meniscus therefore are used to look for other conditions. An x-ray will identify arthritis of the knee, and injury to the bone or loose bodies (fragments of bone) in the knee, which can mimic the symptoms of a cartilage injury.

MRI imaging is not helpful in the diagnosis of a degenerative meniscus, especially if x-ray shows arthritis.

Self management of degenerative meniscus

Footwear

Poor ankle support is a common cause of knee pain, therefore ensuring you wear well maintained footwear that supports the ankle is important in the management of knee pain. Some people will find orthotics beneficial. Speak to your healthcare team to arrange this.

Weight loss

If you are overweight you are putting extra load through your knee. This will be contributing to your arthritis/degenerative meniscus, therefore losing weight will improve your symptoms.

There are useful tools to find out if your weight is contributing to your arthritis and advice on losing weight on the NHS website:

BMI calculator Weight loss plan Exercise advice

Warm and cold compresses

Warm compresses can be useful for your day to day pain, whereas cold compresses are useful to manage swelling and pain as a result of that swelling.

Walking aids (e.g. Nordic walking poles)

Using walking aids in both hands can significantly reduce the load through your knees, allowing you to keep mobile for longer.

Painkillers

Various over the counter pain killers are available for the management of pain. It is important to note these will not cure the condition, only numb the pain. It is therefore important to continue with all other aspects of treatment. If you have any questions your local pharmacy will be able to advise about what is safe.

Exercises

When starting an exercise for the first time it is important to ‘start low and go slow’. This means start with gentle exercises concentrating on the movement and slowly progress through weight bearing to resistance exercises.

It is important to note that exercise with arthritis/degenerative meniscus is completely safe and will not make your condition worse.

Pain killers can be used to help you do the exercises. Talk to your doctor for more specific advice regarding pain killers.

There are many other options which can improve your pain including appropriate footwear and weight loss (if you are overweight).

Exercise 1: seated knee extension

Sit upright with your thighs supported on a chair.
Bend your target knee as far back as possible.
Straighten your target knee as far as possible and hold for a few seconds, then relax and lower.
Don’t lift your thighs off the chair.

Exercise 2: heel slides

Lie on your back with your knees bent.
Slide one heel out to straighten your knee.
Hold in this position, feeling a gentle stretch in the back of your thigh, then return to the starting position.

Exercise 3: inner range quads in supine

Place a rolled up towel or other object under your knee.
Slowly straighten your knee as you raise your foot.
Keep your knee on the towel at all times.
Lower back down and repeat.

Exercise 4: step up

Slowly step up and down on a step.
Lead with your affected leg both ways.

Exercise 5: chair squat

Stand in front of a chair of an appropriate height (a lower chair increases the difficulty and a higher chair is less difficult).
With your feet about a shoulder width apart, sit with your hips back as if to sit into a chair whilst raising your arms in front of you.
Touch the chair with your bottom and then return to standing whilst lowering your arms.

What next?

If you are still experiencing symptoms despite following the above advice, it is important you seek advice from your GP. Your GP may decide to refer you to the musculoskeletal clinic or to a physiotherapist.

Page updated 01/12/2020. Review date 01/01/2024

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