Meniscus injuries are one of the most frequent causes of knee pain, especially in athletes and active adults—but they can also affect older individuals due to age-related degeneration. If you’re experiencing knee locking, clicking, or persistent swelling, it’s important to understand the type of tear and the best treatment options, backed by current scientific evidence.
🧠 What Is the Meniscus?
The meniscus is a wedge-shaped cartilage that cushions and stabilizes the knee joint. Each knee has two menisci:
- The medial meniscus (inner side)
- The lateral meniscus (outer side)
The menisci absorb shock and distribute weight. Tearing this structure can disrupt knee stability and lead to long-term joint damage if not properly managed.
✅ Common Types of Meniscus Tears
Understanding the tear pattern helps guide the right treatment. Here’s a breakdown of the main types:
1. Longitudinal (Vertical) Tear
- Runs along the length of the meniscus.
- Common in younger, athletic populations.
- Risk of progressing into a bucket-handle tear.
2. Bucket-Handle Tear
- A flap of the meniscus flips into the joint space.
- Common cause of mechanical locking.
- Usually requires urgent surgical repair.
3. Radial Tear
- Starts at the inner edge and moves outward.
- Often not repairable if located in the avascular (white) zone.
4. Horizontal Tear
- Splits the meniscus into upper and lower layers.
- Common in older adults.
- May be associated with meniscal cysts.
5. Flap Tear (Parrot-Beak)
- Creates a flap that may catch during movement.
- Can cause intermittent locking or clicking.
6. Complex Tear
- A combination of multiple tear patterns.
- Often degenerative and challenging to repair.
7. Degenerative Tear
- Gradual fraying of cartilage due to wear and tear.
- Common with osteoarthritis.
🚨 Mechanical Symptoms: What They Mean
Mechanical symptoms are a red flag for structural damage that may require urgent care:
- Locking (inability to fully straighten or bend the knee)
- Catching or clicking during movement
- Recurrent swelling or giving way
These signs often point to a displaced meniscus flap, such as a bucket-handle tear.
💡 Can Physiotherapy Unlock a Locked Knee?
Physiotherapy plays a vital role—but there are limits depending on the cause of the locking:
✅ Physiotherapy can help if:
- Locking is due to muscle guarding, pain, or swelling (pseudo-locking)
- Symptoms are mild or intermittent
- The tear is stable and not displaced
❌ Physiotherapy cannot fix:
- True mechanical locking caused by a displaced meniscus fragment
- Bucket-handle tears that are physically obstructing joint movement
In those cases, urgent surgical referral is necessary to avoid further damage.
⚕️ Evidence-Based Treatment Options
1. Conservative Management (Non-Surgical)
Suitable for:
- Degenerative tears
- Tears without mechanical symptoms
Includes:
- Structured rehabilitation (12+ weeks) focusing on strength, control, and function
- PRP injections (Platelet-Rich Plasma) for degenerative cases (emerging evidence)
- Peptide therapy (e.g. BPC-157) – experimental, still under investigation
2. Surgical Intervention
Indicated for:
- Tears causing locking or instability
- Athletes or active patients with persistent symptoms
Options include:
- Meniscus repair – preferred where healing potential exists (red-red or red-white zones)
- Partial meniscectomy – removes irreparable tissue
- Meniscus transplant – considered when meniscus loss is significant
3. Rehabilitation After Surgery
Post-surgical rehab is key to long-term recovery:
- Regaining range of motion
- Restoring strength and stability
- Gradual return to sport or activity
👣 When Should You See a Physiotherapist or Specialist?
Seek professional assessment if you have:
- A locked or clicking knee
- Recurrent swelling
- Limited range of motion
- Or if your symptoms aren’t improving with rest
A trained physiotherapist can assess whether your meniscus tear can be managed conservatively—or requires a referral to an orthopedic specialist.
📞 Same-Day Assessment for Meniscus Injuries
At After Hours Physio, we provide urgent physiotherapy for acute knee injuries, including meniscus tears. Early diagnosis and evidence-based treatment can significantly shorten recovery time and prevent long-term joint damage.
🕘 Appointments available 7am – 11pm, 7 days a week
📍 Convenient Eastern Suburbs location
✅ No referral needed