What to Look for In a Knee Brace for Meniscus Tear

KNEE BRACE FOR MENISCUS TEAR

What to Look for In a Knee Brace for Meniscus Tear


Acute meniscus tears are a common sports-related knee injury for both recreational and professional athletes. Fortunately, there are various nonsurgical and surgical treatment options available, as well as rehabilitation exercises and knee braces for a meniscus tear injury.

Identifying the type of tear, location, and severity helps determine how to heal a torn meniscus. What knee brace is best for torn meniscus? Understanding the type of meniscus tear and the role of the menisci in supporting your knee will help you identify the best knee brace for torn meniscus.

What Is a Meniscus?

Your knee is a complex joint that connects your thigh bone (femur) to your shin bone (tibia). In each knee, you have two menisci: a medial (or inner) meniscus and a lateral (or outer) meniscus. The medial meniscus is a C-shaped cartilage that protects the inside of your knee. The lateral meniscus is a C-shaped cartilage on the outer portion of your knee joint.

The menisci have two critical roles. They absorb shock between the thigh and shin bones and help provide some stability of the knee. The menisci are tough and rubbery, which allows them to help cushion your knee joint.

Every time you take a step, your menisci absorb the majority of the weight placed on your leg. Without the menisci, your bones would rub against each other, causing pain and osteoarthritis over time.

Man-having-a-pain-in-his-knee

What Causes a Meniscus Tear?

A torn meniscus is a common injury among athletes and nonathletes and can occur in different ways. A meniscus tear can arise due to an acute injury or due to a degenerative process. Anyone can develop a meniscus tear, although it is less common in children under age 10.

Typically, a torn meniscus is caused by forceful twisting or rotation of your knee when your foot is anchored to the ground. For instance, sudden pivots or contact from being tackled can cause a tear. A tear can also occur when the knee is hyper-flexed such as during a deep squat, lifting something heavy, or even kneeling.

Sports-related tears are typically acute and due to sudden motions or impact when playing a sport or practicing. As a result, you often know precisely when the injury occurred. Athletes that participate in contact sports and sports that require pivoting, such as basketball, tennis, or golf, are at increased risk for a torn meniscus.

However, the risk of a meniscus tear also increases with age due to the degeneration of the cartilage. Over time, the cartilage gradually weakens and has reduced blood supply making the meniscus more vulnerable to a tear.

Individuals with osteoarthritis, a history of knee injuries, or obesity are also at a higher risk for a meniscus tear. In this situation, a tear can occur when doing daily activities, like getting out of a car. The cause of the injury may not be known. Occasionally, a torn meniscus due to degeneration can occur with no trauma.

Are There Different Types of Tears?

The menisci can be torn in different places. Knowing the type of tear and how the tear occurred helps determine possible meniscus tear treatment options.

Tears are identified based on how they look and where the injury occurs in the cartilage. The doctor will investigate whether the injury is stable or unstable, the location, the pattern, and the severity.

Tears in the outside one-third of the meniscus may heal on their own or can be repaired with surgery. This is because that area of the menisci, often referred to as the red zone, has a good blood supply. Damage to the inner two-thirds of the meniscus can’t heal on its own. This part of the meniscus, called the white zone, doesn’t have a blood supply.

What Are the Symptoms of a Torn Meniscus?

When a meniscus tears, you may hear or feel your knee pop.’ However, some people report not noticing or experiencing symptoms at the time of the knee injury.

Initial symptoms, including swelling and pain, will occur in the knee joint. The pain typically is felt on the inner or outer side of the knee instead of the knee cap. That said, the swelling and pain may develop gradually over a few hours, especially if the tear is less severe. Tears due to degenerative processes may not result in much, if any pain, and can go unnoticed.

woman-injury-knee-after-exercise

 If you have a minor tear, you typically will have slight pain and swelling that often resolves in 2 or 3 weeks. Swelling often worsens over 2 to 3 days with a moderate tear. Additionally, you may feel a sharp pain when you squat down or twist your knee. With a severe tear, you often have trouble straightening your knee. You may feel like your knee may give way or lock up. Swelling may start soon after the injury and increase over the next 2 or 3 days.

Other symptoms may include:

  • Stiffness,
  • Difficulty moving your knee or having a full range of motion,
  • Feeling like your knee is locking up,
  • Feeling like your knee is giving way.

After the initial inflammatory response ends, other symptoms can occur over time, such as:

  • Occasional swelling of the knee without a known cause,
  • Hearing or feeling your knee pop when climbing stairs,
  • Pain when running or walking for long distances,
  • Extra fluid in the knee joint,
  • Continued reduced range of motion in the knee.

When your knee feels like it is locked up and can’t be fully extended, it may be caused by part of the meniscus being stuck in the knee joint. It’s critical to get your knee evaluated in this situation to avoid further, long-term damage.

How Is a Meniscus Tear Diagnosed?

If you suspect you’ve torn your meniscus, a doctor can determine if a nonsurgical or surgical approach is needed.

Doctor Evaluation

Your doctor will start by taking a full history. Your doctor will want to know:

  • When the injury occurred and what you were doing if it was an acute injury,
  • Your symptoms,
  • Any other chronic knee problems or injuries,
  • Types of exercise or sports you participate in,
  • Your overall activity level.

During the physical evaluation, your doctor will feel the joint to look for areas of tenderness and warmth. Tenderness along the joint line can sometimes signal a tear. They will assess the stability of your ligaments and test your knee’s range of motion. They may also examine your quadriceps and hamstring muscles.

During the evaluation, your doctor may perform the McMurray test, which is one of the main tests used to look for a meniscus tear. During the McMurray test, your doctor will bend your knee, straighten it, and then rotate it. This series of movements puts tension on the menisci and will cause a clicking-like sound if there is a tear.

Ultrasound-knee-joint-diagnosis

Imaging

Imaging can help confirm diagnosis as well as determine if there are any additional knee problems, including degeneration or ligament tears like ACL.

Magnetic Resonance Imaging (MRI). MRI is used to confirm a diagnosis of a meniscus tear. This noninvasive tool can show the inner structures of the knee, including cartilage, ligaments, tendons, and muscles. The images can help determine if the problem is due solely to a meniscus tear or if there are additional injuries. This is important since ACL tears often co-occur with some types of meniscus tears. Lastly, the imaging can help a surgeon determine if surgery is needed as well as plan the surgery.

X-ray. Meniscus tears don’t show up on X-rays, but this tool has other uses. X-rays can help identify any fractures, arthritis, or loose bone fragments that might be irritating the joint. It also shows the degree of cartilage wear. X-rays reveal the amount of space the cartilage takes up in the joint. The narrower the space, the more likely that there is reduced cartilage from conditions such as a degenerative process.

What Are the Treatment Options For a Meniscus Tear?

The doctor’s evaluation and possible imaging will help determine whether surgery is required or if the tear may heal on its own. Other factors, such as age, activity level, and any other related injuries, such as a torn ACL, will also be taken into consideration.

Depending on the type of injury, you could opt for a more conservative, nonsurgical approach at first and then pursue surgical options if that doesn’t work. The exception is if your knee is locking up due to torn meniscus in the joint. This type of injury has to be repaired surgically.

Nonsurgical Treatment Options

Surgery may not be required if your tear is small and located in the outer, or red zone, area of your meniscus. Other factors include whether your knee is stable and if symptoms don’t persist over a long period. In this situation, nonsurgical options, including rest and exercises for torn meniscus, may be sufficient to heal your injury.

The RICE protocol—Rest, Ice, Compression, Elevation—is often recommended as an effective way to rest and treat a meniscus tear that doesn’t require surgery.

  • Rest. You may need to limit or stop certain activities, especially those that put tension on the knee or require it to rotate until the tear is healed. Additionally, your doctor may suggest that you use crutches to avoid weight on your leg.
  • Ice. Apply cold packs several times a day as directed by your doctor. Be sure not to put the cold pack directly on your skin.
  • Compression. An elastic compression bandage or a knee brace for meniscus tears may help prevent swelling or add additional stability to your knee. Before using a brace, consult your doctor to ensure that a bandage or brace is right for your type of meniscus tear.
  • Elevation. When resting or reclining, prop your leg up higher than your heart to help reduce swelling.

Over-the-counter pain medications, such as aspirin, can help reduce swelling and pain. Talk with your doctor about what medication may work best for you.

Surgical Treatment Options

Arthroscopic knee surgery is commonly used for meniscus tears. The goal of the operation is to preserve as much of the meniscus as possible. While uncommon, some tears may require open knee surgery.

Procedure. During arthroscopic surgery, a surgeon inserts a small scope into your knee through a small incision. This scope allows them to see the structures inside your knee. They will insert miniature surgical tools into a different small incision to operate. Usually, the procedure lasts about an hour, and the patient will likely go home that same day.

Types of Surgeries. The kind of operation needed will depend on the tear. To fix the injury, your surgeon may perform a:

  • Partial meniscectomy by removing the damaged parts of your meniscus and smoothing frayed edges,
  • Meniscus repair where the surgeon sutures the torn meniscus pieces together,
  • Total meniscectomy which entails removing all of the meniscus.

Overall, arthroscopic surgery is low-risk. Complications are uncommon, although all operations come with some degree of risk.

If surgery is needed, your doctor may refer you to physical therapy before surgery to strengthen your knee in preparation for post-surgery rehabilitation. You may also be fitted for crutches before surgery.

Is Physical Therapy For a Meniscus Tear Necessary?

Physical therapy or rehabilitation exercises at home are often recommended. Physical therapy can help speed recovery and minimize any complications, especially if you have surgery.

Torn meniscus rehabilitation exercises help strengthen your knee, surrounding leg muscles, and help you recover full range of motion. Additionally, physical therapy may work as well as surgery for tears due to degeneration or osteoarthritis.

A physical therapist can ensure you are performing the right exercises for your stage of recovery and help monitor your progress. The exercises will focus on helping you regain a full range of motion, such as flexing and extending your knee, stretching your leg muscles, and building strength.

The types of exercises may vary depending on your specific situation. During this process, your focus is on healing your knee. Therefore, it’s critical to pay attention to the pain signals your body sends you. Healing your injury takes time, and pushing yourself too hard may slow down your progress.

Physical-Therapist-Using-Ultrasound-Probe-On-Patient-Knee

What Is the Recovery Time Following a Meniscus Tear?

It’s important not to rush through your recovery. Your menisci will need time to heal regardless of whether you had surgery or not. As with physical therapy, it’s important to pay attention to symptoms such as pain and swelling.

Giving your knee ample time to heal will give you the best chance to return to full functioning. Returning to your regular activity levels too soon could cause further injury.

Recovery Time Without Surgery

For most people, a meniscus tear in the red zone will take 6 to 8 weeks to heal fully. During this time, you may need crutches for part of the time to help keep weight off the leg. Additionally, your doctor or physical therapist may assign you rehabilitation exercises for torn meniscus to build up strength.

Recovery Time With Surgery

The recovery depends on the type of surgery and the severity of your tear. Most people return to normal functioning from arthroscopic surgery to remove the torn meniscal fragments in 3 to 6 weeks.

If you require a meniscus repair (stitches), recovery time is typically longer. A meniscus repair can take up to 3 months to heal.

Do You Need a Knee Brace For Meniscus Tear?

Knee braces for meniscus tears can help provide support and stability. However, knee braces don’t heal or treat the tear.

It’s essential to understand the type of injury you have and the desired function of the knee brace to select the right knee brace for you. Consulting your doctor or physical therapist can help you identify what you need from a knee brace for meniscus tear.

Some knee braces will help prevent your knee from rotating too far, and other braces can help reduce the amount of weight that certain parts of the meniscus needs to hold. Other types of braces might be used when playing sports to help prevent a tear.

What Should You Look For In a Knee Brace For Meniscus Tear?

When looking for a knee brace, take into account the type of injury you have, the type of surgery, and whether you need a brace for daily wear.

Mild Meniscus Tear or Degenerative Tear

knee sleeve that provides mild compression may help provide some additional support during recovery. The compression can add warmth around your knee, making it feel better. Additionally, the brace can remind you that your knee is recovering so you don’t overuse your knee too soon.

Look for a knee sleeve that fits comfortably, but doesn’t put too much pressure on your knee. Too much pressure can make it hard to extend your knee fully and may not help properly support your knee during recovery.

Materials such as neoprene are usually lightweight and comfortable to wear for long periods. Some sleeves will have a cut out around the kneecap area, which may be more comfortable.

If a sleeve is difficult to put on, there are wrap-around options that can provide mild compression. The advantage of a wrap-around style is that it can fit comfortably on top of pants if desired, and can be easier for people who are having trouble bending over. However, this style may loosen while being worn and may need adjustment throughout the day.

Meniscus Tear on One Side

If the meniscus is torn on one side or you have osteoarthritis due to bone-on-bone rubbing, an unloader knee brace may help. An unloader knee brace provides additional support by reducing the amount of weight, or load, that the injured or weakened meniscus has to hold. The brace shifts the weight to another uninjured area of the meniscus. This approach can help reduce pain and make it more comfortable to do your normal activities.

Ideally, look for an unloader knee brace that fits snugly but without putting pressure on your knee. To ensure a full range of motion, look for designs that have a flexible, often elastic, hinge system that allows for easy movement while still offering support.

Some unloader knee braces are designed with a web-like design. This design can provide stability and support while making the brace more comfortable and allowing more airflow.

Meniscus Tear on Both Sides

If the meniscus is torn on both sides, a ligament brace or hinged brace may offer the best support. This type of brace can provide general knee support, which can be especially useful if you have osteoarthritis as well. Additionally, if you have a torn ACL, this style of brace may help support both your ACL and menisci.

There are a variety of styles available to suit different needs. Look for a knee brace that has hinges on both sides to offer support. You will want a brace that fits snug without putting pressure on your knee joint.

Some braces come with an opening in the back called an open popliteal. This opening can make the brace more comfortable to wear since the brace material won’t bunch at the back of your knee when bending the joint. This opening also allows for more airflow.

If you’re looking for a brace that provides more feeling of warmth and compression, then you may prefer a neoprene fabric. However, another material used in some braces—Drytex—can provide some compression, but with more breathability. This material may be useful for people living in warmer climates.

How Do You Prevent a Meniscus Tear?

It can be challenging to prevent meniscus tears since they can happen unexpectedly, even when doing everyday activities. However, to minimize your risk, consider:

  • Performing warm-up exercises and stretches before engaging in exercise or sports,
  • Keeping your leg muscles, especially your thigh muscles, strong with regular exercise,
  • Consulting your doctor about using a protective sleeve or knee brace as a preventative measure if you play sports that require pivoting or contact sports,
  • Stretching regularly to stay flexible,
  • Wearing supportive shoes.

What Is the Long-Term Outlook Following a Meniscus Tear?

With rest, proper treatment, and rehabilitation exercises for torn meniscus, most people regain full use of their knee following a meniscus tear. A knee brace for meniscus tear can be a useful tool to help provide stability to your knee during recovery or as a preventative measure.


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