Whether your knee joint pain has progressively gotten worse or the pain started suddenly, if you are experiencing serious pain around your knee, you might be wondering what is wrong and what you can do to treat your pain. While there are many causes of knee pain, a meniscus tear and an ACL tear are among the most common types of knee pain for athletes.
Meniscus Tear
Meniscus tears are one of the most common knee injuries. They are generally caused by twisting or turning suddenly, most often when the knee is bent and the foot is planted. There are three levels of meniscus tears:
- Minor tear– There will be slight pain and swelling. It will usually heal in two to three weeks.
- Moderate tear– The pain will be at the center or side of knee. Swelling will get worse over the first two to three days. While you may be limited in how much you can bend your knee, walking is generally possible. The pain may get worse when you twist your knee or squat. While the symptoms may go away in just a week or two, if left untreated, the pain may return. The cycle of pain followed by no pain may continue for several years.
- Severe tear– With a severe tear, the torn meniscus may move into the joint, causing the knee to pop, lock, or catch. You might be unable to straighten your knee, and it may feel wobbly or give out with little to no warning. The injured area may become stiff and swell either right after the injury or within the first two to three days.
No matter what type of meniscus tear you experience, one of the top ways to help it heal is to rest and ice your injured knee. You may also want to elevate the leg by propping it up on a pillow. Wrapping the knee with an elastic bandage is also often helpful.
While a minor tear can often heal by simply resting, icing, compressing, and elevating the injured area, you will likely need a doctor’s help to treat a more serious meniscus tear. If you suspect that you have a meniscus tear, it is best to visit a doctor right away. The doctor may perform a physical examination of the knee, checking for tenderness, range of motion, and knee stability. The doctor may also use x-rays and MRIs to get a better idea of the damage to the knee. If the tear is serious, your doctor may have you see an orthopedic surgeon.
For more serious meniscus tears, physical therapy is often needed. If physical therapy does not help or if the tear is found to be more serious, surgery might be used to either repair or remove the meniscus. The recovery time after surgery varies. With a less serious surgery, the person can generally return to heavy work or sports within four to six weeks. With a more intrusive surgery, the person may take several months to heal. It is important to obey your doctor’s orders when it comes to returning to your normal lifestyle. This will help the injured knee to heal more efficiently.
ACL Tear
The anterior cruciate ligament (ACL) is one of the ligaments that provides stability for the knee joint. The ACL, along with the posterior cruciate ligament, controls the back and forth motion of knee. Unfortunately, an ACL tear is among the most common knee injuries for athletes. It is most likely to happen to athletes in sports, such as soccer, basketball, football, and other sports with quick stop and go motions. An ACL tear may happen when a person changes directions or stops suddenly, while slowing down when running, when a person lands incorrectly after jumping, or from direct contact during a collision. It can also happen during non-athletic activities, such as when you fall off a ladder or trip on a curb. Female athletes are more likely to suffer an ACL tear than their male counterparts participating in the same sport. This might be due to the physical anatomy differences between males and females as well as physical training differences.
There are three grades of ACL tears with the least serious being a Grade 1, which means the ligament is stressed but still able to keep the knee joint stable. With a Grade 2, the ligament is stretched to the point of it becoming loose. This is often called a partial tear. A Grade 3 involves a complete tear of the ligament. The ligament is in two parts, and the knee joint is unstable. Unfortunately, most ACL tears involve full or almost full tears of the ligament. Some of the symptoms of an ACL tear include:
- A popping sound at the time of the injury
- Discomfort in the knee when walking
- The knee gives out on the person
- Pain and swelling, with the swelling starting within 24 hours of the injury
- Loss of full range of motion of the knee because of pain or swelling
As with other serious knee injuries, one of the first steps should be to stop what you are doing. While you may be able to walk, you may need to lean on someone else, having the person help you off the field or court. RICE (rest, ice, compression, and elevation) should start as soon as possible after the injury. If you are experiencing the symptoms of an ACL tear or other serious injury, especially swelling and difficulty putting weight on the injured knee, you should see a doctor right away. Your doctor will likely look over your knee, determining the extent of the damage. Often, x-rays or MRIs are used to assess the damage to the knee. Do not put off having a doctor look at your injured knee. Continuing to use the injured knee may increase the damage.
While some ACL tears can be treated with rest and rehabilitation, such as a brace and physical therapy, nonsurgical treatment generally works best for people who are elderly or who are not physically active. Unfortunately, athletes and other active people generally need surgery to repair a torn ACL. Most the time, surgery will not be done right away. This allows for the inflammation to go down, thereby increasing the chances of proper healing. About half of ACL tears involve damage to other parts of the knee, including the meniscus, knee cartilage, or other knee ligaments. Because of this, the surgery may involve repairing other damaged parts of the knee.
While you are waiting to have surgery, your doctor will likely have you do specific exercises, which will help to rebuild range of motion in your injured knee. This rehabilitation, including physical therapy, will continue after the surgery. The length of rehabilitation depends upon the specific person and should continue until the knee is stable and strong. After undergoing ACL surgery, it may be several months before the person can return to their previous physical activity.
While proper treatment for these two injuries as well as other knee injuries is important, prevention is preferred over treatment. Warming-up properly, wearing proper footwear, slowly increasing your physical activity, and stopping physical activity if you feel knee pain can all help to reduce your chances of a knee injury. If you are overweight, losing weight will take some of the stress off your knees, decreasing your chances of a knee injury. You may also want to wear a knee brace during activities that put stress on your knees, especially if you have suffered a previous knee injury.