The knee has two cartilages or menisci (medial and lateral). The medial meniscus is more apt to be injured during soccer play than the lateral and is frequently torn in combination with a medial collateral ligament.

Anatomical Details

The meniscus found between joint structures is called fibrocartilage; the knee meniscus is one example. This hyaline cartilage functions to provide a smooth gliding surface between bones and absorb shock. When this cartilage is damaged, there is increased wear on the bone and degenerative and/or arthritic changes may appear. When this occurs, joint movement is painful and may become restricted. The meniscus is mostly avascular (lacks blood supply). When the meniscus is torn or injured, it does not repair on its own due to this limited blood supply.

Mechanism of Injury

• Twist of your soccer player's knee (i.e. while he is running or cutting towards the soccer ball), with or without a direct collision.
• Rapid change in direction on a weightbearing knee (i.e. reacting to a ball kicked to his side).

Signs and Symptoms

• Locking of your player's knee. She is usually unable to fully extend her injured leg. This may be due to a floating piece of cartilage getting trapped and preventing movement.
• "Popping" sound at the time of injury.
• Pain on her joint line or within her joint, especially with squatting and/or twisting.
• Sensation of "giving away" due to instability.
• Swelling and decreased range of motion (ROM).
• Specific tests as conducted by a physician will determine the extent of the injury.

On-Site Management

P.R.I.C.E. PROTECT the area from further damage (i.e. wrap). REST the area to promote healing. Your athlete should place ICE on the area for 10-20 minutes every 1.5 to 2 hours for the first 2 to 3 days or until the pain goes away. COMPRESS his knee using a tensor while icing. ELEVATE his knee to promote circulation towards his heart. Decreasing the swelling will assist in making a proper diagnosis of his meniscal tear. Once the knee becomes swollen, it is difficult to make an exact diagnosis.

Medical Referral. Meniscus tears commonly occur with severe knee sprains. If pain and loss of function are severe, make sure your soccer player does not walk on the injured leg, splints the knee in a comfortable position, and goes to a physician or an emergency medical facility. Surgical intervention is usually required to repair the damage or remove floating pieces.

Rehabilitation

Healing. Progressive range of motion and soccer specific strengthening of structures around your soccer player's knee joint may cause symptoms to subside. If symptoms continue, however, referral to a physiotherapist may be necessary.

Return to Activity. Your player cannot return to soccer activity until she is released by a physician and has normal knee strength and motion.

Prevention. Although there is no absolute way to prevent a meniscal tear, there are some measures that can be taken to prevent risk. For example, when playing soccer on surfaces such as Astroturf, shoes with smaller or less numerous cleats can help prevent the foot from becoming completely planted if forced into rotation.

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