Meniscus Injuries in
the Gym Athlete
The meniscus is a piece of cartilage in the knee joint that acts as a shock absorber and helps to distribute weight evenly across the knee joint. The knee joint has two menisci, one on the outer side of the knee (lateral meniscus) and one on the inner side of the knee (medial meniscus).
The meniscus is C-shaped and has a tough, rubbery texture. It sits between the femur (thigh bone) and the tibia (shin bone) and helps to cushion the joint and provide stability.
It also helps to distribute the synovial fluid, a lubricating fluid that nourishes and protects the knee joint.
Tears can range from small/minor tears, or quite severe and extensive tears. The more severe, extensive tears are not particularly common in weightlifting. Examples of a large meniscal tear in gym context are:
A sudden, rapid increase in load: For example adding 40-50kg to the bar during a squat in one given session
Beginning a new program which consists of considerably more volume, not allowing the cartilage in the meniscus to adapt to the new load over time
The knee buckling during a jump lunge (crossfit or F45)
There are a number of different types meniscus tears as well:
Radial tear: This type of tear runs from the outer edge of the meniscus towards the center, and can cause the torn piece to flip over or move out of place.
Horizontal tear: This type of tear runs parallel to the surface of the meniscus, and can cause the meniscus to split into two separate pieces.
Flap tear: This type of tear occurs when a piece of the meniscus is partially torn, creating a flap that can catch in the knee joint and cause pain and swelling.
Bucket-handle tear: This type of tear is a large vertical tear that runs the length of the meniscus, and can cause a piece of the meniscus to become detached and move out of place, creating a "bucket-handle" appearance.
Complex tear: This type of tear involves a combination of different tear patterns, and can be more difficult to treat.
The blood supply of the meniscus can also impact its healing
The outer third of the meniscus, also known as the red-red zone, has a direct blood supply from small blood vessels that run into the meniscus from the surrounding tissues. This area has a greater potential for healing because of its direct blood supply.
The middle third of the meniscus, known as the red-white zone, has a less direct blood supply and a lower potential for healing. The inner third of the meniscus, also known as the white-white zone, has no direct blood supply and the lowest potential for healing.
The limited blood supply to the meniscus can make it difficult for the body to repair itself after injury. In cases where the meniscus is torn and the tear is located in the red-red zone