Meniscus Tear (Cartilage Tear) of the Knee
Musculoskeletal (MSK) Services
Last updated: July 2026
Review Date: July 2028
What Is a Meniscus Tear?
A meniscus tear is one of the most common knee injuries and can affect people of all ages. The meniscus is a piece of tough, rubbery cartilage that acts as a cushion between your thigh bone (femur) and shin bone (tibia). Each knee has two menisci – one on the inside (medial meniscus) and one on the outside (lateral meniscus).
The menisci help absorb shock, distribute weight across the knee joint and improve stability during walking, running and twisting movements. When one of these structures becomes torn or damaged, it can lead to pain, swelling and difficulty moving the knee.
What Causes a Meniscus Tear?
Meniscus tears can occur suddenly following an injury or develop gradually over time as part of the natural ageing process.
Acute Meniscus Tears
Acute tears are usually caused by a sudden twisting movement while the foot remains firmly planted on the ground. They are common during sports such as football, rugby, skiing and tennis but can also occur during everyday activities involving a sudden change of direction.
These injuries are more common in younger people and may occur alongside other knee injuries such as ligament damage.
Degenerative Meniscus Tears
As we get older, the meniscus naturally becomes less flexible and more prone to wear and tear. This means a tear can develop during relatively simple activities such as squatting, kneeling or even stepping off a curb.
Degenerative meniscal tears are particularly common in adults over the age of 40 and are often associated with early osteoarthritis. Unlike traumatic tears, they may develop gradually without a single obvious injury.
What Are the Symptoms?
Symptoms vary depending on the size and location of the tear. Some people experience only mild discomfort, while others develop significant pain and reduced movement.
Common symptoms include:
- Pain on the inside or outside of the knee.
- Swelling that develops over the first 24–48 hours.
- Stiffness or difficulty fully straightening the knee.
- Pain when squatting, kneeling or twisting.
- Clicking or catching sensations within the knee.
- A feeling that the knee is giving way.
- Locking of the knee, where it becomes difficult to fully straighten or bend the joint.
Symptoms may worsen during activities such as walking downstairs, running or getting up from a chair.
How Is a Meniscus Tear Diagnosed?
Your clinician will begin by asking about your symptoms, how the injury occurred and which activities make your pain worse.
A physical examination of your knee will usually include assessing:
- Your range of movement.
- Areas of tenderness.
- Swelling.
- Knee stability.
- Special tests that place gentle stress on the meniscus.
In many cases, a meniscus tear can be diagnosed through a clinical examination alone.
If further investigation is required, imaging such as an MRI scan may be recommended. X-rays are sometimes used to identify arthritis or other causes of knee pain but cannot show the meniscus itself.
Treatment Options
Most meniscus tears improve without surgery. Treatment focuses on reducing pain, restoring movement and gradually strengthening the muscles that support the knee.
The most appropriate treatment will depend on:
- Your age.
- Your activity levels.
- Whether the tear is acute or degenerative.
- The severity of your symptoms.
- Whether your knee is locking or giving way.
Pain Relief
Simple pain relief and anti-inflammatory medication may help reduce discomfort during the early stages of recovery.
Always follow the advice of your pharmacist, GP or healthcare professional before taking any medication.
PRICE
During the first few days following an injury, the PRICE principles may help reduce pain and swelling.
Protection
Protect your knee from further injury by avoiding activities that significantly increase your pain. A knee support or walking aid may occasionally be recommended.
Rest
Reduce activities that aggravate your symptoms while keeping the knee gently moving where possible. Prolonged complete rest is generally not recommended.
Ice
Apply an ice pack wrapped in a towel for 15–20 minutes every two to three hours during the first 48 hours. Never place ice directly onto your skin.
Compression
A compression bandage may help reduce swelling and provide gentle support during the day.
Elevation
Whenever possible, raise your leg above the level of your heart to help reduce swelling.
Physiotherapy
Physiotherapy plays a vital role in recovering from a meniscus tear and is often the most effective treatment.
Your rehabilitation programme may help to:
- Reduce pain.
- Improve knee movement.
- Restore strength.
- Improve balance and stability.
- Return you to work, sport and everyday activities.
Exercises typically focus on strengthening the quadriceps, hamstrings and gluteal muscles while improving balance and movement control. Research has shown that structured exercise programmes provide excellent outcomes for many people with degenerative meniscal tears.
Exercises for a Meniscus Tear
Exercise is one of the most effective treatments for a meniscus tear. Keeping the knee moving and gradually strengthening the muscles around the joint can reduce pain, improve stability and help you return to your normal activities.
Your physiotherapist will design a programme tailored to your individual needs, but the following exercises are commonly recommended during rehabilitation.
Quadriceps Contractions
This exercise helps activate the muscles at the front of your thigh and improve knee stability.
How to perform the exercise:
- Lie on your back with both legs straight.
- Pull your toes towards you.
- Tighten the muscles at the front of your thigh.
- Push the back of your knee firmly into the bed or floor.
- Hold for 5 seconds before relaxing.
Repeat 10 times.
Inner Range Quadriceps Exercise
This exercise strengthens the quadriceps while improving knee control.
How to perform the exercise:
- Lie on your back.
- Bend one knee and keep the other leg straight.
- Place a rolled towel beneath the straight knee.
- Tighten your thigh muscles and straighten your knee while keeping it resting on the towel.
- Hold for 5 seconds before slowly relaxing.
Repeat 10 times.
Prone Knee Flexion
This exercise helps restore knee bending.
How to perform the exercise:
- Lie on your stomach.
- Slowly bend your knee as far as comfortable.
- Keep your hips flat against the bed.
- Hold for 5–10 seconds before lowering.
Repeat 10 times.
Straight Leg Raise
Straight leg raises strengthen the quadriceps without placing excessive strain on the knee joint.
How to perform the exercise:
- Lie on your back with one leg bent.
- Keep the affected leg straight.
- Tighten your thigh muscles.
- Lift your leg approximately 20 cm from the floor.
- Hold for 5 seconds before lowering slowly.
Repeat 10 times.
Heel Slides
Heel slides improve knee movement and reduce stiffness.
How to perform the exercise:
- Lie on your back.
- Slowly slide your heel towards your bottom.
- Bend the knee as far as comfortable.
- Hold for 5–10 seconds before returning to the starting position.
Repeat 10 times.
Bridging
Bridging strengthens the gluteal muscles, hamstrings and core, which all help support the knee.
How to perform the exercise:
- Lie on your back with your knees bent.
- Keep your feet flat on the floor.
- Lift your hips until your shoulders, hips and knees form a straight line.
- Hold briefly before lowering slowly.
Repeat 10 times.
Single Leg Bridge
Once your strength improves, your physiotherapist may progress you to single leg bridging.
How to perform the exercise:
- Begin in the bridge position.
- Shift your weight onto one leg.
- Slowly straighten the opposite leg while keeping your pelvis level.
- Return to the starting position and repeat on the opposite side.
Repeat 10 times on each leg.
Squats
Squats strengthen the muscles around the knee while improving balance and control.
How to perform the exercise:
- Stand behind a chair for support.
- Slowly bend your hips and knees.
- Push your hips backwards as though sitting into a chair.
- Keep your knees pointing forwards and avoid allowing them to collapse inwards.
- Return slowly to standing.
Repeat 10 times.
Single Leg Balance Exercise
Balance exercises improve joint awareness and help reduce the risk of future injury.
How to perform the exercise:
- Stand on one leg with a slight bend in the knee.
- Maintain your balance while keeping your hips level.
- If advised by your physiotherapist, use a resistance band to increase the challenge.
- Return to the starting position.
Repeat 10 times on each leg.
How Often Should I Exercise?
Most rehabilitation exercises can be completed two to three times each day, provided your pain remains manageable. Some mild discomfort during exercise is normal, but pain should settle shortly afterwards.
If your symptoms become significantly worse, reduce the number of repetitions or speak to your physiotherapist for further advice.
Corticosteroid Injections
A corticosteroid injection may be recommended if pain and inflammation continue despite physiotherapy and self-management.
The injection works by reducing inflammation within the knee joint, which may help improve movement and reduce pain. In some people, this makes it easier to begin strengthening exercises and return to normal daily activities.
Relief varies between individuals. Some people experience significant improvement, while others notice only limited or short-term benefit. If appropriate, corticosteroid injections can sometimes be repeated, although your clinician will discuss the benefits and risks based on your individual circumstances.
Will I Need Surgery?
Most people with a meniscus tear do not require surgery.
Research has shown that for many degenerative meniscal tears, a structured programme of physiotherapy and exercise provides similar long-term results to arthroscopic (keyhole) surgery.
Surgery may be considered if:
- Your knee repeatedly locks.
- A large tear is preventing normal knee movement.
- Symptoms continue despite appropriate rehabilitation.
- Your consultant believes surgery is the most appropriate option.
If surgery is recommended, this is usually performed using arthroscopy, also known as keyhole surgery. During the procedure, a small camera is inserted into the knee joint, allowing the surgeon to trim or repair the torn section of cartilage.
Recovery varies between individuals, but many people begin returning to everyday activities within six weeks, although full recovery may take longer depending on the type of procedure performed.
Recovery
Recovery from a meniscus tear depends on:
- The type of tear.
- Your age.
- Your overall health.
- Whether surgery is required.
- How closely you follow your rehabilitation programme.
Many people notice gradual improvement over several weeks, although degenerative tears may take several months to fully settle.
Continuing your exercises and gradually increasing activity levels are key to achieving the best outcome.
Further Information
Most meniscus tears improve with time, appropriate rehabilitation and activity modification. Physiotherapy plays an important role in reducing pain, restoring movement and improving strength, helping many people return to their normal daily activities without the need for surgery. If you have ongoing symptoms or concerns about your knee, speak to your healthcare professional or physiotherapist for further assessment and advice
