By Peter H. Edwards, Jr., M.D.

Meniscal tears are common among athletes who experience repetitive running, twisting and

cutting on the field. As these activities regularly occur on the soccer field, it’s no surprise that

soccer players are among athletes most often experiencing meniscal tears.

Understanding the Anatomy of the Meniscus

The meniscus is a half moon shaped piece of cartilage between the weight bearing joint

surfaces of the femur (thigh) and the tibia (lower leg). It is wedged shaped and is attached to the

lining of the knee joint along its edge. A healthy knee has two menisci. The lateral meniscus is

on the outside, and the medial meniscus is on the inside. Together, they act as shock absorbers

and stabilizers in the soccer player’s knee.

The meniscus is, for the most part, avascular. This means, the meniscus doesn’t bleed if cut and

doesn’t have blood vessels inside. The exception lies at the edge where the meniscus joins to the

vascular knee lining, providing the outermost 30 percent of the meniscus with a blood supply.

As a result of this avascularity, a torn meniscus can’t heal unless the tear is small and confined

to the peripheral vascular zone. Similarly, the nerve supply providing pain and sensation to the

meniscus is, for the most part, limited to the zone where the blood vessels are located.

Older soccer players may tear their meniscus from experiencing trivial trauma, such as twisting

the knee, squatting, or from repetitive activities such as running. These activities can place

extra stress on the knee joint. The meniscus has a tendency to degenerate with age, which can

make older soccer players more susceptible to meniscus tears. An early arthritic change in the

knee joint often takes place in conjunction with degeneration of the meniscus.

Diagnosing an Early Meniscus Tear

Pain, swelling and mechanical symptoms like catching or locking in the knee joint are often

symptoms of a meniscus tear. A physician can diagnose a meniscus tear by evaluating a soccer

player’s history and by conducting a physical examination of the player’s knee.

An orthopedic surgeon may order further diagnostic studies like an MRI (Magnetic Resonance

Imaging), which provides a three dimensional image of the interior of the knee joint. A

minimally invasive surgical procedure called arthroscopy may be needed to inspect the

meniscus and, at this time, the tear will be repaired.

Treating a Meniscal Tear

Deciding to repair the meniscus is based on many factors, including: the location and pattern of

the tear, the soccer player’s age, and predictability of whether the injury can heal. In young

athletes with certain patterns of injury, repairing the meniscus tear through arthroscopy may be

necessary. In older athletes, certain patterns of tears are not suitable for repair and respond to

conservative treatment options such as physical therapy. If these treatments are not successful,

and the athlete is still experiencing pain, surgery may be the next step.