Degenerative Meniscus

What is degenerative meniscus?

  • The meniscus is a C-shaped piece of tough, rubbery cartilage that acts as a shock absorber between your shinbone and thighbone. Wear and tear over time is normal but in some cases a tear can occur, particularly following a twisting movement.

How common is degenerative meniscus?

  • Meniscus tears are incredibly common.
  • In the general population, it affects 35% of people over 50 years (1).

Should I worry?

  • No.
  • Degenerative meniscus tears are very common and are seen as part of the normal wear and tear process.
  • Although a meniscal tear can lead to knee osteoarthritis (OA), it can also occur in isolation and often respond well to conservative management.
  • A degenerative meniscus tear is not linked to other serious pathology.

Who is most likely to suffer from degenerative meniscus?

  • Typically, those aged over the age of 60.
  • Those with pre-existing knee osteoarthritis.
  • The overall male-to-female incidence is approximately 2.5:1.

What are the common symptoms?

  • Pain, stiffness and swelling.
  • Catching or locking of your knee.
  • The sensation of your knee “giving way”.
  •  You are not able to move your knee through its full range of motion.

What can I do?

  • Avoid exercises involving pivoting, deep squatting and twisting.
  • Try some exercises to enhance your strength and stability.
  • Lose weight if overweight.
  • Advice from a qualified physiotherapist will be helpful in most cases.

How long will it take to recover?

  • This will depend upon several factors including, but not limited to, medical/lifestyle factors, stage of injury, your ability to follow your rehabilitation, etc.
  • Recovery will take about 6-8 weeks if your meniscus tear is treated conservatively (without surgery).
  • Current guidelines generally discourage arthroscopy (keyhole surgery) for patients with clear signs of osteoarthritis on X-ray (9).

1. Introduction

Someone with a degenerative meniscus may present with pain, stiffness and swelling. Catching, locking or the sensation of your knee “giving way” may also be experienced. The medial (inside) meniscus is more frequently torn, partly because of its different shape but also because of its attachment to the medial collateral ligament (inside knee ligament).

Meniscal tears often happen when you play sports, but you can also get them as a result of ‘wear and tear’ as you get older. When people talk about ‘torn cartilage’ in their knee, they usually mean a meniscus injury. They are given different grades depending on how severe an injury it is.

Depending on the symptoms you experience, conservative treatment should be the first option. Current guidelines generally discourage arthroscopy (keyhole surgery) for patients with clear evidence of osteoarthritis on X-ray (9).

Our understanding of the best way to manage degenerative meniscus problems is continually developing and unfortunately, it is not unusual for patients to be working on outdated and potentially ineffective treatment approaches. We review research on a regular basis and continually update our website to ensure we are giving the best advice by integrating current evidence with our clinical expertise.


2. Signs & Symptoms

3. Causes

Symptoms usually develop following a forceful rotation or twisting of the knee, such as when coming to a sudden stop. Symptoms can also develop insidiously (without known cause). It is well documented that natural ageing results in the menisci (cartilage) being more prone to tearing (4). Repetitively putting full body weight on the knee such as when kneeling, deep squatting or lifting heavy objects can also contribute to symptoms. Obesity and being overweight are also contributing factors. A person with predisposing degenerative diseases such as osteoarthritis is more likely to suffer from degenerative meniscus.


4. Risk Factors

This is not an exhaustive list. These factors could increase the likelihood of someone developing degenerative meniscus. It does not mean everyone with these risk factors will develop symptoms.


5. Prevalence

In the general population, degenerative menisci affects more than 35% of people over 50 and there is a 24% prevalence in those with no evidence of osteoarthritis on X-ray (5). It is more common in older people who are heavily involved in sport, particularly sports that require twisting and rotation of the knee such as football, tennis and basketball.

6. Assessment & Diagnosis

Musculoskeletal physiotherapists and other appropriately qualified healthcare professionals can provide you with a diagnosis by obtaining a detailed history of your symptoms. A series of physical tests might be performed as part of your assessment to rule out other potentially involved structures and gain a greater understanding of your physical abilities to help facilitate an accurate working diagnosis.

Your treating clinician will want to know how your condition affects you day-to-day so that treatment can be tailored to your needs and personalised goals can be established. Intermittent reassessment will ascertain if you are making progress towards your goals and will allow appropriate adjustments to your treatment to be made. Magnetic resonance imaging (MRI) is currently the preferred choice for detecting meniscal injuries and planning subsequent treatment. A thorough understanding of the imaging protocols, normal meniscal anatomy, surrounding anatomic structures and anatomic variants, and pitfalls is critical to ensure diagnostic accuracy and prevent unnecessary surgery (6).

7. Self-Management

As part of your treatment, your musculoskeletal physiotherapist will help you understand the condition and what needs to be implemented to effectively manage your degenerative meniscus. This will include activity modification strategies, as well as other useful treatments aimed at reducing discomfort. Regular adherence to a condition-specific rehabilitation programme is important in the management of this condition. It should be noted that rehabilitation exercises are not always a quick fix, but if adhered to on a consistent basis (weeks to months), over time they have been shown to yield positive outcomes.


8. Rehabilitation

If you have a knee meniscus tear, you may benefit from a specific exercise programme to rehabilitate your knee. Working with a musculoskeletal physiotherapist can help you regain maximal knee range of movement and strength, and can help you return to your normal optimal level of activity.

Research even shows that participation in physiotherapy for a meniscus injury may help avoid surgery for your knee (7). Your musculoskeletal physiotherapist may use various methods and treatments to control your pain or knee swelling or to improve the way the muscles around your knee contract and support the joint.

9. Degenerative Meniscus Rehabilitation Plans

Early Plan

This programme focuses on maintaining a range of movement within the knee, appropriate loading of the affected joint and maintenance of lower limb strength and stability. We suggest you carry this out once a day for approximately 2 – 6 weeks as pain allows. Pain should not exceed 3/10 on your perceived pain scale.

Early Plan - Rating

Intermediate Plan

This is the next progression. More focus is given to progressive loading of the joint and lower limb strengthening. As with the early programme, some pain is to be expected but ideally at a low level. Pain should not exceed 4/10 on your perceived pain scale.

Intermediate Plan  - Rating

Advanced Plan

This programme is a further progression with challenging progressive loading of the affected joint. Again, some pain is acceptable but ideally at a low level. Pain should not exceed 4/10 on your perceived pain scale.

Advanced Plan  - Rating

10. Return to Sport/Normal Life

For patients wanting to achieve a high level of function or return to sport, we would encourage a consultation with a physiotherapist as you will likely require further progression beyond the advanced rehabilitation stage.

As part of a comprehensive treatment approach, your musculoskeletal physiotherapist may also use a variety of other pain-relieving treatments to support symptom relief and recovery. Whilst recovering you might benefit from a further assessment to ensure you are making progress and to establish the appropriate progression of treatment. Ongoing support and advice will allow you to self-manage and prevent future reoccurrence.

11. Other Treatment Options

Surgery is rarely indicated with degenerative meniscal tears due to the fact that the outcomes have not been shown to be superior to conservative management. Likewise, the indication for using corticosteroids for this condition has not been proven by the research. There may be situations where these treatments are needed and these will be discussed with your orthopaedic consultant. 


Book an Appointment

Please book an appointment with one of our physiotherapists if you think you are suffering from this condition and would like to find out more.

We have Pure Physiotherapy clinics across the country including Norwich, Dereham, Bolton, Manchester, Rochdale, Sheffield and Barnsley. Please view our clinics to find the closest physiotherapy clinic for you.


  1. Ehud Rath, John C Richmond. (Aug 2000). The menisci: basic science and advances in treatment.
  2.  Martin Englund, Ali Guermazi, Stefan L Lohmander. The role of the meniscus in knee osteoarthritis: a cause or consequence? PMID: 19631077 OI: 10.1016/j.rcl.2009.03.003
  3. Sarjoo M Bhagia, MD Consulting Staff, OrthoCarolina (Apr 24, 2020) ; Voluntary Teaching Faculty, Carolinas Rehabilitation. . Medscape.
  4. Erik Hohmann, Richard Angelo, Robert Arciero , Bernard R Bach, Brian Cole, Mark Cote, Jack Farr, Julian Feller, Brad Gelbart , Andreas Gomoll , Andreas Imhoff, Robert LaPrade , Bert R Mandelbaum, Robert G Marx, Juan C Monllau, Frank Noyes , David Parker , Scott Rodeo, Nicholas Sgaglione , Kevin Shea, Donald K Shelbourne , Shinichi Yoshiya, Vaida Glatt, Kevin Tetsworth. Degenerative Meniscus Lesions: An Expert Consensus Statement Using the Modified Delphi Technique. PMID: 31901384.
  5. Rachelle Buchbinder, Ian A Harris, Andrew Sprowson. (Nov, 2016). Management of degenerative meniscal tears and the role of surgery.
  6. Jie C. Nguyen, Arthur A. De Smet, Ben K. Graf, Humberto G. Rosas. (Jul 14 2014) MR Imaging–based Diagnosis and Classification of Meniscal Tears.
  7. Jonathan Cluett, Brett Sears. ( May 2020.) Physical Therapy Exercises for a Knee Meniscus Tear.
  8. Silbernagel, K. G., Thomeé, R., Eriksson, B. I., Karlsson, J., Sahlgrenska akademin (2007). Institute of Clinical Sciences, .Sahlgrenska Academy.  Continued sports activity, using a pain-monitoring model, during rehabilitation in patients with achilles tendinopathy: A randomized controlled study. The American Journal of Sports Medicine, 35(6), 897-906. doi:10.1177/0363546506298279
  9. R Siemieniuk. Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline. BMJ 2017; 357 doi: (Published 10 May 2017).
Other Conditions in Knees, Orthopaedics

Meniscus Injury

Structural knee injury, triggered either by a tear or through wear and tear.

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Patellar Tendinopathy

Knee pain at the lower border of the kneecap which is also known as ‘jumper’s knee’.

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Fat Pad Impingement

A rare condition affecting the adipose (fat) tissue that sits under the kneecap (patella) between the joint spaces of the knee.

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Knee Osteoarthritis

Common age related changes to the structure of the knee joint which may be associated with pain, stiffness and loss of function.

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