Knee injections | meniscal injuries
In our previous blog about knee joint injections, we briefly mentioned an important structure deep in the knee – the meniscus. Meniscal injuries can cause pain and dysfunction during load bearing activities such as walking, running and kneeling. Injection therapy can complement physiotherapy to achieve a solid, long-term recovery.
What is a meniscus?
Your menisci (pleural of meniscus) are ‘C’ shaped rings of cartilage which are vital to the stability and shock absorption in your knee. Unlike most musculoskeletal injuries, the meniscus cannot heal itself. However degenerative meniscal tears are now known to be extremely common and are to be thought of as “wrinkles with age“. There are two main ways in which you can injure your meniscus – either traumatically such as a sports injury or as a result of ‘wear and tear’.
Degenerative meniscal injuries
Degenerative meniscal injuries are the result of a usually lengthy period of ‘wear and tear’. These can present acutely with pain during load bearing activities but are usually accompanied with a diagnosis of osteoarthritis. Often many people don’t know they have a degenerative meniscal tear but a sudden twist or maintaining your knee in a rotated position (such as a length drive) can exacerbate the injury and cause pain. The great news is that physiotherapy can help. Here are the physios we successfully treat lots of degenerative knee conditions with a combination of manual hands-on treatment, injection therapy and strength & conditioning. But don’t take our work for it, read Pete’s 5 start review of our service.
Traumatic meniscal injuries
Traumatic meniscal injuries are less common and usually the result of an accident or sports injury. In younger people a timely examination is important as a surgical repair of the meniscus might be considered. More commonly surgery is not a consideration and a combination of physiotherapy and sports specific training can get you back on the field of play. There is a growing body of evidence that injection of hyaluronic acid can relieve pain and expedite recovery in sports people with traumatic meniscal injuries.
A Mixed picture
We all know someone who’s football career was ended by “cartilage damage” and now has “bone on bone” in their knee. Before you retort with “yea, alright grandad” – let’s consider this. Perhaps these people did experience a traumatic meniscal tear during their sporting career and this initial injury has resulted in a degenerative, arthritic process. We see lots of this type of injury – patients who were previously keen footballers, rugby players, runners, etc and now are experiencing knee pain. There is so much physiotherapy can offer this type of presentation, much like Pete’s experience above.
Knee injections – meniscal injuries
As discussed the menisci provide many of the important functions of your knee – stability, shock absorption, distributing contact pressure, maintain balance and lubrication. Injection therapy can assist many of these vital functions. We detail the benefits of the injections we offer in a previous blog, but briefly
Steroid injections have powerful anti-inflammatory properties and can be useful to dampen down pain and inflammation.
Hyaluronic acid injections can help to restore the viscosity of the knee joint to assist with load bearing. HA has been shown to last longer that steroids and has minimal side effects.
Combined steroid and hyaluronic acid injections can be useful to settle and irritable and inflamed joint (steroid) but also ensure the longer term health of the knee (hyaluronic acid).