How do I know if I tore my ACL, MCL, or meniscus? – Injury Health Blog (2022)

Tears to the ACL, MCL, and Meniscal tears are among the most common injuries to
the knee. Tears happen when any of these disks or ligaments are overly twisted or
rotated. This causes stress to the disk and the cartilage between your shin and thigh
bone.

  • The role of the Menisci is to limit over manipulation and cushion the shin and
    thigh bone that lie on either side.
  • The Anterior Cruciate Ligament (ACL) is one of the most important ligaments in your knee. It helps to stabilize the knee joint by connecting
    your thigh bone to your skin bone.
  • Your Medial Collateral Ligament (MCL) is a thick band of tissue that goes from the inner part of the shinbone to a few inches past the
    knee.

Contents

  • 1 How do I know if knee pain is meniscus or ligament?
    • 1.1 Menisci
    • 1.2 Ligament (ACL, MCL)
  • 2 What is worse, a ligament or meniscus tear?
  • 3 Can you tear your meniscus and ACL/MCL at the same time?
  • 4 Non-Surgical Treatment
    • 4.1 RICE
    • 4.2 Medications
    • 4.3 Therapy
    • 4.4 Devices
  • 5 Surgical Treatment
    • 5.1 Menisci
    • 5.2 ACL
    • 5.3 MCL

How do I know if knee pain is meniscus or ligament?

Menisci

The presenting symptoms may vary depending on how severe the injury is.

  • Feeling as if your knee is about to give away
  • Feeling as though your knee is locked in place when you try to move
  • Decreased ability straighten knee fully
  • Tenderness at the lower half of the knee.

Ligament (ACL, MCL)

The presenting symptoms may vary depending on how severe the injury is.

  • Quick swelling
  • A feeling of “giving way” when weight bearing
  • Tenderness in the middle of the knee
  • Knee tingling or numbness
  • Decreased ability straighten knee fully
  • Tenderness on the side of the knee joint

There are a few signs and symptoms that are mostly associated with a meniscus injury, versus a ligament injury. Meniscal injuries, for one, don’t usually have any bruising. When you try to move your knee, you will feel as if your knee is “locking up”.

You may try to your knee back and forth to “unlock” your knee when this happens. Most ligament tears will result in moderate to severe bruising at the location of the injury and lack this “locking” sensation.

Meniscal tears also are a result of wear and tear over time, whereas ligament tears are the result of traumatic injury. Traumatic injuries include vehicle collisions, sports injuries, and falls. At the time of injury, you will also hear a loud “pop” with most ligament tears.

There are a few tests that you can do at home in order to know if your knee pain is because of a meniscal injury. One such test is the Thessaly test. To perform the Thessaly test, first, stand one knee. You may use a wall or stand in order to support yourself. Slowly lift the affected knee a little bit off the ground and begin to flex your knee back and forth. If this causes any pain or “locking” sensation, it is likely that you have a meniscal injury.

Other tests include the Childress Test and the McMurray Test. Unfortunately, most tests for ligament injury require a physician or therapist, because of the complexity of these types of injuries. However, performing the above test can help you rule out meniscal injury, which is a great place to start.

What is worse, a ligament or meniscus tear?

Generally, a ligament tear is worse than a meniscal tear. Meniscal tears have a shorter recovery time, may not need surgery, and will more than likely allow a patient to walk with a lot of stability.

Ligament tears tend to be more severe, with longer recovery times, invasive surgery, and mostly requires the assistance of medical devices (such as crutches) for the patient to walk. When comparing the ACL and MCL ligament tears, the ACL has the longest recovery time and the most severe long-term effects.

This is because of the complexity of ACL surgery. The ACL surgery requires a graft, in which a surgeon crafts a replacement ligament from donors and reconstructs the ACL.

Can you tear your meniscus and ACL/MCL at the same time?

In short, yes, it is possible to tear your meniscus, and ACL/MCL at the same time. This is most often the result of a traumatic injury, where many parts of the knee are exposed to harm.

Having multiple injuries to your knee in such a manner will result in a severely decreased quality of life (wheelchairs, or assisted living) and will most likely require multiple surgeries to reconstruct the knee. This type of injury also has longer recovery times, as there are

Non-Surgical Treatment

There are many ways to treat tears. The more severe the tear, the more invasive the medical attention that will be required to heal. A Grade 1 tear can be managed using the RICE (Rest Ice Compression Elevation) method.

More severe tears require medical attention. Please note that most ligament tears take 3-8 weeks for a full recovery, whereas meniscal tears can take from 3 to 6 months. Meniscal tears have long term knee issues and difficulty, but ligament injuries increase the likelihood of future injuries

RICE

Rest. Avoid moving the knee, specifically movements that cause any pain.

Ice. Ice you’re your knee 15 to 20 minutes, every 2 hours during the first 24 to 48 hours.

Compression. Use an elastic bandage to provide compression on the swollen knee. Start wrapping clockwise from the back of the knee. Loosen the wrap if necessary, to ensure that there is proper circulation. If pain increases, loosen the wrap even more.

Elevation. Position the knee above your chest. This will allow gravity to aid in the healing, by drawing the blood away from the injured area. This will reduce swelling and help to manage the pain.

Medications

Your doctor will prescribe you anti-inflammatory medication to manage pain and reduce swelling. Over-the-counter medication like NSAIDs, can also help but may increase the risk of bleeding and ulcers. Consult your doctor before taking any of these.

Therapy

A physical therapist can help with designing activities to help improve flexibility, stability, balance, and strength. You can also perform stretches and strengthening exercises on your own to aid in recovery.

Devices

Depending on the injury, your doctor may recommend you use crutches, wear splints, elastic bandages, wraps, and tapes.

Surgical Treatment

Menisci

There are three main surgeries available for injury to the menisci. These are meniscectomy, meniscal repair, and meniscal reconstruction. A meniscectomy is the surgical removal of all or part of the torn menisci.

General meniscal repair fixes the torn menisci via keyhole surgery and is minimally invasive. Meniscal reconstruction requires multiple minimally invasive surgeries to aid in healing after major meniscal repair.

ACL

The three types of ACL surgeries are autograft, allograft, and synthetic graft. The autograft surgery requires your doctor to take ligament from somewhere else in the body. This is then used to reconstruct the ACL.

The allograft uses tissue and ligament from a deceased patient, to reconstruct. The synthetic graft is the use of man-made material to repair the ligament and aid in healing. Because of the variety and complexities of ACL surgeries, ACL tears have notably longer recovery periods.

MCL

MCL repair usually involves a keyhole surgery. This means using tissue from the patient’s body, or tissue donated from another patient to reconstruct the MCL.

During the surgery, several small incisions will be made around the injured area in order to access the injured ligament. These small incisions result in minimally invasive surgery, with shorter recovery times than ACL surgery.

References

“ACL Reconstruction – Mayo Clinic.”Mayo Clinic, 6 Mar. 2021, www.mayoclinic.org/tests-procedures/acl-reconstruction/about/pac-20384598.

Drburke. “ACL vs MCL Tear: Differences, Causes and Treatments.”Dr. Burke Orthopedics, 19 Apr. 2021, drburkeortho.com/acl-vs-mcl-tear-differences-causes-and-treatments.

“How to Tell If Knee Pain Is Meniscus or Ligament Injury.”YouTube, 9 July 2020, www.youtube.com/watch?v=PA1IgaJhx4o.

“Is an ACL Tear Worse Than a Meniscal Tear?”Jacksonville Orthopaedic Institute, 9 Oct. 2020, www.joionline.net/trending/content/acl-tear-worse-meniscal-tear.

“Medial Collateral Ligament Mcl – Knee – Surgery – What We Treat – Physio.Co.Uk.”Physio, 6 May 2020, www.physio.co.uk/what-we-treat/surgery/knee/medial-collateral-ligament-mcl.php#:%7E:text=MCL%20surgery%20involves%20repairing%20the,tendon%20or%20allograft%20(donor).

Sterett, Team. “I Tore Both the ACL and the Meniscus. Do I Need Multiple Surgeries?”Dr. Bill Sterett, 5 May 2020, drsterett.com/sports-medicine-blog/acl-and-meniscus-surgery.

“Thessaly Test.”Physiopedia, 5 Feb. 2019, www.physio-pedia.com/Thessaly_test#:%7E:text=The%20Thessaly%20test%20is%20a,same%20symptoms%20the%20patient%20reported.

“Traumatic Injury.”UF Health, University of Florida Health, 12 Oct. 2016, ufhealth.org/traumatic-injury.

Turner, Sylvie. “Is My Knee Pain Arthritis or a Torn Meniscus?”Sports-Health, 9 Aug. 2018, www.sports-health.com/blog/my-knee-pain-arthritis-or-torn-meniscus.

—. “Is My Knee Pain Arthritis or a Torn Meniscus?”Sports-Health, 6 May 2019, www.sports-health.com/blog/my-knee-pain-arthritis-or-torn-meniscus.

“What Is the Role of the Childress Test in the Physical Exam of Meniscal Injury?”Medscape, 24 Apr. 2020, www.medscape.com/answers/308054-158716/what-is-the-role-of-the-childress-test-in-the-physical-exam-of-meniscal-injury.

How do I know if I tore my ACL, MCL, or meniscus? – Injury Health Blog (1)

Chioma Ugochukwu

Chioma is an undergraduate at Harvard College, planning to pursue a concentration in life sciences with a secondary in economics. As president of both the Harvard Foundation of the International Medical Relief of Children and The Harvard chapter of the MassachusettsMenstrual Equity Coalition, she has a strong background in medicine and public health. In the past year, she has participated in several public service opportunitiesand laboratory researchstudies.

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