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There are many ways you can help children and their families get the care they need.
If your child or teen has sustained a meniscus tear, it will comfort you to know that Children’s Hospital Boston’s Orthopedic Center has a tremendous amount of experience treating this injury, developing therapies for healing and conducting research that leads to better care.
How do meniscus tears occur?
Football players and others in contact sports can tear a meniscus when twisting the knee, pivoting, cutting or decelerating. In athletes, meniscus tears often happen in combination with other injuries such as a torn ACL (anterior cruciate ligament).
Are there different kinds of meniscal tears?
In young athletes, the meniscus can tear in a number of different ways:
[illustration courtesy of the American Academy of Orthopaedic Surgeons]
What should I do if I think my child has torn his meniscus?
If you think your child has a meniscal tear, see his doctor right away for diagnosis and treatment. Without treatment, a loosened fragment of the meniscus may drift into the knee joint, causing it to slip, pop or lock; if this happens, the knee can get stuck, often at a 45-degree angle, until it’s moved manually or otherwise manipulated.
How are meniscal tears diagnosed?
Your child’s doctor can usually diagnose an injury to the meniscus based on a physical exam of the knee (see McMurray Test in Tests). The orthopedic surgeon may also require further diagnostic studies, including:
How is a meniscus tear treated?
Initial treatment follows the basic “R.I.C.E.” formula: rest, ice, compression and elevation, combined with non-steroidal anti-inflammatory medications for pain. If the knee is stable and doesn’t lock, this conservative treatment may be all that’s needed. Blood vessels feed the outer edges of the meniscus, giving that part the potential to heal on its own. So, small tears on the outer edges often heal themselves with rest.
Additional measures to support this conservative approach to treatment can be:
If the tear doesn’t heal on its own, surgery or other techniques may be needed.
Why are there more meniscal tears and overuse injuries in kids these days?
Youth and adolescent participation in organized sports has grown to about 35 to 40 million kids across the United States. Not surprisingly, the incidence of sports injuries is rising—statistics suggest that 30 to 60 percent of student athletes will have an overuse injury at some point in time. In one Sports Medicine practice at Children’s, for example, at least half of the young patients have an overuse injury.
Aren’t organized sports supposed to be good for kids?
Organized sports are very important and help kids—not just in the sports themselves, but in academics and social situations—and they’re good for children’s overall development and growth. The downside is that “overuse syndrome,” where the kids repeat the same drill over and over, causes overuse injuries.
How can parents and coaches help kids avoid meniscal tears and overuse injuries?
Parents and coaches have a great deal of influence—for better or for worse. They should stress moderation in training and should restrain the zeal with which they push youth and teens.
Coaches themselves should learn and use proper training techniques and should avoid too many repetitive drills, since these are the overwhelming reason for overuse injuries. Coaches should also teach proper running mechanics and other sports-motion techniques.
Physical education departments should make sure that the surfaces of a track or field are in good shape, and that proper equipment, footwear and protective gear are used for each sport.
Our orthopedic specialists advise:
Can a meniscal tear be prevented?
A torn meniscus is not strictly a preventable injury, since sports such as basketball, soccer, skiing, gymnastics, volleyball and football do put athletes at some risk to tear a meniscus. But athletes and active young people can reduce their risk by:
Are there other guidelines and resources for injury prevention and safer training?
The American Academy of Orthopaedic Surgeons (AAOS) has issued comprehensive guidelines for helping to prevent sports injuries. Below is an excerpt from the AAOS recommendations:
Will my child be OK?
The good news is that 98 percent of patients with simple meniscus tears are able to return to sports and regular activities without knee instability.
After your child’s knee has healed, and after his strength and stability have returned through physical therapy, he should be able to return to his previous sports and activities—usually within six months. (But his doctor may recommend lifestyle changes for him if he has joint changes, such as arthritis or instability, which couldn’t be corrected even with surgery.)
Your child’s rehab team will help him relearn normal movements and pain-free activities. After he has successfully eliminated most of his discomfort and has returned to his normal routine, it’s important for him to continue to be involved in some form of orthopedic fitness to ensure continued physical health and well-being.
What is the Orthopedic Center doing to encourage injury prevention and safer training?
With Children’s goal of dramatically reducing overuse injuries in youth sports, members of our team often travel to local and regional schools, youth groups and sports clubs to teach leg strengthening and other techniques. We also conduct frequent safe training programs and clinics for coaches. Call 617-355-3501 for details.
As more and more kids play organized sports, there’s been a rise in the number of meniscal tears and other overuse injuries (microtraumas to bones, tendons, ligaments or muscles) among adolescents and children, largely from repetitively using the same parts of the body. Football, tennis and basketball players can tear a meniscus by twisting the knee, pivoting, cutting or decelerating. Meniscus tears often happen in combination with other injuries, especially a torn ACL (anterior cruciate ligament).
Meniscus tears usually cause enough discomfort that an injured child will seek medical or parental help. Consult your child’s doctor if:
At greater risk than some young athletes are those whose sports involve quick pivoting, cutting, decelerating and side-to-side motions, such as football, tennis, skiing and basketball.
Complications after proper treatment for meniscal tears are rare, but can occur if surgical repair has been needed. Complications can include:
Extremely rarely, there can be acute injury to the popliteal artery (0.01 percent), weakness or paralysis of the leg or foot, or a blood clot in the calf veins (0.12 percent).
Many teens who have a meniscal tear are not only high-performing, determined athletes, but also high-performing, determined students. If you approach your healing period with that same spirit of determination, you should be back to sports and your active lifestyle within a few months, depending on how severe your tear was in the first place.
The most important thing you can do to get back into your sport is to give your knee a total rest. But even though you know the importance of rest to your recovery, you may still find this to be a tough time. If you feel frustrated, depressed or angry during this important time, speak to your doctor, parent or counselor—they’re all on your team, and they all want to help.
If your teen is like many young athletes who’ve sustained a meniscal tear, he’s not only a high-performing, determined athlete—he’s also a high-performing, determined student. Encourage him to approach his recovery period with the same spirit of determination that he applies to other areas of his life. With patience and perseverance, he’ll probably be back to sports and his active lifestyle within a few months.
Even though you and your teen know the importance of resting his knee, you both might experience his healing period as a difficult time. Parents who identify with their children’s success can feel frustrated or depressed along with their children, so speak to your doctor or counselor if you need help.
Our Sports Medicine specialists advise young athletes to:
If your child needed surgery, his long-term outlook is excellent. Most patients who’ve had surgery for meniscus tears can return to sports and regular activities without knee instability. Some patients do complain of stiffness and pain after surgery, but current surgical and physical therapy techniques have minimized these problems.
Boston Children's physicians provide orthopedic care at Boston Children's locations in Lexington, Peabody, Weymouth and Waltham, as well as at our main campus in Boston.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”