Knee pain as a result of a meniscus tear is extraordinarily common in both the young teenage Carlsbad soccer player as well as the mature La Jolla tennis player.  The tear can occur from a twisting or pivoting mechanism.  This is commonly seen on the football field.

Quarterbacks, running backs, and wide receivers tend to get all the attention from fans and NFL analysts. One of the most underrated positions in all of sports could very well be NFL’s long-snapper. The position of long-snapper is important enough that most NFL teams use a roster spot specifically for a designated long-snapper. Unfortunately for the Steeler’s, long-snapper Greg Warren suffered a torn meniscus in practice two weeks ago. Warren has played every regular season game for the last four years for the Steelers but he is likely to have that consecutive game streak come to an end at the beginning of this season.Greg-warren-meniscus-tear

The meniscus is a wedge of cartilage that acts as a shock absorber and stabilizer between the thighbone (femur), shinbone (tibia), and kneecap (patella). A meniscus tear can result in reduced cushioning between the femur, tibia, and kneecap, as well as reduced stability. The result of a meniscus tear is an intense amount of knee pain, stiffness, swelling, decreased range of motion, and instability. Without treatment, there is a good chance that a piece of the meniscus can come loose. This often results in a slipping, locking or popping of the knee. Meniscus tear often occurs as a result of a twisting or pivoting motion in non-contact situations. They can also be caused by direct contact, as with a tackle to the knee. In the case of Greg Warren, the meniscus tear injury was sustained without direct contact.


Meniscus Tear Diagnosis:

The process of diagnosing a meniscus tear begins with a visit to a physician.  The doctor will most likely be the McMurray test, which involves bending, then straightening, and then rotating the knee. If there is a click then it is considered a positive McMurray test and if there is no click it is a negative McMurray test. A positive test would mean that there might be a meniscus tear.

After the McMurray test the doctor may order a battery of imaging tests to check for a meniscus tear and other associated knee injuries. An X-ray would be used to determine if there is a different cause of the symptoms. Rather, an MRI would reveal damage or tear to soft tissue such as a meniscus.meniscal-tear-injury

Meniscus Tear Treatment:

Treatment of a meniscus tear can involve either surgical or non-surgical treatment. Non-surgical treatment involves rest, ice, compression, elevation along with medication to relieve pain and swelling. Surgical treatment may be a meniscectomy or a meniscus repair. In a meniscectomy, the orthopedic surgeon trims away the damaged meniscal tissue. Meniscal repair involves the suturing torn meniscus pieces back together.

Rehabilitation is dependent on the severity of the injury and can require about two weeks for injuries that do not require surgery. Three to four weeks of rehabilitation is required for meniscectomy surgeries. Three to four months of rehabilitation is required for a meniscus repair. In the case of Greg Warren, he likely underwent a meniscectomy as he is scheduled to return to the field about a month after the injury. A little math shows that Greg Warren will be snapping again by week three of the 2014-2015 NFL season, which is great news for Greg Warren and the Steelers.meniscus-tear-view

If you have been told that you need an arthroscopy for a meniscus tear or would like a second opinion, call to schedule an appointment with our award winning sports medicine doctors at Orthopedic Surgery San Diego Clinic.




Some people wonder what happened to the Tennessee Titans RB Chris Johnson (CJ2K)Did you know that CJ2K played a majority of the season on a torn meniscus last year? Yup, it’s true, since week 3 on the NFL season, CJ2K played on a meniscus tear. If his silver-plated teeth weren’t a dead give away, then playing on a symptomatic torn meniscus does Mr. Johnson is the real deal…he is as tough as they come.

To understand toughness that it would take to play on a torn meniscus, you must first understand the meniscus itself. The meniscus is essentially a wedge of cartilage in your knee. This tough and rubbery meniscus acts as a shock absorber between the femur and the tibia. In layman’s terms, the meniscus is a cushion between the thighbone and the leg bone. An intact meniscus is essential for proper cushioning and stability. When the meniscus is torn, there will be significant pain and swelling.  It can cause a sharp searing pain that will bring you to your knees…literally.  It can cause instability which can lead an athlete to fall. One of the worst feelings when dealing with a torn meniscus is the feeling you get when you place the brunt of your weight on that knee. It almost instantaneously does one of two things, locks up or gives out. Now imagine running for 1,000 yards and 6 touchdowns against an NFL defense on one of those bad boys. Gives you a new respect for CJ2K, doesn’t it?


There are two real ways to treat a torn meniscus and neither of them involves continuing to use your knee the way that Chris Johnson did. Non-surgical treatment involves the age-old acronym RICE. Rest, ice, compression, and elevation. This is pretty standard protocol for any inflammatory process.  Measures like these can work for what is called a “degenerative tear”.  Much of the scientific studies today talking about how arthroscopies aren’t helpful are targeting treatment of degenerative tears.  However, acute meniscal tears that occurs in relatively younger athletes usually happens as a result of a twisting or pivoting maneuver.  The tears usually require an arthroscopy for symptom relief. Knee arthroscopy is one of the most common orthopedic procedures involves the use of miniature cameras and surgical instruments to repair and/or clean away the tear. After a successful surgery comes a tremendous amount of rehabilitation.  Rarely, meniscus tears are actually repairable.  This is a special kind of tear that can actually be repaired.  We can use platelet rich plasma (PRP) clots to augment the healing.  The rehabilitation process for repairs takes longer but is well worth it.  After a meniscus repair, the athlete will need a month on crutches followed by range of motion and strength exercises. The total rehabilitation time is approximately 3 to 4 months.


So what does this all mean for our 2009 fantasy football MVP, Chris Johnson? He had a successful meniscus repair surgery at the end of January and was completely rehabilitated by training camp.  He gets a change of scenery as he heads to the run-happy New York Jets. To expect another 2,000-yard season would be foolish, but to think that he will bounce back to be the back we all thought he was, is not completely out the realm of possibilities


© 2023 Dr. Robert Afra – San Diego Orthopedic Surgery Shoulder – Knee – Elbow