Knee Cartilage Damage VS Meniscus Tear – Which Do You Have?

Have you ever wondered what the difference between cartilage in the knee and meniscus is?

This is a question that we get all the time. And I’m going to explain the exact difference between the two, so that you can find out if your problem is more just regular knee cartilage or if it’s more of a meniscus issue.

Real quick, my name is Dr. David Middaugh. And I’m a specialist physical therapist over at El Paso manual physical therapy. And this channel is dedicated to helping people stay healthy, active and mobile. while avoiding and unnecessary surgery, injections and medication. please hit subscribe and turn on your notifications so that you don’t miss any helpful videos that we put out each and every week. So let’s get to it.

The knee has tons of different things in it. Knee cartilage is one thing and knee meniscus is another thing. Now just to be clear, cartilage is the bigger umbrella term. And meniscus is a type of cartilage. So when you talk about the meniscus, it’s actually a type of cartilage and shaped a certain way with a specific purpose. It’s different from normal cartilage like we see in joints.

Have you hear our podcast the goes in-depth about Meniscus Tears? Check it out here: Meniscus Tears – Everything You Need To Know

Cartilage is just a soft, it’s kind of hard, but it’s more soft. It’s very firm, tissue that’s on the end of bones and it cushions bones together and you have cartilage all over your body inside your finger joints, right where the bones meet where anywhere there’s a joint, there’s generally going to be cartilage.

There’s a few exceptions, but for the most part, you’ve got cartilage everywhere, there’s two bones that meet together in your wrists and your elbows. And of course, in your knees. There’s tons of cartilage in the knees. But what’s unique about the meniscus is it’s more like a disc, if you think about the discs in the spine. So I’ve got my, my skeleton here, you’ve got the vertebrae right here. And then you’ve got the disc, which is also a type of cartilage that cushions between the two bones.

It’s the same thing over in a knee. But what’s unique about the cartilage that sits between the bones here is it has to support the entire weight of your body above the thigh bone as you move. So it’s shaped a certain way that it’s got its own name, we’ve got a special test for it, it gets injured differently than other cartilage tissue.

So that’s why we separate out the meniscus apart from all the other cartilage, just to give you a more simple picture of it. So let’s talk about the difference between knee cartilage in the meniscus. And the move in a bit here, as you can see I’ve drawn is a side view of the thigh bones and the knee bones. So here’s the thigh bone right here. That’s the kneecap. And this is the shin bone all in blue.

In orange right here is the meniscus. And its job is to cushion the thigh bone and all the weight above it on the shin bone and the foot. So it’s more of a cushion than anything else kind of like the discs in the spine.

When there’s abnormal forces going through the knee, because of muscle imbalances, because of the way that you sit the way that you walk the way that you move. Then that cushion that meniscus, that orange tissue right there can get damaged, it can get irritated, different things can happen. It can tear the cartilage lining on the in red right here, let me use my pen to point the cars lining and red on the back of the kneecap. And on the end of the thigh bone is what we typically talk about as cartilage.

Now it’s possible to damage any of these. And they happen differently. So the the sensations that people get from a damaged meniscus versus damaged cartilage on the end of the thigh bone and on the back of the kneecap are kind of different. So as you can see on the actual bones here, the kneecap, the kneecap is right here and right behind where the kneecap touches the thigh bone.

There’s cartilage right in there. And those two surfaces are covered in cartilage and they roll on each other so they can slide frictionless, so they can be as little friction as possible so that the knee can move freely and you can do all your everyday activities, when that gets damaged can get a little bit rough and generally will sound a bit crunchy whenever you bend your knee.

People that are in their 30s 40s or beyond will sometimes start to get a little crunchy little sounds at the knees make as they bend them. Sometimes it’s painful. Sometimes it’s not often it’s not painful. And what that usually is the cartilage behind the kneecap, either on the thigh bone, or on the kneecap itself on the back is just a little bumpy or rough and it’s making there’s more friction than there supposed to be. S

o it’s making some noise whenever the knee goes to bend and straighten. But the meniscus itself typically doesn’t make a whole lot of noise. Unless there’s a tear. There’s a terrio here more like a clunk or a thud. Sing a single popping sound as we usually have is not a bunch of little crunchy sounds.

Now Sometimes there’s pain with it, sometimes there’s not. And it’s not always going to be a tear. If you get a pop or a click, it could be that the joints just a little bit stuck. And it’ll pop once or click once, and it’s free, and you may never have a meniscus tear. But if you get repetitive, loud clicking and popping, number crunching, it’s different than you’re looking at more of a meniscus damage or meniscus tear, possibly, depending on on you getting checked out with an MRI.

There are special tests that a physical therapist like me can do to isolate, isolate out the meniscus. And if the test has done well, it’s got pretty decent accuracy when compared to a an MRI. Of course, the gold standard is surgically going in with the camera and looking at them in this case to see there’s any tears, but you don’t want to expose yourself to surgery unless you have to have something fixed. And there’s a good shot, that it’s torn and it’s going to get fixed properly.

When it comes to finding out the difference the differences between the two. That’s generally what you’re looking at, is it more of a crunchy grinding sound and you’re looking at more of the cartilage on the end of the thigh bone and the back of the kneecap. It’s more of a single pop that happens each time you bend your knee and straighten your knee, then it’s probably more meniscus that’s generally what happens.

It’s not like a hard and fast rule. It is not black and white, for sure. But what’s causing this problem is I think the answer that you’re looking for. And the good news about it is that it’s usually the same root problem that can cause both the meniscus problem and the cartilage problem behind the kneecap and thigh bone.

Usually there’s an imbalance or there’s some chronic injury that’s been developing over time, that’s causing pressures to go in appropriately through the knee joints. And it’s wearing down either the the cartilage behind the kneecap on the thigh bone, or the way that the thigh bone is sitting on the shin bone, this upper bone in the lower bone is rubbing the meniscus wrong, there’s things rubbing wrong is the most simple way that I can put it and that needs to be addressed.

So that over time, you can take those back pressures off and allow your cartilage and or meniscus to heal properly. And you need to just fix the movements and move better, you need to get stronger in the right muscles that you’re not out of balance. There is no medication that will fix this is there’s experimental procedures out there. They can theoretically regenerate cartilage or meniscus tissue, which is also a type of cartilage.

But nothing’s 100% proven and 100% successful. There’s things out there like regenerative medicine, where they do PRP injections, platelet rich plasma. Stem Cell injections is another one of course. And personally, as a specialist, physical therapist, I’ve seen people that have had those types of treatments. And it’s makes some people report that it improves their situation quite a bit. And some say that there’s no difference.

I have not seen anybody though, say that it hurts them. That’s been my experience. This is all new stuff in medicine. And it’s not proven yet 100%. But what we do know for sure is that cartilage, whether it’s the knee cartilage back here, or the meniscus tissue between can heal, meaning just like your skin can heal, if you cut it open, if you’ve got to cut on your skin, you give it some time, and it scars down, and then it closes up and you’re fine. You can get scar tissue on your cartilage on your meniscus.

That’s a good thing because that scar tissue is going to be 70 to 80% as strong as the original tissue, which is great. You may be thinking 70% I’d rather go get some stem cells put in and get tissue that’s 100%. Well, the likelihood of the stem cells actually working is kind of up in the air right now I’d say it’s 5050 or less probably.

So healing that root problem is a bigger deal. And then I would have to say this, if you do go get the stem cells, and it’s successful for you, which is fantastic. It’s a pretty penny to get stem cells injected.

Then you have to ask the question of how did they get the meniscus tear or the cartilage damage before that led up to the to me getting these stem cell injections or this platelet rich plasma injection.

Because if that problem isn’t fixed, then the fix that you just made with the stem cells is only going to last you so long, because you might still have that underlying root problem of the movement in the muscle imbalance or the way that you’re moving is not well and you’re it’s just a matter of time before you were down those newly put on stem cells or the or the effects of the platelet rich plasma has now gone away because you never change the way you move.

You never change the way you strengthened and you’re just ruining the procedure that you had done. So fixing the strength and fixing the way that you move is number one, in my opinion. It isn’t a quick fix. It doesn’t take away the pain immediately. But it sets you have to have long lasting pain relief and protecting your joints from getting arthritis and other worse things that might require you to have some major surgery later on like a knee replacement.

So I hope this help you understand the difference between normal knee cartilage as the medical field describes it, which again is right here, and the cartilage behind the kneecap and the meniscus tissue right between the bones right here. I hope this picture helps. Let me show it to you one more time. And then we’ll talk about how you can start to fix the root problem.

So remember, the red is the knee cartilage and the Orange is the meniscus tissue. Now, if you’re looking for exercises to fix this meniscus problem, or your knee cartilage problem, this video is not intended to show you exercise. It’s just intended to explain the differences.

But I’ve got a video that I made. It’s a link in the description right here that’s covers the top five hip exercises that you need to be doing to fix your knee problem. Go check that out. Now if you liked this video, please give us a thumbs up and also subscribe so you don’t miss out on any of the other future videos that we’re going to be putting out every single week. Thanks so much and we’ll talk to you guys next time.