A meniscal tear usually occurs with a twisting weight-bearing movement. A right-handed pitcher throwing his weight forward onto the left leg and twisting is an example. A misstep can lead to an acute tear of the meniscus. Chronic and repetitive stress can cause slow degeneration and tearing, often seen in the older patient. With meniscal pain the tenderness is localized to the side of the knee with the tear.
Meniscal pain is usually sharp and occurs during athletic cutting maneuvers.
A meniscal tear or flap may get caught between the femur and the tibia at the joint resulting in a painful locking sensation. You can kneel, jump somewhat, and go down stairs pretty well with a meniscal tear, but climbing stairs, which loads the meniscus can hurt. Sitting is not a problem for the patient with meniscal injury. When a meniscal tear is present there may be swelling due to an accumulation of fluid within the joint and tenderness at the joint line right over the tear. Twisting tests for a meniscal tear will produce a painful palpable clunk felt by the examiner.