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Meniscus Tears vs. ACL Tears: What You Need to Know

The knee is the largest joint in our body, making it the most susceptible to injury—affecting millions of people each year. If you played a sport or are an avid sports fan, you’ve seen athletes go down from a knee strain, sprain or tear.

Two of the most common sports-related knee injuries are to the meniscus, or cartilage, or to the anterior cruciate ligament, or ACL.

The meniscus functions as a shock absorber and helps an athlete distribute weight between the upper and lower legs. Meanwhile, the ACL is a band of tissue that runs through the middle of your knee and provides structural support for the knee during twisting and intense activities. While these are two completely different structures, athletes can experience injuries to both at the same time during twisting maneuvers and the injury can range from mild sprains and strains to partial or complete tears.

Difference between a sprain, strain and tear

A knee sprain is a stretch or tear in a ligament, whereas a knee strain is a stretch or tear of a muscle or tendon. A knee tear is an injury to one of the ligaments, muscles or layers of cartilage that support and stabilize the knee.

“In general, a strain would be considered a stretch or partial tear but it usually doesn’t require any surgical intervention,” said Evan Lederman, MD, an orthopedic surgeon and chief of sports medicine at Banner – University Orthopedic and Sports Medicine Institute. “A tear may be considered a partial tear, in which some of the structure is damaged, or a complete tear, in which a ligament or meniscus is torn in two or separates from the bone.”

Symptoms of a meniscus tear and an ACL tear

Meniscus tears

  • Pain with daily activity, such as squatting or kneeling
  • Tenderness on the inside or outside of the joint
  • Catching or locking or feeling of instability in the knee
  • Stiffness and swelling

ACL tears

“The symptoms of an ACL tear will include a feeling that the knee has given away or shifted while the foot is planted and the knee is twisted,” Dr. Lederman said. “You may even feel or hear a pop when the injury occurs.” Other symptoms might include:

  • Tenderness and pain along the joint line
  • Usually swells up quickly—within 24 hours
  • Difficulty bearing weight or walking

Treatment options

Prompt first-aid care can help reduce pain and swelling after a knee injury. This includes following the R.I.C.E. model of self-care: Rest, Ice, Compression and Elevation. While some injuries may require surgery, treatment of torn ACLs and meniscus begin conservatively.

“Meniscus and ACL tears may be amenable to nonoperative treatment, but it’s important that you see a physician for a full evaluation,” Dr. Lederman advised. “A sports medicine specialist is an expert at diagnosing and treating meniscus and ligament injuries.”

Non-surgical options

  • Immobilization: wearing a brace or cast to prevent your knee from moving for a short time after injury
  • Physical therapy: exercises to strengthen the leg muscles that support your knee and restore function
  • Nonsteroidal anti-inflammatory medicine: to reduce pain and swelling

Surgical treatment

There are circumstances where surgery may be required, depending on the severity and location of the tear, your level of activity and if your knee remains painful despite rehabilitative therapy. After surgery, you'll need to do rehabilitation exercises to gradually return your knee to full flexibility and stability.


Injuries to the meniscus, whether or not they require surgical treatment, will generally take about three months to resolve. “In some cases, it may even be quicker,” Dr. Lederman said. ACL injuries tend to take more time. “Nonoperative treatment will tend to take three to six months, while surgical treatment may be six to 12 months,” Dr. Lederman explained.


“Many ACL and meniscus injuries can be prevented if the muscles that surround the knee are strong and flexible, if you use proper form and technique, and if you maintain a baseline level of physical fitness year-round,” Dr. Lederman said. “It’s also important to be in tune with your body as prompt recognition of symptoms and earlier evaluations can reduce the chance of requiring surgery in the future.” 

Are you experiencing knee pain? Don’t wait. Schedule an appointment with an orthopedic or sports medicine specialist and have your knee evaluated. To find a Banner Health specialist near you, visit bannerhealth.com.

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