medial meniscus tear

Nov 23, 13 7:23

Post #1 of 62 (11344 views)

Ok so Ive read about other people's tears and Ive decided every case is different. A lot of it depends on how healthy your knees are to begin with. So here is my story. Ive been racing for over 20 years Im 47. Ive never had an injury thats taken me out for any length of time. This year while racing Lake Placid I tore my hamstring on my left leg it was low - close to the back of my knee and healed quite well on its own. Now here it is November and Im preparing for AR Worlds in Costa Rica. A 9 day adventure race. I headed out for what should have been a straight forward hike last weekend and I slipped and fell on some wet rocks and hurt my knee. It twisted in when I slipped. It was a slick day with rain and a lot of rocks and patchy ice. I fell 2 or 3 more times on the rocks and ice. It seemed the more careful I was the worse it went. Anyway the knee started clicking and felt weird and hurt. We finished the hike out even running on the smoother stuff at the end just to get done since it was cold and rainy and we were ready to be done. On the drive home it swelled up like crazy and the pain got worse. By the time I got home and went to bed it was aching so much and it hurt a lot to bend it.
I had an MRI done on Tuesday and it shows an Oblique tear in the medial meniscus with a partially detached displaced fragment extending into the inferomedial gutter.
MCL sprain
moderate joint effusion with periarticular edema
edema surrounding both retinaculum without evidence of a tear
lobulated cyct deep to the pes anserine tendons suggestive of bursitis.
It also says the fat pads are intact and all the tendons are intact.
Im quite sure the edma references are because the injury was fresh. Yesterday I had a cortisone injection with some fluid drained out. Only 8cc's it was clear.
What does anyone have for experience with this type of thing? There is no running involved in this race and I do not plan on running any time before I go. The race starts on December 3rd.
Trailqueen

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 23, 13 9:12

Post #2 of 62 (11320 views)

I've had two medial meniscus tears. First was 18yrs ago playing college soccer and was combined with a major ACL tear, partial MCL tear, and ruptured cyst. Had ACL reconstruction and meniscus cleaned up. Came back fine with minor swelling due largely to meniscus tear, but wasn't inhibited at all.

Fast forward 6yrs and I retore my meniscus in same place (also playing soccer). Had it cleaned up via scope and was told by doc that I'm missing 1.5cm of my meniscus and shouldn't ever run more than a few miles at a time for fear of further injury and having to have full meniscus replacement (it's very close to bone on bone).

So, I took it very easy for a few years, then met my girlfriend (now wife) in grad school who I started running with fairly regularly. Since then (I'm now 38) I haven't stopped...doing a couple IMs, 25+ HIMs, and lots of running races. I still get some swelling after hard workouts, but knock on wood have been able to do most everything I want, so long as it's in a straight line. I can't play soccer, basketball or tennis as it swells terribly and takes me weeks to recover and I probably shouldn't snowboard, but some things are worth the pain and swelling afterwards. :)

Like you said, every situation is different and I just feel blessed that after my second tear and doctor's warning not to run, I'm still able to train and race tri. I also take glucosamine daily which seems to help.

Good luck!

Last edited by: sailnfast: Nov 23, 13 9:15

Re: medial meniscus tear [sailnfast] [ In reply to ]

Nov 24, 13 12:06

Post #3 of 62 (11256 views)

Im not sure how big the tear is but the doc said its a pretty good tear. The report says with detached piece. Im assuming thats what they would remove with scoping it. I also guess that getting it done sooner rather than later is the best option.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 25, 13 7:37

Post #4 of 62 (11181 views)

Sooner rather than later is probably a good idea. I've had multiple tears accompanied by repairs and a complete removal on the medial side of my left knee. While recovery is short and a meniscus tear is less severe than a ligament tear, the long term issues are what you need to be worried about. You might be able to get it repaired and have no long term issues but if you race on it and tear it worse repair might now be an option.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 25, 13 9:47

Post #5 of 62 (11155 views)

Trailqueen wrote:

Im not sure how big the tear is but the doc said its a pretty good tear. The report says with detached piece. Im assuming thats what they would remove with scoping it. I also guess that getting it done sooner rather than later is the best option.

I had something similar to what you are describing at about your age, which was 5 years ago. I went to the doctor because in a race I turned a corner and my left knee wasn't there for an instant. I went down hard. Over the next couple of weeks it would happen under high load - a sharp down hill turn to the right - and I started to hesitate.

I went to 3 doctors that wanted to do different things. Two of them told me I was too old to get it fixed and that my running days were over. A guy named Stevenson, that used to be on the Jets staff, finally told me all that was needed was a little snip to remove the flap, PT, OTC Orthotics, and finally a slight modification in my running.

I still have pain in that knee from time to time, and I will never go under 3 hours in the marathon again, but I do just fine otherwise.

"...the street finds its own uses for things"

Re: medial meniscus tear [AutomaticJack] [ In reply to ]

Nov 25, 13 10:09

Post #6 of 62 (11145 views)

Thanks for all the good advice. Im quite sure now the race is out. Im waiting to find out about surgery soon so that I can get on to getting better. Some things are not worth the risk. Saddly.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 25, 13 10:42

Post #7 of 62 (11130 views)

I had a tear in January 2012 and put off surgery as I couldn't believe a little fall would create a surgery situation. I spent a lot of money on massage and PT but finally went under the knife in September 2012. It's all good now.
But what I wanted to say is that between January and September I continued to run - it was painful and really slowed me down - but activity was doable. I'm not sure of your situation is but perhaps it's still possible to do the event with a bit of drugs. My doc seemed to think I couldn't make it worse by continuing to run.

Good luck.

Wanda

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 25, 13 10:59

Post #8 of 62 (11116 views)

at age 58 had medial tear; they operated and took 60% of posterior horn. it took a while to get running, about 6 weeks. but the other leg compensated so i had PF issues in the nonoperated knee until at age 64. had mri that showed medial tears in that leg. since i was much older the doc did not think we needed to operate since it was not clicking and locking.....just degenerative tears. and operating at that age almost guarantees OA, which was already there. options? quit running or maybe try prp. i had been researching stem cell and prp (regenexx website) and decided to get the stem cell and prp at emory university which is close to home. while their procedure is not as high powered at regenexx sounds, it really has helped my knee especially with OA. i had that procedure mid september with follow up just prp in late october. i started running about 2 weeks ago and so far so good (actually excellent as the knee is much better).

the knee that was operated on is good for shorter runs ie 6-8 miles. no more IM for me. if i had it to do all over again, i would have tried stem cell and prp before taking out such a large chunk of the meniscus. i first tore it in 04 and used celebrex to get me thru an IM and ran for another 2 years roughly before it locked on me.

i would look hard at prp and stem cell. if you get surgery, be careful returning as the good leg may compensate which puts more load on the good knee. even subltly.

good luck

Re: medial meniscus tear [Wanda] [ In reply to ]

Nov 25, 13 11:26

Post #9 of 62 (11107 views)

Yes Ive had conflicting reports about causing or not causing more damage. What struck home with me is the detatched fragment in there could rip up more meniscus and cause a bigger rip and more irritation than what is already there. I dont want to risk that. Ive considered the option of doing the race and taking a lot of pain meds and anti- inflammatories but it seems like just going on a 9 day sufferfest rather than a 9 day race that could be fun. Besides the risk of more injury on an already compromised situation.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 26, 13 11:35

Post #10 of 62 (11034 views)

I tore my medial meniscus while jumping rope (yes, with all the things I have done, it was jumping rope and landing weird that did it). It hurt pretty good for a few days, then started to feel better so I tried a run, only made it a few minutes. This continued on for awhile, I'd let it stop hurting, but as soon as I tried to run it would just come back. I then went skiing for the first time, I was a bit worried since my knee was already hurting but since it was the pounding of running that made it hurt I figured I'd be okay. Of course, I twist my knee because I am learning and huge pain follows, I just knew I messed it up good. As I gingerly try to get down the mountain the pain subsides, I stop anyway figuring it was because I was still warmed up and I'd be suffering later and the next day. Amazingly, no pain that night, and the next day my knee felt better than it had in months. Started running again without issues after. Only healing ski crash ever???

I did end up having an MRI in the knee for another issue (turned out to be quad tendonitis) and they noted a parrot beak tear. The flap must have been folded over on itself or extending out and the slight twist of the knee while skiing somehow put it back in place. The ortho wanted to schedule surgery soon or at end of season, I said no thank you and have been running on it fine. I did play some basketball and it hurt for a good week, so it looks like it is straight line only for me.

You could always do the race and hope for a healing fall! Not likely, but as long as there is a flap of tissue that is causing friction, I just can't see anything getting better.

Re: medial meniscus tear [tyrod1] [ In reply to ]

Nov 26, 13 14:03

Post #11 of 62 (11002 views)

Do you have the Dr name or website for Emory? I am going to get PRP locally (MSP) with the hope that will help with issues I've had recently. The Dr mentioned an osteotomy to me this morning as a possible solution for my knee issues. I'm going to exhaust all the options before I look at that. I'm only 35 but I've now had a complete menisectomy on the medial meniscus. I've had repairs on the lateral with a partial menisectomy so I'm buying time until a replacement. I was able to get about 6 months of very limited running in after the last surgery (Feb 2013) but I've now got pain constantly regardless of activity type or level. I had an MRI a few days ago and there was no other damage so the Dr thinks the pounding on the medial side is catching up with me. I've had 2 ACL reconstructions in the same knee, too.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 26, 13 15:24

Post #12 of 62 (10989 views)

I had a tear in May of 2012 from running hard downhill in a trail race and it just 'popped', stopped me for a minute but I finished the race, swelling in the days after. Cortisone worked well for me until this past August. Knee pain on the long runs after 10 miles, scaled all mileage back and went ahead with the half marathon. I ran really well until the last two miles when it decided it had had enough. Have an MRI scheduled. Not sure the cortisone will work for a second time, hoping to avoid surgery until I can't. Cycled more this past month, hurts when I bike hard though. Time to do something about it.

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Re: medial meniscus tear [MDM1978] [ In reply to ]

Nov 26, 13 15:56

Post #13 of 62 (10978 views)

sent you pm....needed to add you have to make sure leg muscles are working optimally as i think pain signals screws up muscle firing. that is just my opinion not from doc. anyway muscle imbalances can greatly impact how we function.

Re: medial meniscus tear [MDM1978] [ In reply to ]

Nov 27, 13 7:34

Post #14 of 62 (10926 views)

MDM1978 wrote:

Do you have the Dr name or website for Emory? I am going to get PRP locally (MSP) with the hope that will help with issues I've had recently. The Dr mentioned an osteotomy to me this morning as a possible solution for my knee issues. I'm going to exhaust all the options before I look at that. I'm only 35 but I've now had a complete menisectomy on the medial meniscus. I've had repairs on the lateral with a partial menisectomy so I'm buying time until a replacement. I was able to get about 6 months of very limited running in after the last surgery (Feb 2013) but I've now got pain constantly regardless of activity type or level. I had an MRI a few days ago and there was no other damage so the Dr thinks the pounding on the medial side is catching up with me. I've had 2 ACL reconstructions in the same knee, too.

An osteotomy is not as bad as one might think :-) I am about a bajillion times happier after mine than I was before it. And, frankly, if you've had any cartilage/ligament work, recovery will be much easier than those (IMO. And, well, assuming there are no complications. But even WITH complications, I didn't find it that bad). Although if you have bi-lateral damage (is your medial injury on the same knee as the lateral?), that's considered a pretty big contraindication, unless the second compartment damage is minimal.

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Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 27, 13 11:05

Post #15 of 62 (10899 views)

I tore my left ACL, MCL and medial meniscus years ago. I rehabbed and came back stronger. Almost a year to the date, I tore my right ACL, MCL and medial meniscus. Again, rehabbed and came back fine. Since then I have had multiple meniscus tears with only a couple times of having them snipped. The second surgery was only because I had meniscus wrapping around my reconstructed ACL (patella tendon) and the doc obviously recognized it would weaken the ACL. Since, I have taken collagen and had cortisone shots where needed...I have a few dingleberries based on the recent MRI, but did a 70.3 and a marathon without too many issues.

It sounds like if the swelling goes down (not horribly bad with 8cc's of clear fluid), and a bit of rest, you could likely do it, but eventually, it will likely need to be snipped. You can come back from a scope so quickly anymore...I walked in without the ability to squat down and walked out feeling a lot better.

Good luck, hopefully it starts feeling better, but with an MCL sprain and the meniscus tear, it will not be comfortable...it will likely feel like there is a rubber band in your knee stretching and snapping and will have some interior flimsiness with the MCL sprain...

Re: medial meniscus tear [mmrocker13] [ In reply to ]

Nov 27, 13 11:14

Post #16 of 62 (10895 views)

The lateral side is pretty good - I had 2 small repairs on it and they shaved off about 15% as the damage was to the posterior edge. The MRI last week showed the lateral side still looks good and that is why the Dr mentioned as osteotomy. I'm glad to hear you didn't think it was too bad because it sounds horrifying to me. Sounds like the recovery is similar in time to the ACL so at least I have experience there.

I'm taking all of December off and going to have a PRP injection later this month with hopes that will help. I have an unloader brace that I'm going to use when I slowly get back into action. It didn't seem to really help in the past but it can't hurt.

To the op - good look with everything and let us know how it goes.

Happy Thanksgiving to everyone.

Re: medial meniscus tear [ejharrington79] [ In reply to ]

Nov 29, 13 6:13

Post #17 of 62 (10849 views)

all the recurrences make me nervous. I wonder why the other knee goes? imbalance? have people experienced this when they have had the surgery and without? im told that if you dont have the surgery you will have an imbalance so its better to have it.
Ive been told now that the tear is 40-50% and thats big!!! I opted not to do the race. I had to make a tough decision for the safety of myself and my team. I could not imagine what could happen if we were out in the mountains after 2-3 days hiking in and the knee locked up or I could not go on. At that point the whole team is stopped. It just made no sense and in the end of it, it would have been selfish to go. They did manage to replace me.
Not only that but I sure hope I have many more races ahead of me. Im signed up for 2 ironmans this coming year and a few halves. I dont want to jeopardize my whole season and as it is Im not sure what this is all going to bring.
As of right now there is no swelling and no pain. Im happy about that. I just didnt have time to test things out and be sure it was going to be ok. Saddly my flight was this morning and here I am sitting on the computer and not on that plane.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 29, 13 7:13

Post #18 of 62 (10826 views)

Likely favoring the injured knee and causing issues on the other. Sorry to hear you had to make such a difficult decision. However, you have the right focus with so many other races in 2014. Best of luck!

Re: medial meniscus tear [ejharrington79] [ In reply to ]

Nov 29, 13 8:24

Post #19 of 62 (10814 views)

thank you.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Nov 29, 13 16:43

Post #20 of 62 (10758 views)

I had a tear with a flap that was catching and needed to be trimmed. I had the surgery on Sept 10, 2010 and by Thanksgiving I ran my annual 10K 2-seconds slower than the year before. Its been a few years but below are a few things that really helped me the most:

Game-Time Ice Machine - my knee was like a waterbed post surgery and after 1 session my swelling was reduced by a factor of 50. Find a PT location that offers this machine!
Slide board: I purchased one for about $200 and it really helped build my ad/adductors. As triathletes we do so much flexion/extension and not so much side-to-side.
Start short and increase running milage very very slowly. I cannot overemphasize this point enough!

Good luck and let us know how you're improving.

Re: medial meniscus tear [DC Pattie] [ In reply to ]

Nov 30, 13 6:23

Post #21 of 62 (10695 views)

Thank you for that!! Gives me hope! Right now I need hope.

Re: medial meniscus tear [Trailqueen] [ In reply to ]

Dec 2, 13 12:46

Post #22 of 62 (10612 views)

I just got this diagnosis on Friday past; medial meniscus tear. My podiatrist found it after ordering an MRI of the knee, now I'm waiting an additional week and a half to see the orthopod. In the meantime, more of nothing but swimming.

This is about to ruin a ski trip for me (January, reservations made already), and I'm wondering whether I'll be able to run again. The bike doesn't bother it much, and swimming not at all. However improving my swim split by swimming all the time won't mean a dang thing if I have to DNF when I get off the bike.

Other than a dull pain though, it ONLY hurts when I run.

I could use some hope myself. Fingers crossed for a good diagnosis, but the doctor doesn't seem to be in too much of a hurry to move it along. I'd go under the knife tomorrow if I could start my recovery sooner....

Re: medial meniscus tear [benjpi] [ In reply to ]

Dec 2, 13 15:18

Post #23 of 62 (10582 views)

If this is your first injury to that knee and they can repair the tear the long term prognosis is very good. Give it the time to heal and rehab accordingly and you'll be OK. No need to lose hope yet!

Re: medial meniscus tear [benjpi] [ In reply to ]

Dec 2, 13 16:03

Post #24 of 62 (10572 views)

Don't lose hope. 3 1/2 years ago I had medial meniscus tear on my right knee trimmed and have done two ironmans and many shorter distance events since. 3 weeks ago today I had the left knee done as well. Last Thursday and again today I slowly ran 3 miles. I'll be 60 years old at the end of this month. Keep in the best shape you can before surgery. Find a good PT and ice & ibuprofen are your best friends. I also walk every today to help build strength.

Re: medial meniscus tear [tricut1] [ In reply to ]

Dec 2, 13 17:36

Post #25 of 62 (10553 views)

Thanks for all the positive vibes, they help. I'm personally a big fan of PT; I had a guy that helped me get over some ITB issues back in my MTB racing days.

Great to hear that you are all recovering well, and that you're able to run so soon afterwards. I'll keep my fingers crossed!

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