So, I went to see my knee doc becsuse I am having pain on the outside of my knee that gravitates to right across the front. I have a snapping IT band that you can physically feel pop by touch when I flex my leg they’ve I’ve managed over the years. So I figured it was that or maybe even patella tendinitis and just needed therapy.
According to the doc it is most likely a torn meniscus of some degree. She said that a buildup of fluid on the outside of the knee led her to that diagnosis. The conservative approach is therapy and anti inflammatories. Therapy has been mostly dry needling, stretching and strengthening glutes. All in hopes of freeing up the IT band and supporting the knee better.
My question is whether or not this approach is really worth the exercise or if I should move towards confirming the diagnosis via MRI and treating with a surgical solution. I’ve been no stranger to surgeries over the years so I know what rehab is all about.
Just wondering if anybody out there is having success continuing in a similar situation or that has in the past? Not asking the Internet for a diagnosis.
For reference I am only able to run a little over a mile before it really kicks in. It has completely shut me down at a mile and a half once. And it aches even with no exercise.
I had the same issue about 3 years ago. Torn meniscus with fluid build up in the outside of knee cap. It was very bothersome. Doc wanted to have surgery. I started to really focus on strengthening my quads and hamstrings. It took about 6 months of this. I was still running 3-4 times a week. I managed the pain the best I could. Ice and Advil. I now probably bike and run around 10 hours a week and I haven’t thought about my knee in almost two years. So yes it is possible.
I had a torn meniscus about 10 years ago and its very difficult to deal with if you keep on exercising, especially if you also do something that needs frequent change in direction.
My first advice: don’t wait, get an MRI. no use thinking of potential risks based on guesswork.
Second advice: get the fluid buildup sucked out. This doesn’t need surgery, just a long needle and a knee surgeon. Will only need a few days to recover from this. However, once this is done, you may get the perception that things are fixed…but, the fluid can build up again.
IMO also ignore any suggestions of steroidal injections…they generally end up doing more harm than good.
IMO also ignore any suggestions of steroidal injections…they generally end up doing more harm than good.
I’m going to second this. I’m lucky to have had healthy knees thus far but I’ve had an abnormally high number of friends with knee problems over the years. From my observation, which borders on a proper study due to the sample size, steroid injections do more harm than good in the long run.
Get the MRI! It is better to know whats going on and then not. You can properly target the area needed depending on the diagnosis.
I am about 7 weeks post meniscus repair, MCL resurfacing and Plica resection and now out door biking. Running is not possible yet but in a few weeks i will get the go ahead. Neverhte less, the MRoi told us what was login on so I could start the proper strengthening exercises pre surgery to make the comeback quicker. Best of luck on your diagnosis.
Torn meniscus in March '12. No surgery. Lots of physical therapy, strengthening exercises, more cycling & some aqua jogging. The sports med ortho doc I went to discussed my options as a 50+ year old & whether or not surgery would be the cure all. Knees are in great shape otherwise so I opted not to have surgery. I can’t do the breaststroke kick, but am happy with the decision not to get cut on. Perpetual rehab has been working with the occasional aches & pains.
@ttx I have had 2 almost identical surgeries to you but my outcome has been pretty bad. I’m glad someone has had some success. I have also developed some pretty bad trichlear dysplasia and my patella is giving me a lot of problems no matter how much strengthing and rehab I do.
For me it was a torn medial meniscus and it was not possible to run very far before the pain would be too much. I had the surgery and was back to racing 10K’s in 2-months (10 weeks).
I have a tear of the medial horn on the left meniscus. That happened in 2009. No surgery, just strengthening and a change in running volume and structure. Plus pain that I know the source of so I just ignore it.
In this trial involving patients without knee osteoarthritis but with symptoms of a degenerative medial meniscus tear, the outcomes after arthroscopic partial meniscectomy were no better than those after a sham surgical procedure.
Source: http://www.nejm.org/doi/full/10.1056/NEJMoa1305189
Of course, I’d get an MRI to find out if that’s really your problem or not.
AN MRI will give you a diagnosis, yes.
Also the extent and type of tear should be seen by this test.
My MRI from 2008 showed a horizontal tear of the medial horn. My “non-knife-happy” ortho explained the degenerative nature of horizontal tears and that these are commonly seen in middle age and older people. Repair (removal) commonly leads to a short lived benefit and earlier arthritis.
I shut down running for 6 months and have done 5 IMs and a dozen or so marts and half marys since, with PRs among these races.
Cartilage sparring should be the emphasis when the knee is concerned.
I had a pretty nasty torn meniscus on the outside as well, pain was outside to front. Seems likely I had a minor quad tear as well.
I couldn’t put weight on the leg for about 2 weeks, too 2 1/2 months to get back to work.
Sports doctor said because my range of motion was good, the best thing I could do was some ( very light at first ) strengthening exercises, and get back on the bike going mostly easy at first.
Once things were feeling mostly normal in ordinary life, but still weak on the bike, I tried to run, but my knee was still sooo weak that it felt like it was going to give out on every step.
Went to heavy weight training in the gym for 3 months.
After 9 months, I finally started to run again ( mostly easy )
I’m about 2 minutes off of my best 10k time, and doing a half marathon tomorrow, first triathlon since the accident will be in early May.
Things are pretty normal though now.
Still waiting for my MRI almost 11 months later ( Canadian healthcare isn’t all it’s trumped up to be sometimes )
I think I’ll go ahead with the MRi as has been suggested. Deductible for the year (July to July) has been met so what the heck.
I’ll keep up the therapy as we determine what we’re really dealing with. I was skeptical of the diagnosis at first but the more I read seems like it might be spot on.
We talked about draining close to a race for relief. So that option is there.
It sucks that this is happening at the start of the season. Which is why I want to figure it out and now and hopefully save at least half of it.
Biking doesn’t seem to aggravate it too much. You would think swim,img would be ok, but I did let out a loud “oomph” under water coming off the wall in the pool yesterday.
Running is almost a non starter right now. And I’m getting all kinds of fun compensatory pains. Which are a whole other matter.
You can put it off forever…but you WILL eventually get surgery or have to quit being as active. It can get worse from activity.
Having been through a few surgeries from my hockey days, my suggestion is this: find a “convient” time and get it done if there is damage. This next fall I’ll be going under the knife for more damage caused by my youth (shoulder surgery).
I put it off for so long that I can no longer underhand throw a ball (overhand went out a few years back). All i’ve done was buy time…and a longer recovery time.
What exercises were you doing? rep counts etc… thanks in advance.
I had a pretty nasty torn meniscus on the outside as well, pain was outside to front. Seems likely I had a minor quad tear as well.
I couldn’t put weight on the leg for about 2 weeks, too 2 1/2 months to get back to work.
Sports doctor said because my range of motion was good, the best thing I could do was some ( very light at first ) strengthening exercises, and get back on the bike going mostly easy at first.
Once things were feeling mostly normal in ordinary life, but still weak on the bike, I tried to run, but my knee was still sooo weak that it felt like it was going to give out on every step.
Went to heavy weight training in the gym for 3 months.
After 9 months, I finally started to run again ( mostly easy )
I’m about 2 minutes off of my best 10k time, and doing a half marathon tomorrow, first triathlon since the accident will be in early May.
Things are pretty normal though now.
Still waiting for my MRI almost 11 months later ( Canadian healthcare isn’t all it’s trumped up to be sometimes )
The very first things he had me do were just bodyweight leg extensions, essentially just getting the leg through it’s range of motion while sitting, and while laying on my back, put a rolled up towel under my leg just under my leg just above the knee, and try to get as close to full extension as possible, once I had the range of motion to be able to do that, and essentially it was just do it a handful of times and hold as comfort allowed twice a day or so.
After that, walking was difficult mostly cause my quads seemed to be giving out so easily, so he wanted me to do “mini-squats” essentially starting from standing, just going VERY slightly into a one legged squat, at first it was maybe 15% since the leg was so weak, while supporting the rest of my weight and preventing myself from falling with my arms. I was starting around 5-6 of these at a time.
Light cycling my my trainer, mostly just to get range of motion, but force pretty well as comfortable, mostly to help flush out any excess fluid etc. he said.
Essentially just progressed deeper and heavier very slowly from there.
Others might be in a very different starting place than me though, and have slightly different weaknesses with their injuries or range of motion problems etc. I was pretty lucky that my tear still allowed pretty full ROM as my swelling and inflammation dropped.
Hey df, took me about 3 months to get my MRI, I’m in Toronto though so plenty of hospitals…anyhow, I have partially torn acl, and full range of motion, when you starting moving into the heavy stuff, what kind of exercises were you doing?
The very first things he had me do were just bodyweight leg extensions, essentially just getting the leg through it’s range of motion while sitting, and while laying on my back, put a rolled up towel under my leg just under my leg just above the knee, and try to get as close to full extension as possible, once I had the range of motion to be able to do that, and essentially it was just do it a handful of times and hold as comfort allowed twice a day or so.
After that, walking was difficult mostly cause my quads seemed to be giving out so easily, so he wanted me to do “mini-squats” essentially starting from standing, just going VERY slightly into a one legged squat, at first it was maybe 15% since the leg was so weak, while supporting the rest of my weight and preventing myself from falling with my arms. I was starting around 5-6 of these at a time.
Light cycling my my trainer, mostly just to get range of motion, but force pretty well as comfortable, mostly to help flush out any excess fluid etc. he said.
Essentially just progressed deeper and heavier very slowly from there.
Others might be in a very different starting place than me though, and have slightly different weaknesses with their injuries or range of motion problems etc. I was pretty lucky that my tear still allowed pretty full ROM as my swelling and inflammation dropped.
Took me about 3 months to have the sports doctor send in a requisition, and my appt is in july, 15 months after the accident
It really was gradual, I was doing bodyweight squats, LIGHT LIGHT leg extensions and leg curls for accessory work ( single leg ), and gradually started to add weight.
I also really liked the isolateral leg press machine, as it ensured that the proper leg is actually doing the work.
Once I could do fairly similar reps and weight for the accessory work on both legs, the squats got heavier, and I was doing rack pulls as well. The main thing was to make sure that you’re not shifting to the good side from the weight being heavy, so use of a mirror and a good spotter is a pretty good idea.
My squat might be embarrassing for a powerlifter, but it’s now the heaviest I’ve gotten to, squatting more than my bodyweight now for the first time in my life!
Thanks df, appreciate the advice. I’ve just been doing mostly body weight stuff and working on the bike. I don’t have a gym membership but have been thinking about it as I’d like more heavy weights. Did you notice any muscle imbalances develop?
Took me about 3 months to have the sports doctor send in a requisition, and my appt is in july, 15 months after the accident
It really was gradual, I was doing bodyweight squats, LIGHT LIGHT leg extensions and leg curls for accessory work ( single leg ), and gradually started to add weight.
I also really liked the isolateral leg press machine, as it ensured that the proper leg is actually doing the work.
Once I could do fairly similar reps and weight for the accessory work on both legs, the squats got heavier, and I was doing rack pulls as well. The main thing was to make sure that you’re not shifting to the good side from the weight being heavy, so use of a mirror and a good spotter is a pretty good idea.
My squat might be embarrassing for a powerlifter, but it’s now the heaviest I’ve gotten to, squatting more than my bodyweight now for the first time in my life!
