I’m looking for a second opinion, before I call my Dr back.
This fall, ran my first stand-alone marathon, on 10/4/09 (Twin Cities) then a 1/2 marathon (11/1/09) on a hard packed stone bike trail. I ran both races very hard, and 4 days after the second race following a treadmill run, my left knee started hurting. The symptom is pain when completely flexing my knee, and some pain during/after running at the inside, back of my knee. There was/is almost no swelling at all. I’ve run twice since 11/5 and my knee stiffens up afterward and is sore.
I can bike without pain and have gone out for 40 + miles of hills without a problem, in fact the biking seems to help my knee feel better. So I ran today (2 easy miles on trails) after a two week layoff and my knee feels like I lost the two weeks of healing. There isn’t any feeling of catching in this knee, but I get an ocasional pop from the knee cap itself when I start walking, which isn’t painful and doesn’t seem connected to the area that is sore. The other knee is noisy at times, no issues.
My GP said I “dinged” my meniscus. (His words). No x-rays, or other testing done. He bases this opinion on the fact that I have most pain when I hyperflex the knee.
I am 52 and have been running/biking for 8 years with no prior knee problems. I’ve done 2 IM-WI, '06 and 08, this year a 1/2 marathon in May and a 1/2 ironman in June, I had a sore left hip, on the same side earlier, which was relieved with all without incident. I’m entered in IM-WI 2010.
What I’m wondering, is does this sound like a meniscus injury? Should I press for a more definite diagnosis? The GP said “let pain be your guide” and do what doesn’t hurt + rest & ice & NSAIDs. If I layoff running all winter and then discover it still hurts to run in three months, will I have wasted that time waiting for this to improve, when exploration/treatment would have moved things along faster?
Get the 2nd opinion but I wouldnt stop running completely nor would I listen to a GP. No offense to any GP’s but they are usually jack of all trades master of none. When you try to run again after not running, it will be worse because now your legs won’t be as strong to support it. Running put’s 8x your body weight on your joints, swimming and biking none. Now, if you have surgery, you’ll have no choice and will have to be very careful for about 5-6 weeks while it heals and not run.
Personally I would just ease up to maybe no more than 3-4 miles a few times a week till about January and take 400mg motrin a couple times daily and then in January start adding mileage back by 5-10% at a time and see how that goes. I get knee pain from my seat post sliding down in my seat tube too. I don’t feel it on the bike but I do on the run. Maybe your bike is having similar issues.
Try doing nothing but biking for a couple of weeks and see how it feels. I’m 42 and have been running since 15 years old so I try and mix it up a bit. Just biking will help your knee feel better and you won’t lose very much cardio. Worth a shot.
Treating a miniscus injury is apparently a slow process (if that is what it is)…or it is for my spouse, whose been at if for 11 months. It’s getting better but he pretty much gave up running this year. he continues to cycle and swim to stay fit. He did not want surgery as all they could do was go in and clean it up, they can’t actually repair the injury.
You don’t know what your actual injury is yet, no?
I tore my meniscus 3 years ago. It was sudden pain and walking was VERY bad. That said, it sort of got better on its own and I waited awhile to finally get it MRI’ed and then repaired. The repair didn’t take (riskier than removal, but I was young). However, doing 6 mos of PT REALLY made it better and I am running fine now. I’m no replacement for your doctor, but I would push for an MRI just so you have a concrete diagnosis. Whether or not you scope it is up to you and the doc. Sometimes PT can be very good for it because it stabilizes and strengthens the muscles around the knee so there’s less pressure and pain.
But I would always want a 2nd opinion or “real” diagnosis, for my own piece of mind.
Having “dinged” my meniscus twice, and having the tape of my arthoscopic surgery to prove it, I’d say it is unlikely that you tore it without realizing it, or without a sudden sharp pain and concomitant swelling. Moreover, IMO, simple running is probably not likely to tear the meniscus. You need some twisting/bending motion to do that. BTW, X-rays will not show torn meniscus, you need an MRI for that.
I’d try backing off on the running for a while longer.
I agree with others that you should get a 2nd opinion and that should come from a specialist (knee or at the very least a sports doctor).
I am going through something similar to you right now. It is thought that I damaged my meniscus in the past but had strengthened the muscles around it to compensate. I pulled my quadracepts tendon in August and once that spot weakened it was like a house of cards where the rest of the supporting structure fell apart. My knee felt off but was still able to run and quickly but it would ache for the following few days with slight swelling. I iced, tried to strengthen it then went and played hockey. That was the end for me, once my knee was loaded in a turn it basically gave out. I continued to play a bit longer because I thought it would be fine but by the time I took my equipment off it swelled up and could not really walk on it for the next few days.
In the testing I was having no issues hyperextending the knee and had no catching with is the big issue so the Dr was hoping I would not need surgery. I have been doing physio for the last 5 weeks and my knee is better but go see the doctor again this week to see if I have made enough progress or if surgery is required.
Meniscal tears can be treated without debridement depending on where the tear occurs. The meniscus can actually heal itself if the tear occurs in the outer third (vascularized) region and the tear isn’t too big. There are sutures that can be implemented arthroscopically that can repair the meniscus and some show success.
Agreed, get an MRI. I tore mine on a training run for a marathon, and it turned into 2 surgeries later with no articular cartilage (strange though, my 2nd Dr. has no idea why). I didn’t twist mine either, with about 2 miles left in my run, I had a sudden pain on the medial side of my knee for no reason and it never went away. MRI later, torn mensicus…
The popping of the knee cap you feel could very well be your patellar tendon, but you should get a second opinion. It’s important to know what kind of injury you’ve had to your meniscus so you can properly have it treated. Sometimes it will heal on its own, sometimes you’ll have to get a debridement. MRI can be somewhat reliable in diagnosing a meniscal tear, but isnt always and is expensive. A doctor may be able to tell if you have one or not by doing a test where you lay flat on your stomach, bend your knee to 90degrees, and they rotate your foot/tibia. Pain = meniscal tear. Ever have joint locking or instability? Pain in the posterior of the knee is probably what he related to the meniscal tear.
I forgot to mention: don’t do the meniscal tear test that I mentioned by yourself or with a friend. make sure you have it done by a doctor. If it is done wrong and you have a meniscal tear (or even if you don’t have a meniscal tear), you could potentially do more damage than anything else.
I dont know what kind of insurance you have, but I would spring for the MRI now. I have been fighting severe knee pain since April, and just now let them do an MRI. I thought I had
Pes Anserine Bursitis (maybe I do) but it turns out I have a torn meniscus as well. I ran a grand total of 50 miles since May(mostly in tris) Try to race with no training. Cycling
didnt hurt while I was cycling. I think it contributed to the Bursitis. Swimming bothered it because of all the wall push offs. If I wasnt so stubborn I would have probably been healed by
now. I see a surgeon on thursday. He hasnt seen the MRI yet.
How did you know I was going to try to talk my wife into that very thing! I also saw an online video demo of that test, and had thought about doing that. Thanks for the reply.