This is about my wife and I am looking for suggestions and potential workarounds to this issue.
It’s a delicate issue and I understand probably most of you are not medical doctors but sometimes related experiences help.
My wife has been running on and off for over a decade with barely any problems. She did her first IM70.3 back in June and she registered for another in 2019 and we doing together our first ultra trail in August (ultra trail wales).
About a month or so ago my wife started to get some dull pain on her right knee. Since its uncommon for her to experience any pain or niggle during running she went to a sports doctor I had been to before. He did her an MRI scan and noticed an overuse injury on her right knee. He suggested rest and she should get some custom made insoles - over the years she’s been running on low-drop close to ‘barefoot’ shoes: Nike Free 5, vivo barefoot, oncloud and skechers go run. We discussed and I thought strange that she would require insoles for running so suggested she should rest and get a second opinion. So she rested and booked an appointment with an Orthopedist Knee expert. We went for a run on a trail run on Monday (Inov8 Parkclaw) where she noticed the pain was still there and a couple of weeks rest had not fixed it. Today she went to the Orthopedist appointment and he told her she had medial cartilage damage grade 3 on her right knee and that she should hang her running shoes and find something else to do. This was a huge blow to her… and I am understating it. Suddenly the thought of doing an ultra trail or an full ironman which she was keeping to 2020 seem pretty much dead. At this point I suggested she returns to the sports doctor and maybe try that insole solution.
Has anyone here any suggestion or gone through a similar experience?
I have no medical expertise, all I can offer from personal experience is that it can be worth seeing different experts as they may have different views and potential solutions.
E.g. I had recurring back, knee and hip problems after a bike crash in 2004, I then had a bulging disc in 2006. Several specialists told me to stop running, and I was pretty resigned to it. Then as part of my rehab I was referred to a sports rehab specialist who specialised in looking at movement, posture, etc. She looked at all the scans and x-rays and said she couldn’t see any reason I couldn’t run again, helped me with my form and some postural/muscular imbalances that were causing the problems, also made sure I was in the right shoes. Gradually got into running again and now >10 years later in my 40s I’m faster than I ever was.
On the other hand my wife had back problems and was diagnosed with spondylolisthesis. Went through the same thing as me, told by various docs not to run again. So I sent her to the lady who’d sorted me out, but she agreed that with that particular condition that running really wasn’t a good idea. She got her into yoga and pilates, has stabilised the area so the spondylolisthesis is manageable and my wife is swimming and cycling again, but running isn’t coming back.
So my advice would be to make sure you’ve seen a few different people, with a particular focus on experts who specialise in dealing with athletes and rehab. If they all concur that running is a bad idea, then probably best to go with the diagnosis (and maybe buy your wife a new bike?).
Does either doctor have a background in athletics and treating athletes?
I’ve found a doc without an athletic client base is more likely to suggest just stopping what is causing the pain instead of looking for what caused the damaged to occur. For me it was weak hip stabilizers that caused knee pain/multiple torn meniscus’. Only the sports medicine doctor I saw who treats elite level athletes was able to figure that out.
I’m no expert, but I would think switching to a running shoe with more cushion would help considerably. I know the “barefoot” shoes are supposed to make you run with less heel strike and form that takes impact away from your knees. However, I just don’t see the negative to adding cushion and keeping that same form if she has an injury from repeated impact. Training for my last IM I started to get knee and shin pain about 3/4 of the way through training. I realized I had worn my training shoes way too long and bought a new pair. The pain went away immediately. Obviously, she is in a different situation, but cushioning the impact further can only help.
Stop running (for now). Go to a good sports PT and work on structural imbalances (weak hips, glutes, feet, etc.). Also, ditch the barefoot running shoes (a fad that injured many a runner) and try shoes based on wife’s foot shape, arch and how she runs. A doctor can cut and fix a torn meniscus, ligaments, etc. However, the issue causing the problem will not be fixed (most likely hips, glutes, etc.). Good luck and I hope your wife is healthy soon.
I’ve had the same advice in light of both knee and back issues from orthopedists. I’ve had three knee operations in the distant past, including microfracture surgery for a quarter size bare spot on my femur. The back issues were from bulging discs in my thoracic and cervical spine. Surgeons recommended all sorts of invasive measures and stopping all physical activity. I found a sports med doctor who was a member of a local triathlon club. He disagreed with the prognosis and after 3 months of consistent PT to address hip and posture issues, I was pain free and back at it. Keep in mind by the time I got to him I could barely sleep having constant burning sensations throughout my back with severe recurring spasms. That was roughly 10 years ago. Only issues I have now occur when I get lazy and neglect my home routine to keep things in line.
Same issue with my wife’s medical condition which is much more serious. It was the 6th “expert” who had a real plan beyond palliative care. She would be dead if we went with expert 1-5, instead she is thriving.
Another thing we have noticed with my wife’s journey, is young doctors are generally not better. We often assumed that younger doctors would be on the cutting edge, however we found that their lack of experience is very limiting. Very cookie cutter approaches. There are of course exceptions to this rule, but in general over the past 4 years and literally 100’s of doctor interactions we have found it to be true - devastatingly so in some instances.
Point is at the end of the day doctors are just people. Very intelligent, yes, but flawed and limited like all the rest of us. Medicine isn’t as exact as we sometimes like to think it is. If you can afford it, get multiple opinions, apply some common sense and try to start with the least invasive approach first when it comes to non-life threatening maladies.
Get a third or fourth opinion from some great docs.
That said, it’s not the end of the world, you can do IM as a relay while she focuses on swim and bike, you’re the super runner also swimbike races are where a lot of old people end up
I had significant cartilage damage due to an injury about 15 years ago that completely stopped me from running for a couple years. Then I switched to a fore foot strike and cushioned shoes and have been running ever since. It took a few months of SLOW running (or shuffling) to get used the new running form, but after some time it just feels normal now. I’m much slower but at least I’m running. And planning my first full in 2019
I had a degenerative cartilage issue in my knee that was fixed with a high tibial osteotomy and donor cartilage plug in my femur. After a year I was back running pain free. I went to Andrew’s Sports Medicine in Birmingham, Alabama which is pretty top notch for sports surgeries.
Phototherapy might be another option. I’ve dabbled with it for sports recovery but there are medical journals documenting cases where it has promotes stem cell and cartilage growth. You might check if there’s a facility that practices it near you. This is the place I went and has some interesting articles on their site:
Oh yeah. After reading my post I realized my blog link is in my signature. I documented the process I went through with my knee pretty thoroughly just in case it later would be helpful to someone. If you go to the blog post history to the right of my page they should start around November 2013 with the successful surgery in May of 2014.
I’m no expert, but I would think switching to a running shoe with more cushion would help considerably. I know the “barefoot” shoes are supposed to make you run with less heel strike and form that takes impact away from your knees.
Honestly, seek different doctors opinions… I had one doctor who said to me after an MRI that I had the early signs of arthritis and should stop running and suggested I get Supartz shots then another one said that physical therapy would help out more than any shot could!
Long story short, I did get better with the PT and changed my views on a lot things like shoes especially! Ran in low drop close to minimalist and outta nowhere I purchased some nike zoom fly and I’ve posted my best run splits with them as well as most miles in a month and so on!
Maybe a change in shoes and better form could help her with her pains… just by. 02!
This is about my wife and I am looking for suggestions and potential workarounds to this issue.
It’s a delicate issue and I understand probably most of you are not medical doctors but sometimes related experiences help.
My wife has been running on and off for over a decade with barely any problems. She did her first IM70.3 back in June and she registered for another in 2019 and we doing together our first ultra trail in August (ultra trail wales).
About a month or so ago my wife started to get some dull pain on her right knee. Since its uncommon for her to experience any pain or niggle during running she went to a sports doctor I had been to before. He did her an MRI scan and noticed an overuse injury on her right knee. He suggested rest and she should get some custom made insoles - over the years she’s been running on low-drop close to ‘barefoot’ shoes: Nike Free 5, vivo barefoot, oncloud and skechers go run. We discussed and I thought strange that she would require insoles for running so suggested she should rest and get a second opinion. So she rested and booked an appointment with an Orthopedist Knee expert. We went for a run on a trail run on Monday (Inov8 Parkclaw) where she noticed the pain was still there and a couple of weeks rest had not fixed it. Today she went to the Orthopedist appointment and he told her she had medial cartilage damage grade 3 on her right knee and that she should hang her running shoes and find something else to do. This was a huge blow to her… and I am understating it. Suddenly the thought of doing an ultra trail or an full ironman which she was keeping to 2020 seem pretty much dead. At this point I suggested she returns to the sports doctor and maybe try that insole solution.
Has anyone here any suggestion or gone through a similar experience?
Which cartilage? Medial is location not a specific part of the knee. No surgery recommendation from the Doc? Cartilage has a poor healing capability because of a poor blood supply so surgery is usually necessary.
I have some experience with this condition.
In 2008 I pulled up very sore from a run with sharp knee pain. Eventually I had a number of scans that diagnosed significant cartilage damage in the form of deep fissures.
I had the cartilage shaved and smoothed out, and after some rehab was able to return to running. I had continual low level pain for the next seven years, but it was manageable and did not restrict my training volume and racing. I was able to race ironman and marathons and so on during that time.
In 2015 the pain returned in both knees, and again scans revealed new fissures, this time in both knees. I had another surgery including a lateral release to try to regroove the path of the patella but this time it didn’t work that well, and for me, at this point, running is over as I essentially bone on bone in both knees.
I hold out hope for stem cell regeneration in time, but I am able to manage maybe a lap of the track on grass with my kids before the sharp pain returns.
During the period post the original surgery I did a lot of kneecap stability work to try to maintain my knee health.
I hope this helps.
In April, I teared my cartillage in the knee. Grade 4 damage. Had a microfracture surgery. Some weeks ago, I started running again without any pain. I’ve been swimming and biking since September without compromise. Look for a good physiotherapist and do a lot of strength and core training. I mean real strength training with low reps and high wheight.
She had an MRI so it sounds like they know what is wrong…The meniscus will heal a bit though it usually doesn’t heal great because of poor blood supply, it depends where the tear is. She needs to stop doing what bothers it for a while - like 2-4 months and go to PT. All of my meniscus injuries have taken months to fully heal and they all eventually did though mine were traumatic not degenerative. Then maybe different shoes, etc can get her running again. But it might just be that she needs to stop running and do other sports. Meniscus is tricky, sometimes it will heal. Other times its a matter of not doing what bothers it or just getting surgery, which might not even work. If I were her I would just stick to biking/swimming for the time being, get to a PT, and work on letting it heal. There is no right answer here as its going to continue to cause her pain unless she stop aggravating it and giving it time to heal. A different doc isn’t really going to help since you already have a diagnosis, I mean they can either recommend surgery, PT, or rest, there is no magic solution here. A PT is what she needs. Time and pain will guide her.
If you notice I posted a thread about which 100 mile to do……….its also not an imbalance issue…we all have that
I have had problems building for years. Last year they did x-rays, bad arthritis in right knee, no cartilage on inside of left. Doc did not know I ran. First words out of her mouth was “you ever thought about knee replacements”? That was a year ago with two 50k’s with 10,000 plus gain. Still running 35-40 miles a week.
Basically , I cannot do damage anymore by continuing to run. Its just pain management. I am turning 60. I plan my raes with getting cortisone shots for training. Next year before my 100 they are also going to do Hyluronic acid . They told me that if I was not running the pain would probably be worse. That the constant use is probably helping.
The bad news, it is not going to get better. But no reason to stop doing what I enjoy, trail runs. At turning 60, you are going to have pains. I have to ice my knees daily, but with a good Doc, they see me completing a 100 next Sept. Yeah at times it hurts. So I run mainly trails. When I can go to mountains so pace is very slow compared to road times…but I aint sitting n the couch…hope this helps
Any worthwhile physician will avoid diagnosing a problem via imaging. An MRI doesn’t tell you what hurts. What if your wife has had that meniscus tear for 10 years and run pain free all this time? What if her pain is entirely unrelated? Research shows that running can actually be protective for knee pain. We also know that 2/3 of the meniscus is aneural… meaning it can’t cause pain. We also know that the meniscus is subject to changes from aging (called arthritis) from the age of 20 onward. So in the absence of a fracture, dislocation or systemic disease it makes no difference what the MRI says. Stop seeing orthopedists as your wife doesn’t sound like a surgical candidate. Go to a movement specialist that doesn’t operate and can treat knee dysfunction… a physical therapist. There is no need for panic as most orthopedic injuries are self limiting and typically resolve with time as long as it is not subject to continued provocation of symptoms. Avoid what hurts, seek a PTs advice, do the work and she will more than likely return to running in a short period of time.
We have a local orthopedic surgeon who pretty much tells everyone to stop running. His wife was a college runner and has bad knees, so in his mind, running is evil and no one should do it. I was told 10+ years ago by him to stop running… I’ve run 1,200-2,400 miles every year since.
I had a complete medial meniscectomy in 1996 on my right knee and have no ACL in that leg. Partial medial meniscectomy on the left in 2013 and was running less than 10 days later (with my surgeon’s blessing). Still going strong and plan a big build toward Boston, 2019.
I would get a second opinion. Knee pain with some ragged cartilage is not enough to unequivocally tell someone to stop running. She might need some intervention, but she might not. Talk to someone who treats athletes that want to compete.
never listen to a doctor who tells you to stop running… find another doctor, who is willing to help.
The custom insoles could be helpful, worth a try. So is everything else - there isn’t a cure or a surgery for this but by doing everything possible it might be possible to keep running.
maximal cushion shoes are worth trying too. The cartilage is for shock absorption, maximal cushion will help by transferring less.
Start with the non-invasive things, insoles, different shoes, and find a good physical therapist. Do the exercises the PT prescribes.
Surgeries include shaving the cartilage to smooth it out, and varieties of microfracture to encourage new cartilage growth. The shaving is well established but not useful in all cases, the microfracture is relatively new and long-term effects are not yet clear.
I did something to my L knee medial aspect this summer, thought it was ligament but the pain has persisted now for six months despite rest and PT. So researched this in some detail, it is quite depressing.
“Complete recovery is rare. Treatment is designed to improve knee function and delay the development of osteoarthritis.
No single treatment method is optimally successful. Try to follow most, if not all, recommendations.”
“Although there are medicines that can treat the symptoms associated with articular cartilage damage, there are no medications that can repair or encourage new growth of cartilage.”
Any worthwhile physician will avoid diagnosing a problem via imaging. An MRI doesn’t tell you what hurts. What if your wife has had that meniscus tear for 10 years and run pain free all this time? What if her pain is entirely unrelated? Research shows that running can actually be protective for knee pain. We also know that 2/3 of the meniscus is aneural… meaning it can’t cause pain. We also know that the meniscus is subject to changes from aging (called arthritis) from the age of 20 onward. So in the absence of a fracture, dislocation or systemic disease it makes no difference what the MRI says. Stop seeing orthopedists as your wife doesn’t sound like a surgical candidate. Go to a movement specialist that doesn’t operate and can treat knee dysfunction… a physical therapist. There is no need for panic as most orthopedic injuries are self limiting and typically resolve with time as long as it is not subject to continued provocation of symptoms. Avoid what hurts, seek a PTs advice, do the work and she will more than likely return to running in a short period of time.
Agree with this ^^, there are a TON of folks roaming this earth with “cartilage damage” who continue to run and run well.
also swimbike races are where a lot of old people end up