Torn meniscus: Can I run? Lift?

GiddyupTim

I am looking for the experience of people who have had a torn meniscus and have not had surgery.
I may have torn my meniscus a few months back. However, I am quite active and it has not stopped me. It has slowly, gradually been getting better. The swelling took some months to resolve completely, but it has now. I ran with pain, and played tennis, but did not move very well; but those things too seem to be resolving.
I recently saw my orthopedist, just because I thought I should. He too thought I have probably torn my meniscus. But said he was not going to recommend surgery or even an MRI, assuming, I guess, that if I was in a lot of pain I would have told him so.
Does anyone else have an experience with this? Anyone played tennis or another sport with a torn meniscus? Has anyone jogged, and continued jogging?
What about lifting weights? I know of people who had torn menisci who were advised to stop deadlifting, for instance. But those people deadlift much, much more than I do.
Thanks.

SonyaCele

i think lots of us have experienced this. If you got your doctor opinion , all you can do is make your own judgement and decide what kinda wear and tear you wanna put on your body and the consequences down the line. I was advised by my ortho surgeon that over 40, even with healthy knees, i should not run, and i should not lift heavy. I do both, although i did cut down on running because its not comfortable anymore after my knee injury. I lift heavy, and i may suffer consequences in 10 or 20 years from it, or i may not. who knows, I dont do anything that causes pain and i just listen to my body. I think the benefits of the activities far outweigh the dangers, but thats just my opinion. There are a lot of people running and lifting with all kinds of injuries.

fitmom4lifemfp

I had a torn meniscus last spring. (Had an MRI to be sure.) Had surgery in June as I can't stand it when my body holds me back from doing things. I could not run at all, and honestly I amazed that you can, so I doubt that is what you have. I think my first indication of something was when I felt a bit of pain in the right side of my knee (my right knee) during running. The next thing I noticed was not being able to sit down on my knee. It simply was too painful to bend, and that pain got steadily worse. Also, doing planks - the right knee just would not hold straight for very long - it really hurt. Pressure against my knee, like if a dog bounced into me while I was standing straight? Agonizing. I got really protective about my knee, pretty fast.

Long recovery - way longer than I anticipated. I started back running, but probably too soon. I backed off and just am now trying to run a little here and there. I never really stopped much at the gym though...other than the planks and stretching, I didn't notice too much pain there. But I don't do deadlifts, so can't help you with that.

GiddyupTim

Thanks, Sonya, fitmom.
I am asking because generally surgeons recommend surgery. I think my surgeon did not because I am a bit older and he figured that if I was in excruciating pain i would have been begging him.
But, they also used to say that the meniscus does not heal. Now they know it can, at least when the tear is on the outside edge, the so-called "red zone," where there is a blood supply.
Moreover, there was a study a few years back (2013, I believe?) in which they did not just automatically give everyone surgery. Instead, they randomized half to surgery and half to rehabilitation. Though 30 percent of those assigned to rehab decided they wanted surgery during the first few months, at one year out those who stuck with the rehab had results as good as those who were cut.
It reminds me of the situation with torn ACLs and surgery. For many years, if you tore your ACL they moved you into the operating room. Then they realized, starting about 10 years ago, that not everyone needs surgery. Many people do just fine without an ACL -- somewhere between 30-40 percent of people.

SonyaCele

my surgeon made me wait a year before repairing my acl and meniscus, he said if i was 20 years old and an active soccer player he'd do it right away , but because of my age (46 at the time of injury ) i fell into a group he recommended wait to see if we can live with it. I coulda found another dr to do it, but i trusted him so i gave living with it an honest effort. But since i am active, it got in the way of everything i did so i had surgery and fixed the acl and meniscus repair. During that year, i tried to run but the instability stopped me. And i did lift very successfully without my ACL and meniscus damage, even competed quite a few times, with no pain but i was super careful and protective. I'm several years post OP, and running isn't comfortable, but lifting is fine and i think being strong has helped my knee issues.

Azdak

FWIW, here is my experience. I have had 3 surgeries for meniscus tears--R knee 1994, L knee 2004, R knee again 2007. Ist was from running, other two from dogs.

For me, while the overall pain was not super bad, the meniscus damage precluded me from running so there was never a question of not having the surgery. I tried "medical management" for the first one in 1994 and it was a complete waste of time--did not prevent the surgery and did not reduce the pain by one bit.

The knee surgeries have not hampered my ability to run or to lift weights. TBH, I have had very little knee pain since 1994.

Now, to balance that: The first surgery coincided with a sharp increase in work duties and other issues over the next years, so my running sharply decreased. I would say that 90% of my running since then has been on a treadmill, but even 10 miles on a treadmill has not affected the knees in the least.

The same with resistance training--I can lift as heavy as I can, doing any exercise I can, with no issues. However I am also not very flexible and cannot reach full parallel when doing heavy squats, so maybe it would be different if I could go down lower (I can reach parallel with goblet squats, and no problems with that).

I think your rehab has a big effect on the length and completeness of recovery. I waited 2-3 weeks to start rehab for surgery one and developed a nasty case of PFS. For 2 and 3, I started home rehab the day after surgery, aggressively worked on reducing the swelling and restoring ROM. I played golf six days later, and was back to running within 4 weeks. Causal? Coincidental? No idea, but it certainly felt better.

cathymarie75

I had my acl done in high school in 93 and menscious done last January. I have arthritis in my knee and get injections in it to postpone knee replacement since I'm in my early 40's doctor wants to try to push it off as long as I can. I recently tore meniscus in my other knee and got a cortisone shot to hold off on surgery and it has helped, been working out and lifting. Take spin and combat classes.

jemhh

My husband recently went through meniscus surgery. He tore it on 1/2. He was off work due to it because of the kind of job he does (80% calm, 20% very active.) His ortho suggested surgery right away. After a delay to get insurance approval for the MRI, he had surgery on 2/15. It was really easy surgery and the recovery has been swift. He didn't do any PT type rehab but starting the second day after surgery he walked a bit and then moved to riding a bike. By 2/28 he was comfortable enough to walk around a car show for a couple of hours. He went back to work last week.

fitmom4lifemfp

jemhh wrote: »

My husband recently went through meniscus surgery. He tore it on 1/2. He was off work due to it because of the kind of job he does (80% calm, 20% very active.) His ortho suggested surgery right away. After a delay to get insurance approval for the MRI, he had surgery on 2/15. It was really easy surgery and the recovery has been swift. He didn't do any PT type rehab but starting the second day after surgery he walked a bit and then moved to riding a bike. By 2/28 he was comfortable enough to walk around a car show for a couple of hours. He went back to work last week.

I had my surgery on a Friday and was back at work the next Wednesday. I did have to use crutches, which I HATE, as my dr. did not want me to put any weight on it for a few days. Was back in the gym in 2 weeks, would have been back sooner but I was not allowed to do any activity that would cause me to sweat, for 2 weeks). I did PT twice a week (they wanted me to go 3x a week but that was just too much time for me to take off in a week) and I guess I went for a couple of months. I've definitely had a couple of episodes with it - running up and down hills/stairs really took a toll a couple of months ago. It wasn't the *up* that got me, I think it was the DOWN. I was hurting for a week. Stupid. Stopped running for a while, and it is much better. I am more careful now. Most days I don't even think about my knee at all. It's much more stable and strong now. I can't imagine not having had surgery - I would have been a basket case. LOL.

GiddyupTim

Everyone's telling me they ended up under the knife.
Rats!
Nobody who has done okay without cutting?

fitmom4lifemfp

GiddyupTim wrote: »

Everyone's telling me they ended up under the knife.
Rats!
Nobody who has done okay without cutting?

Honestly I don't know anyone that has had a torn meniscus diagnosis, and NOT had surgery. It does not just go away on its own. FWIW, I am 61, had the surgery at 60 - my age did not affect my dr's recommendation for surgery. I'm active. She knew that was the only way to get back to my "normal".

GiddyupTim

Thanks, fitmom. It is true, I think. The surgery is so successful and so minimally invasive that people opt for it.
But there is this new realization that the outer edge of the meniscus does actually heal. They used to think it never healed.
Plus, there was the study -- widely cited, though perhaps not accepted by surgeons -- showing that rehab can be about as successful as surgery.
Here is a link: http://www.nejm.org/doi/full/10.1056/NEJMoa1301408#t=article
And here is an article about that study: http://www.nytimes.com/2013/12/26/health/common-knee-surgery-does-very-little-for-some-study-suggests.html
Mostly, I think, I believe my knee has been improving. The swelling has resolved. The pain and discomfort have been abating. But i play tennis, a sport with much starting and stopping and twisting, on a hard surface. So, I am worried that it may be just a matter of time before I make my tear worse.

dominette3168

My personal story: I was a very active youth, played softball and volleyball until I was 25, and joined the military at 19. My first medical restriction for knee problems was put on me when I was 22. Once the restrictions were lifted I pushed thru, played sports, and ran until I was about 33 when I was finally given an MRI due to the pain. I had torn meniscus and it was an old tear that never healed. I've been in and out of physical therapy for three years and can no longer run. If I do anything more than a half mile my knees swell up like cantaloupes. It sucks, I miss running. Follow dr's orders, and listen to your body. Demand further tests (MRI's etc.) if you feel like it's more than what they said or gets worse. If I could go back 14 years and demand the MRI the first time I went to a doctor, I might not have so many problems now. Constant aches, hitches, grinding knees, reduced cardio activities...not worth not listening to my body and trusting the "professionals". I'm 36, I should NOT be this broken already.

Azdak

GiddyupTim wrote: »

Thanks, fitmom. It is true, I think. The surgery is so successful and so minimally invasive that people opt for it.
But there is this new realization that the outer edge of the meniscus does actually heal. They used to think it never healed.
Plus, there was the study -- widely cited, though perhaps not accepted by surgeons -- showing that rehab can be about as successful as surgery.
Here is a link: http://www.nejm.org/doi/full/10.1056/NEJMoa1301408#t=article
And here is an article about that study: http://www.nytimes.com/2013/12/26/health/common-knee-surgery-does-very-little-for-some-study-suggests.html
Mostly, I think, I believe my knee has been improving. The swelling has resolved. The pain and discomfort have been abating. But i play tennis, a sport with much starting and stopping and twisting, on a hard surface. So, I am worried that it may be just a matter of time before I make my tear worse.

The research studies you cited are helpful--it's always important to subject popular surgical interventions to scientific analysis and rigor.

In the case of meniscus arthroscopy, I think one must exercise a high degree of caution when taking general results and trying to apply them to an individual situation. The authors of the studies stated as such. They also indicated that those most likely to benefit from the surgery are those with sport-related injuries. IMO, it is incorrect to draw the conclusion that the studies show that "rehab can be about as successful as surgery". It would be more accurate to say that one should not automatically assume surgery is necessary because of a meniscus tear and most people should definitely try medical/rehab management first.

Studies that look at the general population tend to have pretty broad definitions of "success". Combine that with all of the other health factors that exist in the general population--condition of the knee in general, body weight, muscle strength in the legs, etc--and, quite frankly it doesn't surprise me that medical management comes out "just as good" in many cases. I see SO many people who have surgery but who don't make any other changes, or don't go through rehab, or had generally crappy knees to begin with. Yeah, for those people the surgery was probably a waste of time and money.

It usually boils down to what types of symptoms do you have and what kinds of activities do you need/want to do. I was very surgery-averse before my first one. I did "prehab" for a solid six months before I agreed to surgery. I could do a lot of things--the night before the surgery, I did a 30-minute workout on a slide board-but I couldn't run and I had pain going up stairs. It became apparent that all the rehab in the world wasn't going to change that. Because of that experience, I didn't even question the other two--just tried to get it scheduled ASAP so I could get to recovery.

Conversely, I most likely have a rotator cuff tear in one shoulder that I would never consider surgery for unless I was in dire straits. I can do almost everything--including lifting heavy weights--except throw a baseball. And shoulder surgery is 10X tougher than knee surgery IMO.

I think that if you go the medical/rehab route, the decision will resolve itself in due time. If you still have symptoms after 6 mos or so, it will be a pretty good indicator that surgery is indicated. But other than time, I don't think you have anything to lose by taking a more cautious approach.

GiddyupTim

dominette3168 wrote: »

My personal story: I was a very active youth, played softball and volleyball until I was 25, and joined the military at 19. My first medical restriction for knee problems was put on me when I was 22. Once the restrictions were lifted I pushed thru, played sports, and ran until I was about 33 when I was finally given an MRI due to the pain. I had torn meniscus and it was an old tear that never healed. I've been in and out of physical therapy for three years and can no longer run. If I do anything more than a half mile my knees swell up like cantaloupes. It sucks, I miss running. Follow dr's orders, and listen to your body. Demand further tests (MRI's etc.) if you feel like it's more than what they said or gets worse. If I could go back 14 years and demand the MRI the first time I went to a doctor, I might not have so many problems now. Constant aches, hitches, grinding knees, reduced cardio activities...not worth not listening to my body and trusting the "professionals". I'm 36, I should NOT be this broken already.

I am sorry. dominette. That does suck.
Thanks, Azdak. But, isn't it true too that, once I have surgery, and they snip out part of my meniscus (more of my meniscus, since I already had it done once) that I will have a permanently compromised meniscus?
I kinda feel that way.

fitmom4lifemfp

GiddyupTim wrote: »

I am sorry. dominette. That does suck.
Thanks, Azdak. But, isn't it true too that, once I have surgery, and they snip out part of my meniscus (more of my meniscus, since I already had it done once) that I will have a permanently compromised meniscus?
I kinda feel that way.

If it is torn, it is already compromised. It will not grow back. And the torn piece will most likely always cause pain, (that's why they trim it). It really just depends on your individual situation. That's why they do MRI's...so that they can see what has happened. You really should talk to your ortho. He can answer all your questions.

http://louisvilleorthopedics.com/knee-injuries/do-i-need-surgery-for-my-meniscus-tear/

Do I Need Surgery for My Meniscus Tear?

Posted by: Dr. Samuel Carter

What exactly is the meniscus?

The meniscus is a rubbery, fibrocartilage structure inside the knee that provides cushioning and support for the knee during impact and weight bearing activities. I often describe it to patients as the shock absorber of the knee. There are two menisci in each knee, one on the medial side (inside) and one on the lateral side (outside). The medial meniscus is slightly larger than the lateral meniscus, and is more commonly torn than the lateral meniscus.

What causes a tear in the meniscus?

In young people, meniscus tears are usually traumatic and a result of a twisting injury of the knee. They can be seen in isolation or in conjunction with a ligamentous injury of the knee – particularly in association with an ACL tear. In older patients, a meniscus tear may occur without any significant trauma. These tears are termed degenerative tears, and occur because the substance of the meniscus may degrade and weaken after years of wear and can tear more easily.

What are the symptoms of a meniscus tear?

Meniscus tears generally cause pain along the joint line and (at least initially) swelling in the knee. Depending on the size and type of the tear, they can also cause mechanical symptoms such as clicking, catching, or even locking of the knee. The symptoms generally will improve slowly over time, but may recur or worsen with activity. Some tears will cause chronic pain, but some may resolve almost completely.

Can a meniscus tear be fixed?

The most common question that I am asked by patients with a meniscus tear is “Can you stitch it back up?” That is a very logical question, and the answer to that question is “sometimes”. In young patients, for example a high-school athlete with a meniscus injury, the best treatment is an attempted meniscus repair. This decision is based on many factors, but unless the meniscus is torn beyond repair then I will almost always try to fix it in a young person. Why? The meniscus with its role as a shock absorber helps to protect the articular cartilage of the knee joint over the life of the knee. If this protection is lost at a young age, then the knee may become arthritic at an early age, which is an orthopaedic problem without a good solution. So, even if the meniscus repair fails in a young person and it requires a further surgery, I feel like it is worth the attempt.

Why wouldn’t you always fix a meniscus tear?

The reason that meniscus tears aren’t always fixed is that the meniscus has no blood supply in adulthood and as a result has very limited healing potential. This is especially true in degenerative type tears, where the meniscal tissue is already compromised and the healing potential is almost zero. Many times, trimming out the torn portion of the meniscus is a better option than repair.

If you trim out the meniscus tear, does it grow back?

No, the meniscus has limited healing potential and essentially no regenerative potential, so it won’t grow back. If it is trimmed out, there is some loss of the shock absorption and protective function. This function was basically lost when the meniscus was torn with most types of tears, so trimming out the tear does not add further damage.

GiddyupTim

Thanks again, everyone.
I really appreciate all your help.
And, I don't mean to argue......but
I have read that people's symptoms and pain often gets better with time.
And, if there is not healing that can occur, when do they suture some tears together? The sutures dissolve. Isn't that because if you put the two edges together they will knit and mend?

fitmom4lifemfp

GiddyupTim wrote: »

Thanks again, everyone.
I really appreciate all your help.
And, I don't mean to argue......but
I have read that people's symptoms and pain often gets better with time.
And, if there is not healing that can occur, when do they suture some tears together? The sutures dissolve. Isn't that because if you put the two edges together they will knit and mend?

Really, you should be asking your ortho. But I researched the hell out of this before my surgery so I understand your persistence.

There are different kinds of tears. Mine was not a result of any sudden trauma or injury. It was degenerative. Came up slowly. I'm older (61) and that is usually the case for older people.

For younger folks, sudden meniscus tears often happen during sports. A player may squat and twist the knee, causing a tear. Direct contact, like a tackle, is sometimes involved.

Older people are more likely to have degenerative meniscus tears. Cartilage weakens and wears thin over time. Aged, worn tissue is more prone to tears. Just an awkward twist when getting up from a chair may be enough to cause a tear, if the menisci have weakened with age.

You might feel a "pop" when you tear a meniscus. (I never did) Most people can still walk on their injured knee. Many athletes keep playing with a tear. Over 2 to 3 days, your knee will gradually become more stiff and swollen.

The most common symptoms of meniscus tear are:

Pain (I had a little, not much though)
Stiffness and swelling (I had some stiffness, but no swelling except I could tell when I bent my knee all the way, there was one swollen area on the outside/front)
Catching or locking of your knee ( I had this - the "catching" was driving me nuts!)
The sensation of your knee "giving way" (I had this too)
You are not able to move your knee through its full range of motion (and this)

Without treatment, a piece of meniscus may come loose and drift into the joint. This can cause your knee to slip, pop, or lock. I had this, as well as a loose flap at the tear. I had to have it trimmed and cleaned out, there was simply no way that it was going to repair itself.


The outside one-third of the meniscus has a rich blood supply. A tear in this "red" zone may heal on its own, or can often be repaired with surgery. A longitudinal tear is an example of this kind of tear. The only way to determine if this is what you have, is to have an MRI.

In contrast, the inner two-thirds of the meniscus lacks a blood supply. Without nutrients from blood, tears in this "white" zone cannot heal. These complex tears are often in thin, worn cartilage. Because the pieces cannot grow back together, tears in this zone are usually surgically trimmed away.

Along with the type of tear you have, your age, activity level, and any related injuries will factor into your treatment plan.


So...given all of that^^...it DEPENDS ON YOUR SITUATION. What kind of tear (if in fact you have a tear) you have. And the only way to know this, is to have an MRI. GO GET ONE.

Gisel2015

GiddyupTim wrote: »

Thanks again, everyone.
I really appreciate all your help.
And, I don't mean to argue......but
I have read that people's symptoms and pain often gets better with time.
And, if there is not healing that can occur, when do they suture some tears together? The sutures dissolve. Isn't that because if you put the two edges together they will knit and mend?

I don't think that at your age sutures are a possibility, but that depends on the kind of tear that you have. If the torn part is sort of "hanging" out and away from the knee join, the surgeon most likely trim that part to reduce the pain and discomfort.

Please read the useful information that @fitmom4lifemfp posted above, specially the last paragraph; and of course, ask your doctor. We can give you information based on our own experience but everybody is different. Only your doctor can address all your issues and questions.

Based on my experience: arthroscopic surgery on my left knee on 2/2014 to fix a torn meniscus that was very painful and flapping around when walking. After the surgery, the doctor told me that I would need a TKA soon due to the advance OA in the knee. Twice a year Euflexxa injections and a cortisone injection once a year kept me going until last October when I had the knee replacement.

I also have a torn meniscus in my right knee with less advance OA, but the tear possibly healed on his own (no pain right now) and the arthritis has been kept under control with Euflexxa, so I keep my hopes up that the treatment will hold for a long time. TKA is not fun and I am not out of the woods yet.

My OA was/is not the due to weight problems; I was never overweight nor was I a runner, but I had been very active (tennis, dancing, karate, kick boxing, etc.) in the past and I am much older than you.

My physical activities right now are limited and increasing very slowly. The good old days are gone forever. That’s is life. It is time to adjust, regroup, keep the weight low and under control, stay as active as possible and keep on living.

dschnitty

GiddyupTim wrote: »

I am looking for the experience of people who have had a torn meniscus and have not had surgery.
I may have torn my meniscus a few months back. However, I am quite active and it has not stopped me. It has slowly, gradually been getting better. The swelling took some months to resolve completely, but it has now. I ran with pain, and played tennis, but did not move very well; but those things too seem to be resolving.
I recently saw my orthopedist, just because I thought I should. He too thought I have probably torn my meniscus. But said he was not going to recommend surgery or even an MRI, assuming, I guess, that if I was in a lot of pain I would have told him so.
Does anyone else have an experience with this? Anyone played tennis or another sport with a torn meniscus? Has anyone jogged, and continued jogging?
What about lifting weights? I know of people who had torn menisci who were advised to stop deadlifting, for instance. But those people deadlift much, much more than I do.
Thanks.

I have torn up both knees over time. After my last surgery, I had physical therapy. The main thing was to strengthen the knee. This was accomplished using exercises that used your own body weight as weights. I also found riding an exercise bike really helps post -op. As my physical therapist explained it, it helps break up the scar tissue in the knee. Also, a really good brace/or Neoprene sleeve to support the knee is very helpful.

stealthq

GiddyupTim wrote: »

Everyone's telling me they ended up under the knife.
Rats!
Nobody who has done okay without cutting?

I did, but I was a teenager and only a small piece tore loose. Got wedged in the joint so I couldn't straighten or bend my knee for a couple of days. Once it worked its way free, I was back to normal. The knee was still healing, of course, but I didn't feel like anything was wrong with it and its never bothered me since.

I don't figure this is too applicable to tearing a meniscus as an adult, though.