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Torn meniscus: Can I run? Lift?

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  • GiddyupTimGiddyupTim Member Posts: 2,818 Member Member Posts: 2,818 Member
    I promise, after this, to stop belaboring this point.
    But, here is the link to an abstract to a report in the American Journal of Bone and Joint Surgery, in which they followed a bunch of people who had meniscus tears.
    If I am reading it correctly, it says that when these people were examined anywhere from two to 10 years after their initial injury, only six of fifty-two patients needed any treatment for those tears. And, when they looked, about two-thirds of those tears had healed completely (It depended a lot on the type of tear) and, even when they didn't, the tear usually did not end up causing a problem with the opposing cartilage on the femur, even when the tear itself had not healed, meaning it was not likely to result in any arthritis in the future.
    www.ajkd.org/article/S0272-6386(17)30536-X/fulltext
    I'm not saying don't have surgery if you have continuing pain. Obviously, I am no doctor. But, maybe there is a part of the story that we don't always get from surgeons?
  • MfplmartMfplmart Member Posts: 2 Member Member Posts: 2 Member
    I have a re-torn meniscus, one that was already snipped 25 years ago. I also have a fully torn acl in the same knee. My ortho told me to run on it after physical therapy and a cortisone shot. Been running ever since with no issues. I do 10-20 miles a week on relatively tough trails and 6-12 miles on roads.
    edited March 2017
  • PocketPoodlePocketPoodle Member Posts: 32 Member Member Posts: 32 Member
    I have one small and one "tiny" tear in my right medial meniscus. In the beginning (three or four years ago) it would sometimes hurt to the point where I almost couldn't walk, but now I just get a bit of pain or discomfort once in a while. I actually went to my doctor some months ago to get a referral for surgery, but he said that since my knee has never locked, he would recommend physical therapy instead.

    I didn't do the physical therapy, but I have slowly started to squat and deadlift, and so far it's going well. Until then, I had done hip thrusts and Romanian deadlifts, and I think strengthening my leg muscles has helped a lot. I don't want to start running again before I have talked to my physical therapist, though.
  • GiddyupTimGiddyupTim Member Posts: 2,818 Member Member Posts: 2,818 Member
    Wow, Mfplmart! I thought I was incorrigible. So, they went in and trimmed your meniscus but choose not to replace the ACL? Do you remember why you didn't have the ACL repaired? Ever have a "giving way" episode?
    PocketPoodle, I agree the strengthening part is a lot of it.
    I had an ACL replacement and a cartilage repair procedure and a trim of the meniscus in this knee about five years ago. But even with all that, I did not have the same leg atrophy and weakness that i have had with this more recent, probable injury. Maybe because there was more discomfort with this? Maybe because I was told to keep the leg strong before surgery because that helps improve recovery?
    I have been doing a ton of power yoga to strengthen my leg again. I haven't worked up the guts to try weightlifting yet.
  • jemhhjemhh Member Posts: 14,274 Member Member Posts: 14,274 Member
    GiddyupTim wrote: »
    I promise, after this, to stop belaboring this point.
    But, here is the link to an abstract to a report in the American Journal of Bone and Joint Surgery, in which they followed a bunch of people who had meniscus tears.
    If I am reading it correctly, it says that when these people were examined anywhere from two to 10 years after their initial injury, only six of fifty-two patients needed any treatment for those tears. And, when they looked, about two-thirds of those tears had healed completely (It depended a lot on the type of tear) and, even when they didn't, the tear usually did not end up causing a problem with the opposing cartilage on the femur, even when the tear itself had not healed, meaning it was not likely to result in any arthritis in the future.
    www.ajkd.org/article/S0272-6386(17)30536-X/fulltext
    I'm not saying don't have surgery if you have continuing pain. Obviously, I am no doctor. But, maybe there is a part of the story that we don't always get from surgeons?

    That study is about kidney injuries. Do you have a link to the one you referenced? What type of activity did the patients participate in on a regular basis? That would be my concern.
  • SCoil123SCoil123 Member Posts: 2,108 Member Member Posts: 2,108 Member
    I tore mine last Summer and the doctors decided against surgery. It was a small tear in a spot receiving good blood flow. I did spend 6 weeks on crutches and another 6 weeks rehabbing before resuming work outs. It has been a process building strength back but I lift and jog again. I also do the modified version (lower impact) of Insanity twice a week.

    I did not start jogging or applying weight until January of this year. The injury was late June. I started with increasing walking intensity with hills and distance and doing resistance training without weights. I worked up from there.
  • mjbnj0001mjbnj0001 Member Posts: 971 Member Member Posts: 971 Member
    I had this last summer. Derailed all activity for several months, couldn't climb the steps to the bedroom floor, and more. I'm older, and a big guy, with no specific, overt cause to this injury. About healing: my ortho said it would never be 100%, and the MRI even showed some residue of an old high-school football injury to the area, so I guess that's my fate. Surgery wasn't recommended. Phys therapy seemed to work for me, and I've continued a series of step-up exercises all winter. Now that it's getting warm again, I'll be walking. Pedaling a stationary bike also seems to help me, as does those lower-leg resistance machines (front and back of calf resist) at the gym (not overdoing the weight used).

    We're sailors, and I lost the season last year due to this injury. Also, I was reluctant to go to the beach in case the surf knocked me around. Just got back from a sailing vac in the BVIs where I was able to do all activities (sail, swim, snorkle), with some aches/pains and some slowness, so I was quite thankful of all the time I spent in both rehab and self exercise in preparation for the trip. I only wished I had pushed myself a bit more. The other thing the doc mentioned was getting as much weight off the knees to retard further damage as I continue aging.

    Good luck in your own journey.
  • rileysownerrileysowner Member Posts: 7,820 Member Member Posts: 7,820 Member
    My experience with a torn Meniscus, living with it for many years before getting it repaired, then again 9 years later for multiple years after re-injuring it, is I could function quite well for long periods of time. However, when the flap of meniscus moved out of its proper place my knee would give way and lock up so I could not extend it or stand on it in any way. This would happen with no warning, and while I could use my hands to force my leg straight which would allow (force) the flap of meniscus back into place. BTW, this was a fairly painful thing to do, and I was told by my ortho that it makes the injury worse and I would be better off letting it go back in place gradually on its own.

    I first injured my meniscus in high school in Physed, but it took years to diagnose because I didn't have the terminology to accurately describe what was wrong. It wasn't until I had it happen and didn't force is back into place and went in with it that they could eliminate other things and say it was the meniscus. I had surgery to repair it not long after and that lasted 8-9 years. I re-injured it, and put up with it, not wanting to go through surgery again as while they said recovery would be easy with the first surgery, it wasn't. Eventually it started to bother me enough that I decide to have it dealt with, and eventually had the damaged part removed. Recovery from that was very easy and quick.

    My GP said that with proper physio I could function normally with it without surgery. However, I am very thankful that I had surgery as I no longer have to worry about the knee giving way at a very inconvenient time like the one time I was going from rock to rock to cross the top of a water fall while hiking. Thankfully I didn't fall in. I forced it back in, and continued, with much discomfort, with the hike since I didn't have much option based on where I was.
  • MfplmartMfplmart Member Posts: 2 Member Member Posts: 2 Member
    When they fixed my meniscus my acl was 90% torn. They didnt fix it because i wasnt having any stability issues and didnt need the fix for the level of sports i was competing. At some point over the intervening years it tore fully. Ortho said probably soon after my surgery.

    Not fixing it at this point because of my age, recovery time and because i am still not having stability issues. Doc basically told me to keep running and if it started to hurt he would go it.
  • GiddyupTimGiddyupTim Member Posts: 2,818 Member Member Posts: 2,818 Member
    jemhh wrote: »
    GiddyupTim wrote: »
    I promise, after this, to stop belaboring this point.
    But, here is the link to an abstract to a report in the American Journal of Bone and Joint Surgery, in which they followed a bunch of people who had meniscus tears.
    If I am reading it correctly, it says that when these people were examined anywhere from two to 10 years after their initial injury, only six of fifty-two patients needed any treatment for those tears. And, when they looked, about two-thirds of those tears had healed completely (It depended a lot on the type of tear) and, even when they didn't, the tear usually did not end up causing a problem with the opposing cartilage on the femur, even when the tear itself had not healed, meaning it was not likely to result in any arthritis in the future.
    www.ajkd.org/article/S0272-6386(17)30536-X/fulltext
    I'm not saying don't have surgery if you have continuing pain. Obviously, I am no doctor. But, maybe there is a part of the story that we don't always get from surgeons?

    That study is about kidney injuries. Do you have a link to the one you referenced? What type of activity did the patients participate in on a regular basis? That would be my concern.

    Oops! I am so sorry.
    Never cared for kidney problems.....
    Here is the appropriate reference. https://www.ncbi.nlm.nih.gov/pubmed/2745476
  • fitbethlinfitbethlin Member Posts: 162 Member Member Posts: 162 Member
    GiddyupTim wrote: »
    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

    FWIW: In that study, the outcomes of interest were set at 6 months and 12 months....but 1/3 of the PT group actually had surgery within 6 months. The conclusion found no difference 6 months after the subjects were randomized into one of the two groups. They did mention the problem with crossover subjects in the methods section and the fact that their method of accounting for this can't overcome some of the inherent bias (because you can't crossover in the other direction). The study population also included people with MRI evidence of osteoarthritis. That might make it more or less relevant to you. I think you mentioned a prior surgery as well - this study excluded anyone who had a prior surgery on the knee followed for the study.

    I would ask my surgeon for their reason for not accepting a study like this. I feel like there's some inherent methodological concerns (including a patient selection bias - 26% of eligible subjects were enrolled?? A 74% screen-failure rate seems high to me, but I work in dermatology, not ortho). That might be a great way of understanding how your surgeon really evaluated the research. I pick my surgeons based on board certification and their ability to analyze and apply research to my particular case. Also, a cutter's gonnna cut - a surgeon who recommends waiting or trying non-surgical interventions first gets my attention in a very positive way.

    <My Personal Soapbox>: This study was funded by the NIH. Getting a 7-center randomized trial paid for by the private sector when there's not a clear profit motive (like in pharmaceutical trials) is pretty difficult. I love that this data is out there, that we can get an actual idea of what works and what doesn't. I love that, because it is funded by the government (ie, us), you can just go pull this off of PubMed. I love that I live in a country that will let me vote for other people who will stop cutting vital scientific research that would be tough to fund in any other way. <Jumping Off Soapbox Now>
  • fitbethlinfitbethlin Member Posts: 162 Member Member Posts: 162 Member
    GiddyupTim wrote: »
    Here is the appropriate reference. https://www.ncbi.nlm.nih.gov/pubmed/2745476

    This is actually a retrospective study. They didn't follow people, they looked back at the records. Totally valid scientific method, and a pretty cost-effective one, but not nearly as powerful as the randomized prospective trial from the NEJM article. Worth considering when weighing the evidence.

  • AnnPT77AnnPT77 Member, Premium Posts: 20,293 Member Member, Premium Posts: 20,293 Member
    I think I'm about to be not-helpful, but not-helpful in a different way from others who've replied. ;)

    I have a torn meniscus (with a bit of osteoarthritis, and some debris in the knee, as I understand it). I have not had surgery. This got diagnosed when I reached the point of sufficient pain that it was interfering with sleep and activities, but I think I may've had the condition for some (many?) years, as I've long had episodes of knee problems.

    A few (3?) years back, I had one cortisone shot. I used the respite time from that to go through physical therapy; The main focus was how to move in ways that would reduce future stress on the knee. (My PT didn't involve a lot of knee strengthening because the PT folks agreed that my legs were already comparatively strong, and the problems were mainly elsewhere.)

    It was helpful - pain was not gone, but much reduced. I practiced the PT exercises even after PT ended, and felt they helped. It wasn't until a year or so later that I started losing weight, and the weight loss has been extremely helpful. (One note: I'd been very active for over a decade before the knee diagnosis, while remaining 60 pounds overweight.)

    Post PT, post weight loss, with no further cortisone shots, I still have some discomfort (it mostly doesn't reach the level I'd call "pain"), but not constant, and not severe. I have a fairly clear understanding of what will aggravate my knee, and mostly avoid doing it. I've also found it soothing to ice my knee after any intense workouts or other knee stressors.

    I don't intend to have surgery until pain interferes with everyday life, limits my preferred athletic activities, and doesn't yield to non-surgical interventions.

    Why this is not helpful to you: I don't run. It hurts my knee (impact is the problem). I don't even like or want to run, so that's not a problem for me. Though I avoid walking as a regular exercise mode (time-consuming, not very fun), I can walk as many miles as I ever seem to want to, recreationally - 4 to 5 at speed for me (4mph), at least, and I've walked 7+ at a stretch without paying any big pain price. I lift some, rather desultorily but progressively/heavy, as an off-season cross-training thing, and haven't had any particular knee problems associated with that.

    What I do, and (for my own satisfaction) need to keep doing is rowing (sliding-seat rowing, in rowing shells, so it's fairly intense leg work, but only in a straight-line hinge fashion, with little/no impact or torque on the knee). I also do some machine rowing in Winter, bike off and on recreationally, and routinely take spin classes twice a week. Ice after, and it stays manageable.

    FWIW.
  • GiddyupTimGiddyupTim Member Posts: 2,818 Member Member Posts: 2,818 Member
    Thanks all.
    So many who have had surgery.
    Sigh.
    I was hoping for otherwise......
  • cforsyth617cforsyth617 Member Posts: 205 Member Member Posts: 205 Member
    Hi, I was a marathon runner, started having knee pain 1 years ago september I think I tore my meniscus running, quit running. In April Physio recommended only running if my pain was less than 3/10 and recommended running with a knee brace. Ran only 6 miles per week as any more caused pain.Found out in July through MRI of this year I had a torn meniscus, Went to see the surgeon in October, by then I was able to run 5 miles twice a week without pain. When I asked about surgery he said that if I could run 5 miles pain free I didn't need surgery. He said that if I decided I needed surgery to come back, I am up to 10 miles at one time without pain. I am slowing working my way up to marathon distance. I find the brace really helps.Also the more weight I lose the less my knee hurts. Losing 18 pounds has made a big difference.
  • GiddyupTimGiddyupTim Member Posts: 2,818 Member Member Posts: 2,818 Member
    Thanks, c
    You give me hope.
    I've been running. I probably should not have been. I had much pain.
    But, I too am finding that the knee seems to be getting better. The other day I ran six miles without almost any discomfort.
    Fingers crossed.
  • Pecosbill7Pecosbill7 Member Posts: 1 Member Member Posts: 1 Member
    Giddyup Tim, ive read through this post and was wondering if you opted for the surgery. I tore my left medial meniscus in 2014. Hurt really awful, especially when I was walking down stairs. Went to see the doc who MRI’d it and confirmed the tear. One of the treatment options offered me was Platelet Replacement Prolotherapy (PRP). It’s basically you own blood which is withdrawn from your arm, centrifuged to separate the platelets from the rest and then the platelets are injected into the knee to provoke a healing response. Had two PRP injections about three weeks apart. Around the two month mark I started noticing a little improvement, to where I wasn’t sure if I was imagining it or not. But by month three I was running down the stairs totally pain free.

    Fast forward to August 2019. Playing senior league baseball (I was then 68), I took off running after a fly ball on a very rough outfield and somehow managed to not only tear the meniscus again but to also suffer a big bone bruise where the tibia and the femoral head collided where there wasn’t enough meniscus to cushion the blow. That was incredibly painful. Doc gave me three PRP injections, spread out over several months but the pain persisted. Even walking was difficult. Doc finally suggested surgery, but I had read too many stories of people having meniscus surgery and having it lead to instability, then arthritis, then an eventual knee replacement. I told the doc I wanted to give PT a fair shot first so he sent me to a PT center and the relief was evident after about the third visit. I have a friend who tore the same meniscus in an accident and who also opted for PT over surgery but I have had much better luck than she has. Her PT was significantly more aggressive than what I received and I think it almost did her more harm than good. I, on the other hand, have returned to lifting weights and playing ball, although I wear a brace and do have occasional discomfort. My philosophy is, any meniscus, as long as it’s not causing a locking of the knee, is always better than no meniscus.
  • ninerbuffninerbuff Member, Greeter Posts: 45,153 Member Member, Greeter Posts: 45,153 Member
    Although this is a zombie thread, I'll still comment. 3 years ago I took a bad spill and not only tore my meniscus, but almost detached my MCL. MRI confirmed the menicus tear and the damaged MCL. Luckily as a trainer in rehab, I knew what I had to do to rehab myself. So I took 4 solid months of daily rehab training slowly getting my knee strength back. Well after 4 months, I went back to squatting. And noticed I couldn't do ATG without pain in my knee. I dealt with it for 2 months then opted to talk to my orthopedist. He told me he could operate but couldn't guarantee that would resolve it. Well if it didn't than I knew where I stood. After the operation, I took another 4 months to rehab again and this time I was able to squat again ATG, which is still what I do now. And today I'm 57 still going strong. Even did a 36" box jump just to verify I still got skills.

    A.C.E. Certified Personal and Group Fitness Trainer
    IDEA Fitness member
    Kickboxing Certified Instructor
    Been in fitness for 30 years and have studied kinesiology and nutrition

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