Torn Meniscus
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Dave .
(Ramapo) - F - M
Torn Meniscus on 07/29/2008 20:20:43 MDT Print View

So, today I had an MRI and saw an ortho/sports medicine doctor for knee pain. I found out that I have a torn meniscus. The doctor says that I'll need arthroscopic surgery to correct the problem.

Bummer, eh?

Anyway, I'm wondering if anyone here has any experience with this injury. Did you bounce back quickly? Does the surgery leave you less than 100% or interfere with hiking afterwards?

I'm investigating second opinions and non-surgical options, but it doesn't look promising unfortunately. I'm pretty wary of surgery in general. Just sort of afraid that my knee might never fully heal and cause me problems on the trail from here on out.

The injury itself wasn't much to speak of. I was hiking in the Whites, coming down a descent in the Willey Range. I had all my weight on my left leg and was stepping forward and down with my right. I bent my left knee past 90 degrees and it sort of popped and articulated strangely. It didn't really hurt at the time, and I thought "I should be careful not to do that any more". After a brief rest on the next peak, my knee had stiffened up and was really sore. This was back in mid June. Since then, I've hiked a fair bit, but I've always felt a bit creaky and had pain in the knee. The rest is history.

I hope this doesn't mess up my ability to hike.

Ashley Brown
(ashleyb) - F
Re: Torn Meniscus on 07/29/2008 20:48:19 MDT Print View

I did something to the meniscus in my right knee on a trek in Nepal about 8 years ago. I was stuck on the trail (staying in a lodge) for about a month before I could go on any further. Symptoms were very similar to what you describe. If I sat on a seat and tried to extend my leg to the horizontal position it produced quite a twinge, and going downhill was the worst. I was later diagnosed with a slightly torn meniscus with a possible infection (though I never had an MRI).

Anyway, I've obviously no idea whether yours is a more serious tear than mine. Sounds like it probably is. I rested mine completely for over a month and it slowly healed up. It has been pretty much fine since and I completed my trek, although I took 2 months instead of 1! No pain at all now (and I play volleyball, which is very hard on the knees) though I take a lot of time to stretch my ITB to reduce pressure on my knee.

It's *always* worth getting a second opinion if you are unsure or uneasy about treatment options. I wish you the best of luck!

Edited by ashleyb on 07/29/2008 20:48:59 MDT.

Nick Chen
(fleetparadox) - F

Locale: Socal
Tear in Meniscus on 07/29/2008 23:11:23 MDT Print View

Sorry to hear about your injury.

Last year I tore my meniscus while playing tennis. Immediately after experiencing the "pop" my knee starting stiffening up and for the next month I experienced pain everytime I tried to bend it.

Gradually, two months after my injury I was able to bend the knee close to 90 degrees. Unfortunately by the time my lousy HMO insurance authorized a specialist orthopedic and his MRI, my meniscus has healed past the point where i could get arthroscopic surgery. It was probably close to 3.5 months before I was back to 80% athletically, but I've heard that the surgery does speed up the process alot quicker. Basically they're cutting away the excess flapping torn tissue that gets in the way of your joint bending (which is what causes the locking up and pain). I would highly recommend getting the surgery (most pro athletes are back practicing 2 weeks later).

Erik Graf
(VanGo) - F

Locale: Southeast
Man, sorry!!! on 07/30/2008 07:38:50 MDT Print View

Sorry to hear that. Best wishes that you'll be back on your feet soon.

My step-father has a torn meniscus. We're flying out to CO a week from today to hike in RMNP. He got a cortizone shot yesterday and hopes that will hold him over until we get back - if not - he's going to have to bail. His physician told him that if he had the time before the trip he could patch him up good as new - but he'd need the recovery time. Hopefully, with ample time to recover - you can have your knee worked on and be just fine afterwards.

Good luck

Sean Walashek
(caraz) - F

Locale: bay area
its a toss up on 07/30/2008 12:35:39 MDT Print View

I tore mine last year playing soccer. The problem with the surgery is it doesn't work for everyone and there is no scope of long term effectivness. I forewent the surgery and am active still (albient always very conscious of my knees) I'm 22 btw. As far as healing goes I would not count on it. I was led to believe that due in part to the poor circulation around the area and the fact that it is cartilige, healing anything more than the very smallest of tears is not going to happen, you may have scar tissue cover it. The physical therapy was painful however has worked in my case. There is always something to be said about the power of postitive visualization so try and intuit what the right answer for your condition is. As far as surgery goes however there are two types. If it is a smaller tear then the surgeon will simply cut away the flap causing the problem, try and imagine someone "sanding" down a rough edge. If it is a more severe tear then orthoscopic surgerey is not the case and a more thourough and more effective over the long term surgery would be to open the knee and "stictch" the tear togeather the recovery time for said opperation would be greater still. My $0.02 is that the quick fix is seldom if ever the most effective when compared to the rest of your life. The injury was likely a cause of many factors, primary of which was possibly an underdeveloped ITB which allowed your outer quad to pull the petella into a position where the tear was inevitable (if you were leading an active life) nutrients such as quercitin, msm, and vit c can all help to rebuild collagen and heal the cartilige, when combined with a comprehensive understanding of the injury and its causes and excercise specifically targeted to strengthening your knees you may have a more time consuming yet more long lasting solution.
Whichever the case I will hope for an effective recovery. Good luck.

Jane McMichen
(jmcmichen) - F

Locale: Maine, DownEast Coast
Re: Torn Meniscus on 07/30/2008 12:48:10 MDT Print View

Sorry to hear you're injured! I would have to agree with the others, though. IF you decide to get surgery, sooner is better than later. Make sure the doc is someone who does LOTS of these repairs and has a good track record - like someone who does surgeries for pro athletes.

If you continue to hike with the injury, or shortly after surgery, consider using a neoprene brace when you'll face a good bit of downhill walking. This *may* help prevent further injury or re-injury. Trekking poles are good for taking stress off knees, too.

Take heart, though. I've had both ACLs repaired/replaced and now they only give me trouble occasionally. Nothing that keeps me off the trail. I just evaluate up and down hills differently than I used to.

Good luck!

Nathan Moody
(atomick) - MLife

Locale: San Francisco Bay Area
Re: Torn Meniscus on 07/30/2008 13:43:55 MDT Print View

My significant other had this AND a torn ACL. The meniscus got cleared up with arthroscopy first - we were sent home with a narrated videotape of the whole thing! Once you see it, you can see that there's no other real way to deal with it. If you meniscus continues to tear you could get into situations where it might move beyond aches to twinging, and then from twinging to buckling knees (muscle reflex when the meniscus tears are pinched within the knee).

The procedure was total cake (ask about what anesthesia they use - could knock you silly for hours depending on what you get), recovery was taken very seriously and therefore went super smoothly. She was right as rain after a couple of months. She was hiking strong in the mountains even before the ACL surgery, which came about 6 months later.

Tad Englund
(bestbuilder) - F - MLife

Locale: Pacific Northwest
Re: Torn Meniscus on 07/30/2008 17:14:37 MDT Print View

David, Even with an MRI it is hard to tell how much damage you have until they go in and look- I was scoped because of similar symptoms as yours. I worked with the ortho-pede's for a year waiting to see what I really had. They even did the old dye test, still inconclusive. The 2 doctors looking at it disagreed with what was wrong, 1 said a tear the other said it wasn't a tear but he couldn't tell what it was.
They were both wrong- when they went in they say that it was MASHED (the tear symptom was from the meniscus folding over its self. Too much extreme skiing and high hurdles, long jump and triple jump in school.
They cut the mashed meniscus away (most of it)
I had the surgery in August on a Friday and put in a half day of work on Monday and Tuesday. Then totally back to full time there after (just a little slow at first).
I did therapy to get into shape for a Heli-ski trip the next February. I did the trip with no problems, we even skied 28,000 vertical feet in one day. I was a little sore that evening, good thing it was our last day.
You might not bounce back as quick as I did, but I've also seen other bounce back faster.
If you are going to do surgery I would have it done in September so you can recoupe all winter and be ready for the next hiking season.
Good luck.

Dave .
(Ramapo) - F - M
Re: Torn Meniscus on 07/31/2008 12:10:35 MDT Print View

Thanks to everyone for their replies and well wishes. On balance, it sounds like this is not an uncommon injury and that people do bounce back with relative ease. That’s somewhat reassuring I suppose.

I’ve done some more research on my own too. I’ve also consulted with another doc. It doesn’t look like I can avoid surgery, but the hospital I’m going to is the same one that treat the NY Mets, so I do feel confident that, since I have to have the surgery, this is a good place to have it done. They certainly have an orientation that leans toward rehabilitating athletes, so that probably bodes well for future hiking.

Also, my doctor said that I can put off surgery until after I get back from Glacier National Park, so I don’t have to cancel a hike I’ve been looking forward to all year.

A couple quick responses to specific things people said:

Ashley, downhills are the worst right now. Just *so* painful.

Erik, I could really do with a cortisone shot right about now. I might have to look into that before Glacier.

Sean, I share your general sentiments about quick fixes, but the area of the meniscus that I damaged doesn’t get enough blood flow to heal on its own. The surgery is needed to clip off the damaged flap so that it doesn’t interfere with the way my knee articulates. But PT and all the nutritional stuff you mentioned are still gonna be relevant to my recovery.

Jane, glad to hear that your injuries don’t keep you from hiking. Hope things work out the same for me!

Nathan, I’ve been hearing a lot of stories lately about how easy and non-invasive the surgery is. Does a lot to put me at ease…

Tad: exactly. The scope actually let’s a doctor visualize the injury, so that’s a lot closer to a gold standard than an MRI. My surgeon says that, after visualizing my injury, he’ll do no more than is necessary to get he knee to the point where it is healing and evenly distributing pressure from weight bearing activities. If anything looks significantly different than the MRI, he’ll do nothing and we’ll talk about it when I wake up. All in all a pretty balanced approach I guess.

Thanks again for the info. The more I learn, the less worried I am that I’ll be too gimped up to hike. In fact, I should still be able to get in some good snowshoeing this winter!

Later,
Dave

Nick Chen
(fleetparadox) - F

Locale: Socal
Meniscus on 07/31/2008 15:31:14 MDT Print View

Dave,

A quick word before you're off to Glacier.

You might want to reconsider the surgery before hiking again. From what I remember my doctor saying, it's possible to aggravate and tear more of your meniscus if you continue to do athletic activities on an already torn one. If you happen to increase the severity of the tear... the arthroscopic surgery might not be as successful as it could be right now.

Just another perspective. I know I tried to push my knee as much as I could after I tore it ... in hindsight, probably not the best idea.

Mike W
(skopeo) - F

Locale: British Columbia
Torn Meniscus on 07/31/2008 20:02:02 MDT Print View

I've had both my knees done, one about 12 years back and the other about 8 years ago. I've never been able to compress them completely since my surgery (squats) but that's not really been a big deal compared to the improvement that I saw!

I would be very careful with your Glacier hike since you can tear it worse once it's injured. My first injury ended up so bad that it locked my knee; I actually couldn't bend it past 45 degrees... which would be quite a problem when hiking. You may also experience quite a bit of swelling if you keep going on the knee once it starts telling you it's had enough.

Another word of caution for after your surgery. The surgery won't affect your ability to stand and mine actually felt so good after surgery that I didn't rest it (you hear of this all the time). I was active almost immediately and ended up with fluid on my knee. Take the time to rest it after surgery and let it heal a bit even if it does feel pretty good.

By the way, I did my second surgery awake and got to see the procedure on the screen. Really cool experience if your surgeon will agree to it!

John S.
(jshann) - F
Re: Torn Meniscus on 07/31/2008 20:23:09 MDT Print View

Yep, if I knew I was headed to surgery in the near future, no way would I risk further injury by hiking on it.