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Helpful ReplyKnee issue - meniscus tear

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stevieg4ever
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2015/01/02 19:01:46 (permalink)
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Knee issue - meniscus tear

Hi ladies and gents
I have a tear on the posterior horn of the lateral meniscus, I found out today after my scan results came back.  I have already had one operation of the meniscus a while back (summer 2011) and am petrified of having another op. 
 
I can’t do any cardio without my knee swelling up but apart from that I don’t have regular or on-going symptoms which is good.  A physio I went to thinks my problems could be because my thighs are too tight and need to be stretched regularly though a lot of the exercises are causing pain and swelling.  He said that my pain and swelling will not be because of any structural issue to do with the knee (i.e. a tear).  The scan results go against this.
 
I am going to see an orthopedic specialist as soon as possible.  All my doctor said is that removing the meniscus may bring on arthritis but I get the impression he doesn’t know what he is going on about to be quite blunt.
 
I am really tense and worried at the moment.  Can anyone lend any advice in particular, how this might affect my gym training in the future?  Should I give up with lower body exercises altogether?  I already abandoned leg extensions after the first op but I know how integral squats, lunges and leg presses etc are towards getting a good physique.
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phil3030
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Re: Knee issue - meniscus tear 2015/01/03 11:52:17 (permalink)
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Hi mate
Do you know what type of meniscal tear you have? Depending on this, the goal for surgery can vary from stitching to repair, or outright removal of the tear/flap.
 
As far as surgery goes, there is no reason why you cannot continue to train after an arthroscopy, with reasonable lower limb input including squatting/deads, indeed building the muscle around your knee is vital if you want to offload the strain put on the joint. There will obviously be a recovery period, but an arthroscopy and meniscal tear repair is a fairly low risk operation in general, if that's the isolated damage. Knee extensions are not a great exercise for ligament damage due to their open chain nature, but if you want to maintain movement control then closed chain will be excellent, and to be fair even open chain will likely be ok after recovery providing you don't experience discomfort doing them.
 
Regarding arthritis, most knee injuries are linked to this. Ligament tears, meniscus tears, blunt trauma to the patella etc. I've torn my ACL, but worked bloody hard after surgery, and I'm squatting heavier than before, back to reasonably high performance levels with my rugby, building more muscle around my knee - especially posterior chain (consider glutes as well). I'm probably going to have an arthritic knee at some point, but I'm positive I will avoid it for as long as possible by doing everything else right.
 
If you can't do the stretching at the minute (I assume heel to backside?) look at going into a lunge and lessening the knee range of movement from full to around 90. Stretch at your hip and foam roll at your knee. Invest in soft tissue massage, free up your quads/hamstrings/glutes/lower back and take the time to work on mobility. Get the supple leopard book from Kelly Starrett and bring your rehabilitation work on your tight areas and restrictions - if you want to avoid further injury and poor outcomes, take charge and optimise what you can.
 
Finally like I say, I wouldn't stress about surgery. If you do things right the outcomes are generally ok, and you can get back to fairly normal activity. Ask the consultant if he can do the operation rather than his SHO/reg as your sporting performance is important to you, and good luck!

My Journal: soon to be revived
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stevieg4ever
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Re: Knee issue - meniscus tear 2015/01/03 14:55:11 (permalink)
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Thanks for the reply mate.  Your words have definitely calmed me down somewhat, my gp was useless.
 
Its a transverse tear on the poster horn of the lateral meniscus.  I am worried because:
a) it would be the second operation on the region (not sure where the first op was exactly)
b) i don't know what the cause is and thats the worst thing at this stage.  I did a lot of lower body gym work for most of the time between the first op and November last year (so for about a year and a bit) so I am wondering if that may have caused it.
c) arthritis, as we have mentioned before the more that is removed the more it can speed up the onset of arthritis.
 
I don't intend to do any impact sports (football, running etc.) I just want to get back to normal living and back to the gym.
 
What do you mean by ' SHO/reg ' fella?
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sillynarbie
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Re: Knee issue - meniscus tear 2015/01/03 15:06:09 (permalink)☄ Helpfulby stevieg4ever 2015/01/03 17:58:20
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I have a lateral meniscus tear in my right now.
 
A lot will depend on what kind of tear you have, as phil mentioned. If you experience "locking" or your knee given way then you might want to consider surgery to get it tidied up so that stops happening.
 
However, if you don't, then my physio was quite adament that having surgery probably won't improve your situation very much. The tear will always be there (there is no blood flow to the meniscus) and therefore surgery doesn't really improve anything. Often they remove the meniscus but this, as you say, leads to a greater risk of arthritis with time.
 
Here are some facts of life for me post tear:
 
1) You can do cardio, but you cannot do impact. That means running/jumping is out, even walking for extended periods can be problematic, but rowing, cycling, and cross training (this is my fave) are OK. They shouldn't cause you any pain.
 
2) You should be able to get back to training legs with time. I can now squat and deadlift without any pain.
 
It took a good year after my tear before I could squat properly again. You just need to rest and to stop doing all impact exercises (because they will inflame your knee and constantly set recovery back). After a period of resting, slowly reintroduce leg training and monitor pain. You'll have to change exercises around to find ones that work for you. Don't even think about high volume or load for a good few months after restarting training.
 
Eventually you'll get there but you need to be patient - that was the hardest bit for me, it was only when I finally resigned myself to the fact that I might never train legs again and took it easy that things started improving!
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sillynarbie
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Re: Knee issue - meniscus tear 2015/01/03 15:14:08 (permalink)☄ Helpfulby stevieg4ever 2015/01/03 17:58:27
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stevieg4ever
Thanks for the reply mate.  Your words have definitely calmed me down somewhat, my gp was useless.
 
Its a transverse tear on the poster horn of the lateral meniscus.  I am worried because:
a) it would be the second operation on the region (not sure where the first op was exactly)
b) i don't know what the cause is and thats the worst thing at this stage.  I did a lot of lower body gym work for most of the time between the first op and November last year (so for about a year and a bit) so I am wondering if that may have caused it.
c) arthritis, as we have mentioned before the more that is removed the more it can speed up the onset of arthritis.
 
I don't intend to do any impact sports (football, running etc.) I just want to get back to normal living and back to the gym.
 
What do you mean by ' SHO/reg ' fella?


You will be constantly frustrated at the incompetence of medical professionals on matters like this. Best thing to do is to learn as much about your injury (and pain) as you can yourself and constantly keep them in check.
 
For instance, when I first went to the doctor, they did a bit of feeling around and then concluded that I have ITB syndrome. She was ready to send me away for 8 weeks (!!!) before another appointment to do some leg exercises to strengthen my quads and leg muscles (apparently 28" quads and squatting for 10 years meant my legs still weren't strong enough). This sort of made sense, since the pain was on the outside of my knee. However, I researched it myself online using anatomy charts etc. before seeing the GP and concluded that it wasn't the ITB because you can actually feel your ITB and where it attaches and that point was about 1-2" above where I was getting the pain. I pointed this out to my GP and she said "hmm, you're right. I guess we better send you for an MRI scan then" at which point they discovered the tear.
 
There are numerous other stories from the hospital too but in the end I got a reasonably competent consultant physio who herself had had a meniscus tear so wasn't full of ****.
 
Just keep learning and don't believe someone who is obviously talking **** to you.
 
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jack5r
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Re: Knee issue - meniscus tear 2015/01/03 19:53:25 (permalink)
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Lots of threads on knees atm.

Always nice to read Phil's posts as a bit of revision as I've got my first placement in MSK on monday!

Body Weight - 83kg 
Bench - 145kg
Squat - 190kg
Clean & Jerk - 129kg
Snatch - 98kg  
 
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stevieg4ever
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Re: Knee issue - meniscus tear 2015/01/05 11:21:48 (permalink)
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Thanks for the words of advice guys.  I have calmed down a bit as I wrote my original post as soon as I returned back from the doctor's.  Ill wait for the copy of the scan and then see a consultant/surgeon before deciding what's the next best course of action.
I want to stretch out my quads and see if that works (as that may be the source of the pain, as my physio believes) before deciding what to do, its complicated.
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