Advice RE: Torn Meniscus

[TShaw]

...at least I think that's what it is, after reading the pages of "Knee Pain" on WebMD; the circumstances of the initial pain (shifting my leg during Leg Press) and the subsequent painful twinges seem to support this diagnosis.

So I searched T-Nation, and found some good (that is, hopeful) info from previous threads. Seems like this isn't that rare an injury, and recovery isn't that difficult.

So here's what I'm asking of those who have experience (either directly or through friends):

1. If I can bend my knee in ways that do NOT cause the painful twinge, is it okay to continue to train legs?
2. Am I causing more damage, even if I don't FEEL the pain?
3. Once surgery is done (and I am hoping to get this professionally diagnosed and dealt with ASAP), how long might I have to stay off my leg completely, or can I walk around? (From previous threads, I gather that 3-4 weeks of recovery/PT and you're right as rain again, but I'm not sure about the time immediately post-op.)

To make this easy, I constructed a handy-dandy poll; just click the "Quote" button to the right and check one:

___TShaw, You're stupid if you think you can put stress on a joint when you are sure there's an injury.

___TShaw, You're just plain stupid, and not worth my time (but please appreciate the fact that I've responded to your post).

___TShaw, All my friends get torn menisci/meniscuses (anybody know if it's first declension?), and they continue to play professional football/leg press 600 pounds per leg/do farmer's walks up stairs. Man up and lift!

___TShaw, I'm not a doctor, but I think you should train so long as you don't feel pain; stop immediately if the pain returns.

___TShaw, Just eat more and lift big.

(The earliest I can see an ortho is a week from today--dammit--so I'm getting anxious about how long this process will keep me from Leg Day. In my loneliness and self-doubt, I have turned to the collective wisdom and moral support of the Nation. Shows you how desperate I really am.)

But seriously, people, thanks for any useful input!

[vroom]

TShaw,

I really like your multiple choice format. Can we pick more than one?

[trailer36]

t-shaw,

i have a fully torn meniscus in my right leg and a partially torn meniscus in my left from 4 years of college sports. i still lift big and do all compound exercises. the only thing that really bothers it is front squats. i am pretty sure that once you tear it you cant do any worse. my buddy who had the surgery to repair his was walking on day three and training by week 3. hope that helps.

[the42nd]

TShaw wrote:
...at least I think that's what it is, after reading the pages of "Knee Pain" on WebMD; the circumstances of the initial pain (shifting my leg during Leg Press) and the subsequent painful twinges seem to support this diagnosis.

So I searched T-Nation, and found some good (that is, hopeful) info from previous threads. Seems like this isn't that rare an injury, and recovery isn't that difficult.

So here's what I'm asking of those who have experience (either directly or through friends):

1. If I can bend my knee in ways that do NOT cause the painful twinge, is it okay to continue to train legs?
2. Am I causing more damage, even if I don't FEEL the pain?
3. Once surgery is done (and I am hoping to get this professionally diagnosed and dealt with ASAP), how long might I have to stay off my leg completely, or can I walk around? (From previous threads, I gather that 3-4 weeks of recovery/PT and you're right as rain again, but I'm not sure about the time immediately post-op.)

To make this easy, I constructed a handy-dandy poll; just click the "Quote" button to the right and check one:

___TShaw, You're stupid if you think you can put stress on a joint when you are sure there's an injury.

___TShaw, You're just plain stupid, and not worth my time (but please appreciate the fact that I've responded to your post).

___TShaw, All my friends get torn menisci/meniscuses (anybody know if it's first declension?), and they continue to play professional football/leg press 600 pounds per leg/do farmer's walks up stairs. Man up and lift!

___TShaw, I'm not a doctor, but I think you should train so long as you don't feel pain; stop immediately if the pain returns.

___TShaw, Just eat more and lift big.

(The earliest I can see an ortho is a week from today--dammit--so I'm getting anxious about how long this process will keep me from Leg Day. In my loneliness and self-doubt, I have turned to the collective wisdom and moral support of the Nation. Shows you how desperate I really am.)

But seriously, people, thanks for any useful input!

I tore my lateral meniscus on my left leg and had surgery to repair it. I also had to have ACL reconstruction, so my total recovery took a very long time. However, if it's just the meniscus and they can either sew it up or clean it up then you should be looking at about 1 month inactivity post-op, but overall a quick road to recovery.
You can continue to train on it, but you may be increasing the onset of arthritis, but you're probably going to get that anyways if you tore it.

A physical therapist would probably restrict you to bodyweight exercises and the bike until you get it fixed.

On the other hand if you are getting it fixed you may as well train as usual and if any further damage is done to the meniscus they just fix during the surgery.

Personally, I don't think the surgery on my meniscus helped too much, and I still have a little pain and irritation, but the stronger my legs get the more they go away.

Good Luck

[Will_Tagye]

I have a torn medial meniscus in my right knee. There are three options that I know of:

1. Suck it up, if the pain or the impact on your life isn't that bad and not worth the surgery then just don't do what hurts.

2. Menisectomy (sp?)- a surgery where they remove the torn portion of the meniscus. Crutches for 2-3 days and then recovery after that. This is what I thought was going to happen as I went to sleep.

3. Meniscus repair- (what I woke up with) a surgery in which the tear is sutured together and the tear heals. 6 weeks partial weight bearing (crutches) and slow recovery.

The type of tear, how long it has been injured, and the location of it will determine the option.

I had a major "bucket handle" tear in the area w/ blood flow so they attempted a repair. well here I am about 4 months later and it is still torn. In the end, part of it healed but not all of it, my leg is waaaay weaker and, I have a shit load of hospital bills.

In hind sight, the only time it affected me was if I bent my knee past about 100 degrees, ie no ATG squats or if it was bent for a long period like a long flight. The surgery really wasn't worth it and I am worse off now. I now can't run, I can barely do body weight squats, and I still can't bend my knee.

That being said, if I was an Olympic lifter, wrestler,or something that demanded my knee to bend regularly then the injury would have had a major impact on my lifestyle and surgery would have been a wise choice. I just wanted it to bend right, and it had not bent right for about 10 - 11 years, slowly getting less and less range of motion.

Make sure you know what the damage is and all of the options you have. Truly determine the impact that it has on your life and weigh that against the pros and cons of each option.

If you decide on surgery, get ready for it. Seriously work on flexability, if you can't touch your toes try to put on your shoes. Also buy your girl a big bunch of flowers and tell her she is the best ever. She will really be a major help the first few days/weeks.

Any other questions feel free to PM me.

Good luck.

[jim2406]

hi,

a horror story approaches :o(

i had a meniscal tear in my left knee, 9 months after an ACL reconstruction - i couldn't figure out how i did it.

i had a meniscal repair on said tear - the plan was for me to be walking straight away, taking it easy for a few weeks and having surgery.

when i woke up, i couldnt move my leg. whenever i did, i had agonising pain, like the skin was tearing.. 3 weeks of no bending of the operated leg, and crying lots to my surgeon later, i had an emergency op where they moved lots of scar tissue out of my knee. apparently it was tangled around the saphenous nerve (sp?), which controls feeling in the leg.

the whole thing took about 6 months to recover from. during the first 3 months, whenever i activated the hamstring in the operated leg, i had pretty bad nerve pain in my leg (apparently not dissimilar to sciatica). when i returned to normal activity, i still had really acute pain in my knee. noone knew why. it turned out a biodegradable screw in my leg from my acl reconstruction (hamstring graft) hadn't biodegraded, had become dislodged (possibly from post-acl surgery), and drifted to become slightly embedded in my patella. ow. this screw was removed. since that, things are a bit better, although if i ever bend my leg all the way back, the knee dislocates and it really, really hurts.

so, 5 operations in just over 2 years = a very unhappy me!

i guess the moral of this story is no operation is risk free! beware!

jim

[TShaw]

Hmmm.

vroom,
Knock yourself out. Seriously. [end subtle humor] I'll bet you want to adapt my poll format to posts on the Politics Forum; it would save a lot of typing over there, wouldn't it?

trailer36,
Are you telling me that it hasn't become worse? That's very good to hear.

the42nd,
I'm 46, and everyone else in the family has arthritis already, so I've kind of been expecting it. still, anything that puts it off for as long as possible....

wtagye,

1. That's a good point; I'm wondering how much worse it can get if I neglect doing anything about it and keep training. This IS sound advice for a lot of situations.

2 & #3. These are the crux, aren't they? Thanks, because I didn't have a concrete idea of these two options.

I am very flexible; I mean VERY, through diligent stretching, so I've got that going for me. And my wife loved the remark about the flowers; she thinks I should listen to you on this one.

jim2406,
Good final lesson, but I'm hoping your ACL situation means it's a VERY different case from mine.

Thanks for all this; it gives me a better idea of what I might be in for.

Any more horror stories?

[trailer36]

TShaw wrote:
Hmmm.

vroom,
Knock yourself out. Seriously. [end subtle humor] I'll bet you want to adapt my poll format to posts on the Politics Forum; it would save a lot of typing over there, wouldn't it?

trailer36,
Are you telling me that it hasn't become worse? That's very good to hear.

the42nd,
I'm 46, and everyone else in the family has arthritis already, so I've kind of been expecting it. still, anything that puts it off for as long as possible....

wtagye,

#1. That's a good point; I'm wondering how much worse it can get if I neglect doing anything about it and keep training. This IS sound advice for a lot of situations.

#2 & #3. These are the crux, aren't they? Thanks, because I didn't have a concrete idea of these two options.
I am very flexible; I mean VERY, through diligent stretching, so I've got that going for me. And my wife loved the remark about the flowers; she thinks I should listen to you on this one.

jim2406,
Good final lesson, but I'm hoping your ACL situation means it's a VERY different case from mine.

Thanks for all this; it gives me a better idea of what I might be in for.

Any more horror stories?

t-shaw,

yep you heard right. it hasnt become worse. i did ass to grass squats tonight with 255 and it hurt a little but not enough to quit. i have had this injury for 3 years so you can get a gauge on it. sometimes my knees hurt alot but mostly in the winter.

[tim290280]

jim2406 wrote:
when i woke up, i couldnt move my leg. whenever i did, i had agonising pain, like the skin was tearing.. 3 weeks of no bending of the operated leg, and crying lots to my surgeon later, i had an emergency op where they moved lots of scar tissue out of my knee. apparently it was tangled around the saphenous nerve (sp?), which controls feeling in the leg.
jim

I did my meniscus when I tore my ACL. That shooting pain is fun isn't it?! Most humbling thing to go from athlete to immobile with pain.

As to the first poster; DON"T DO ANYTHING UNTIL YOU SPEAK TO A SPECIALIST!!!

Someone mentioned arthritis, well its not just arthritis, its continual pain for the rest of your life starting sooner and sooner the more damage you do. This can occur to the point where you need a knee replacement, which is supposed to rate as one of the most painfull things you can have done (epidural into the spine).

Personally I wouldn't train until you get the go ahead. This time length will vary with the severity of the tear, the operation required, and effectiveness of the operation.

[apayne]

trailer36 pretty much has it right. As another poster mentioned, a repair takes a much longer time to heal. You'd have to discuss your specific tear with your doctor to see which option is best for you. There is usually an expiration date on when a repair can be performed, the sooner the better. Good luck!

[Will_Tagye]

TShaw wrote:
Hmmm.

vroom,
Knock yourself out. Seriously. [end subtle humor] I'll bet you want to adapt my poll format to posts on the Politics Forum; it would save a lot of typing over there, wouldn't it?

trailer36,
Are you telling me that it hasn't become worse? That's very good to hear.

the42nd,
I'm 46, and everyone else in the family has arthritis already, so I've kind of been expecting it. still, anything that puts it off for as long as possible....

wtagye,

#1. That's a good point; I'm wondering how much worse it can get if I neglect doing anything about it and keep training. This IS sound advice for a lot of situations.

#2 & #3. These are the crux, aren't they? Thanks, because I didn't have a concrete idea of these two options.
I am very flexible; I mean VERY, through diligent stretching, so I've got that going for me. And my wife loved the remark about the flowers; she thinks I should listen to you on this one.

jim2406,
Good final lesson, but I'm hoping your ACL situation means it's a VERY different case from mine.

Thanks for all this; it gives me a better idea of what I might be in for.

Any more horror stories?

Good luck with whatever you choose, and flowers never hurt.

[tveddy]

I had meniscus surgery in december. I tore it in august during 2adays. The doctor told me that there was a possibility of injuring it worse if i chose to play on it. By december I had 2 more tears, and the original tear was much bigger, in addition to this, i had to have microfracture done where I had worn the cartilage off of the end of my femur in an area 12.5 mm in diameter. I had to have 2 cortisone shots, and lots of anti-inflamitories and pain killers to make it through the season. After the surgery the doctor told me that he didn't understand how I was able to walk on it, much less play football. So to answer your Q, Yes, you can hurt it worse. Much worse.

[apayne]

tveddy, does your doctor think that the cortisone shots had anything to do with the further tears?

You can tear it worse as tveddy has just shown, but a lot depends on your lifestyle. I had to eventually get my surgery because my meniscus was torn in such a way that occasionally it would flap up into the joint and interfere with me extending my knee fully.

Basically, go to your doc if you've got insurance. If you get a standard removal you can expect to be off crutches in a day or two and back in the gym after about three weeks. Good luck.

[AFMEDIC]

As I'm new to the site (BTW it's great) I won't throw too much out there. I work daily with a unit of military jumpers as their "Doc" and see knee injuries often (had a few myself) and know from personal experience that any knee injury will eventually get worse (had an ACL done last summer). Just matters how well you can tolerate the pain. What it sounds like is you possibly have a medial menisical tear, small but concerning. The major risk factor is the posibility of your knee "locking" while pushing some heavy weight. So just be careful what ever you decide.

[TShaw]

apayne and AFMEDIC,
Thanks for the rational words. I've skipped one Leg Day already. Tomorrow at 5:00am I try Leg Press...with light weight to start, of course. Might even chicken out before the warmup.

If I can lift without pain, I intend to. If it starts to hurt, I'm stopping. I can squat AtG with just me and feel nothing in the knee. There's a difference, it seems, if I "break first at the knees" and squat DOWN (pain) or "break first at the hips" and squat as if I'm sitting BACK (no pain). The chance of pain seems to increase the farther forward my knees are; when walking down stairs, if I make sure the heel hits first, I'm fine.

Gonna take it easy and keep on stretching, etc. The feedback here (both the warnings and the encouragement) have really helped me get a better handle on the options I have to think about as this gets officially diagnosed and I have to make choices about what to do next. As much as I've benefitted from the workout and nutritional info that T-Nation has provided, the feedback to this thread and to last autumn's thread on my cholesterol level have REALLY helped make a difference in my health. Thanks to all.

(Just sorry I wasted all that creativity on the handy-dandy poll! Should have saved it for a more frivolous thread! Except, of course, that I would NEVER post a frivolous thread.)

[Mike_Robertson]

Saw this thread yesterday but I'm just now getting to it; forgive me!

First of all, yes, you can make it worse. As well, if you don't get it examined/operated on soon, you lose the possibility of a repair getting done. It's a longer and more arduous process, but in the long term you have a fully functional meniscus again. Remember, it's the shock-absorber at your knee joint, so you want as much as possible there. Be forewarned, however, that about 20-30% of repairs fail, though. The key is being smart about your rehab and keeping it as non-functional as possible for a while.

As well, not getting it operated on can make things worse d/t the increased friction on the articular cartilage at the femur; this can lead to a quicker onset of arthritis as well.

Now, before you look to surgery, know that SOME meniscus tears can be healed non-operatively. Much like the repairs, this are generally limited to small tears in the outer 1/3rd of the meniscus (the vasular portion). However, it's hard to tell from MRI where exactly the tear is.

My thought would be whatever you choose, make a decision fast and go from there. By waiting (I didn't know I actually had a tear) I lost my chance at repair as the tissue was too damaged. The result was a partial meniscectomy where they took out less than 20% of the tissue (obviously, the less they take out, the better). I continued to train on it for ~3 months and actually did a full power meet with the tear, setting PR's on the squat and deadlift.

So to answer your question, yes, you can keep training on it, but it's definitely not the best thing to do. I hope that you are thinking more long-term here and understand that you can always get stronger post-surgery, but you can't necessarily get your meniscal tissue back and healthy again if you ignore this.

If you have any more questions, feel free to ask them here or shoot me a PM.

Stay strong
MR

[TShaw]

Mike, thanks for all that. Let me toss out some details:
9/4--Leg Press -- I felt the first twinge while trying to re-position my right foot/leg during a rep (yep! those moments we wish we could take back, now that we have knowledge and 20/20 hindsight)

9/8--Bulgarian Split Squats--bit of a twinge, but not enough to be worried about (I thought)
9/12--Squats--found I could squat with no pain
9/16--Leg Press--little bit of discomfort
9/20--Bulgarian Split Squats--more twinges; got concerned; searched WebMD; became concerned re: torn meniscus
9/24--Squats--skipped due to concern
9/26--(Monday) called for appointment with ortho; pissed to realize I'd have to wait a week until 10/3 to see him; started thread to get some data from T-Nation.

Yeah, it took 2 weeks before I started taking it seriously. Then again, it ONLY took 2 weeks before I started taking it seriously.

In fact, I'm hoping to get this dealt with ASAP. But the progression is probably going to be: "appt: ortho / appt: MRI / appt: discuss MRI with ortho / appt: surgery" and I have NO idea how long the wait is between each appointment. When, in my mind, the process started stretching to months instead of weeks, I hoped I could rationalize continuing to work Legs until the operation, with the understanding that I'm putting NO load on the legs (except me) for a month afterward.

I guess I'm wrestling with a question that a lot of people here can relate to: am I being rational enough, or is this just OLG behavior? (OLG = "Obsessive Lifter Guy/Gal")

This is, BTW, the first "intrusive" surgery I've ever had. I've never broken a bone or anything. I suppose that, at 46, I was due. But it bothers me that I seem to have an operation in my future, and I do NOT want this to stretch out until it's a bigger problem.

Once again, thanks for the great input.

[TShaw]

Okay. Experimented with lighter weight on Leg Press to see how foot placement affected the knee. Found a narrow stance with feet parallel seemed to be best. Went up to just over 500.

No "uh oh" moments; no times when I thought "THIS was a mistake." But then, it was obvious that my left leg was doing the lion's share of the work.

Leg Curls and Standing Calf Raises felt all right, as well. Still...going to take it easy between now and Monday when I have an appointment with the ortho. The wife is looking ahead and taking charge: when I said "I'll schedule an operation for Friday so I have Saturday and Sunday to stay completely off the leg" she said "No. You'll have it on Wednesday and take the rest of the week off, THEN have Saturday and Sunday ALSO to stay completely off the leg." She even plans on taking some days off to wait on me. Yeah, definitely flowers.