# Torn Meniscus



## sdr gb (11 Mar 2013)

Anybody else got / had a torn meniscus in their knee and did you manage to keep cycling? 

I went to see the consultant this morning for the results of my MRI scan which confirmed a tear in the medial meniscus. He informed me that the usual treatment is surgery to trim away the cartilage.

Unfortunately, he is reluctant at the minute to carry out the procedure as my knee hasn't yet locked or given way. Coupled with the fact that I can carry out most of my day to day business with only a slight discomfort, he says the risks from surgery at the moment far outweigh the benefits.

With regards to cycling, I can only manage around 8 miles before I can feel the pain coming on and I have to stop. The other times it can affect me are walking down a hill or downstairs.

I'll try a few set up changes this weekend to see if I can make things any easier cycling wise but any advice would be more than welcome.


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## jdtate101 (11 Mar 2013)

I've had it before...my family has a hereditary weakness in the knee's. I had keyhole surgery to remove the torn part about 8yrs ago and haven't suffered during cycling due to the low impact. I do occasionally get a stiff sore knee having walked a long distance in cold weather, but usually an hour or so off my feet will make the pain and swelling fade.

It might be worth getting cleats/pedals with lots of float in case it's and position problem. I know sometimes my knee can be aggravated when I walk in shoes without fully insoles (I suffer from fallen arches). I also cycle with Dr.Foot insoles which seems to help. Unless you have bone grinding then cycling should not cause issues, but a full bike fit would be recommended to rule out a mechanical position issue.


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## fossyant (11 Mar 2013)

Personally, if it's affecting your cycling, then I'd be tempted to go for surgery. I don't regret having my shoulder decompressed as 2 years post op I am pain free. Don't expect overnight or quick remedy though - allow a good 12 months post surgery before it really settles down. Should ease up within a few months, but takes longer to be pain free. It's unlikely to improve without surgery though !


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## sdr gb (11 Mar 2013)

jdtate101 said:


> It might be worth getting cleats/pedals with lots of float in case it's and position problem. I know sometimes my knee can be aggravated when I walk in shoes without fully insoles (I suffer from fallen arches). I also cycle with Dr.Foot insoles which seems to help. Unless you have bone grinding then cycling should not cause issues, but a full bike fit would be recommended to rule out a mechanical position issue.


Thanks.
I'll try with more float or flat pedals and see what happens. The bones aren't grinding together so it could be in part down to position. I'll look into it.


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## sdr gb (11 Mar 2013)

fossyant said:


> Personally, if it's affecting your cycling, then I'd be tempted to go for surgery. I don't regret having my shoulder decompressed as 2 years post op I am pain free. Don't expect overnight or quick remedy though - allow a good 12 months post surgery before it really settles down. Should ease up within a few months, but takes longer to be pain free. It's unlikely to improve without surgery though !


I wanted the surgery but as I said, he's reluctant to put me forward just now, even though this has been going on since October. Instead, I've got to go back to see him in 6 months when he'll make a final decision. Might have to exaggerate a bit so that I can have the op.

The only other option is to go private, which at the moment I can't afford.


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## fossyant (11 Mar 2013)

Nightmare. Costs too much private. Did take almost 2 years from initially seeing my shoulder consultant to getting it operated on. Had an initial steroid injection after 15 months (no effect), having been back and forth over the first year, then 3-4 months after the steriod I had anaesthetic directly into my joint as a diagnostic. It felt fab after, shame it wears off fast. Thats when he decided to operate. Decision November, Operation the following Feb.

I have a colleague that has his cartlidge trimmed due to knee trouble (cyclist too) and he's been fine since.


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## jugglingphil (11 Mar 2013)

If you insist that it is affecting your quality of life then your doctor should put you forward for surgery. I imagine that a lot of other exercise will be worse for your knee than cycling.
I had an arthroscopy to tidy up meniscus and in the end remove ACL. After this op, is the time when I started cycling more as a rehabilitation. Knowing about putting up with knee pain, I think it's worth another chat with your doctor.


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## SatNavSaysStraightOn (11 Mar 2013)

do you have any other health issues? I ask becuase for me, staying fit is really important and and not being able to exercise would have a massive impact on those other health complaints (to the point where I would not be fit enough to be operated on) and this could be your line, via your GP etc. (hope that makes sense)


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## sdr gb (11 Mar 2013)

jugglingphil said:


> If you insist that it is affecting your quality of life then your doctor should put you forward for surgery. I imagine that a lot of other exercise will be worse for your knee than cycling.
> I had an arthroscopy to tidy up meniscus and in the end remove ACL. After this op, is the time when I started cycling more as a rehabilitation. Knowing about putting up with knee pain, I think it's worth another chat with your doctor.


I thought I'd managed to get across how much it was affecting me and was a bit lost for words when he said come back in 6 months. 

I can manage about an hour on the turbo so that is keeping my hopes up.


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## Hacienda71 (11 Mar 2013)

No advice, but GWS hope it gets sorted.


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## byegad (11 Mar 2013)

I went to the specialist for a similar knee problem that turned out to be my knee wearing out. I'm 'too young' (At 61.) and the knee 'not bad enough' for a replacement...yet!

So I'm in pain when walking far or riding hard. The temporary solution is lots of painkiller tablets and rub on gel and not hammering it too hard especially when it starts to ache.

I was actually hoping for a torn meniscus as that repair is far easier (A friend had it done 10 years ago.) than an artificial knee, which is somewhere in my future. Not that I'm minimising your pain and I can and do ride a lot further than 8 miles, I hope you can persuade them to do the operation fairly soon and get back onto your normal riding pattern.


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## sdr gb (11 Mar 2013)

SatNavSaysStraightOn said:


> do you have any other health issues? I ask becuase for me, staying fit is really important and and not being able to exercise would have a massive impact on those other health complaints (to the point where I would not be fit enough to be operated on) and this could be your line, via your GP etc. (hope that makes sense)


No, I don't have any other health issues (apart from tinnitus). I'm not overweight and up to the point the problem started, I was as fit and healthy as I'd ever been.


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## sdr gb (11 Mar 2013)

Hacienda71 said:


> No advice, but GWS hope it gets sorted.


Thanks


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## SatNavSaysStraightOn (11 Mar 2013)

sdr gb said:


> No, I don't have any other health issues (apart from tinnitus). I'm not overweight and up to the point the problem started, I was as fit and healthy as I'd ever been.


OK - think the only responce I have is "lucky you" and "bad luck". not sure they should fall in teh same sentence but...


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## sdr gb (11 Mar 2013)

byegad said:


> So I'm in pain when walking far or riding hard. The temporary solution is lots of painkiller tablets and rub on gel and not hammering it too hard especially when it starts to ache.


If the set up changes work, then getting into the mindset of not hammering it too hard will be the key to making any progress. I live in a rather hilly area so I'm glad I bought the bike with a triple chainset so I should be able to find a suitable gear for most circumstances.

The repair does seem easy, it's just getting them to do it.


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## vickster (11 Mar 2013)

I had a meniscus tear (lateral) for 5 months which had to be operated as I ended up with buckling (the knee was locked the whole time as well as being swollen and painful). I wasn't able to cycle - it was a while ago, I did go to the gym so assume I used a static bike. 

The issue with having it trimmed is you will be more susceptible to arthritis in the knee as part of the cushioning has gone. The issue with not having it done is the tear can get worse and so more has to be removed (how old are you as the meniscus tissue actually starts to degenerate from age 30 on!). Meniscus tears rarely heal as most of the tissue has a poor blood supply

All of my mensicus tear symptoms resolved very quickly, but I do still have issues due to hole in the cartilage on the thigh bone. All from a cycling accident, dangerous pasttime 

Fortunately, I have private health insurance through work. A menisectomy is around £2.5k self pay


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## sdr gb (11 Mar 2013)

vickster said:


> The issue with having it trimmed is you will be more susceptible to arthritis in the knee as part of the cushioning has gone. The issue with not having it done is the tear can get worse and so more has to be removed (how old are you as the meniscus tissue actually starts to degenerate from age 30 on!). Meniscus tears rarely heal as most of the tissue has a poor blood supply


 
First off, thanks for that, very informative.

That's what I'm worried about now, the tear getting worse so that the knee locks / buckles. After doing some searching on other sites, it seems this will only be a matter of time.

In answer to your question, I'm 35.


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## vickster (11 Mar 2013)

It may be possible to repair the meniscus depending on size and location of the tear if you don't leave it too long

I use this forum http://www.kneeguru.co.uk/KNEEtalk/index.php - the meniscus pages are very informative too

http://www.kneeguru.co.uk/KNEEnotes/node/2259 (I dk if you'll need to register to read, as with all forums don't be put off by the horror stories, people post bad experiences or if they have questions)

I'd ask to speak to the specialist again - just make sure that lower limbs and especially knees are his main focus

Personally, if you don't have symptoms, I'd probably leave well alone, simply due to the risks of the surgery and the protracted recovery (6-12 months is realistic). Maybe some good focused physio can help alleviate (forget the NHS, find a private sports physio, preferably with an interest in cycling)


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## sdr gb (11 Mar 2013)

vickster said:


> It may be possible to repair the meniscus depending on size and location of the tear if you don't leave it too long
> http://www.kneeguru.co.uk/KNEEnotes/node/2259 (I dk if you'll need to register to read, as with all forums don't be put off by the horror stories, people post bad experiences or if they have questions)
> I


Thanks for the link, I'll have read tomorrow when I've got more time.


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## fossyant (11 Mar 2013)

Keep pushing as you are a fit bloke and the docs can't see beyond the fact this does affect you. You could always phone up again in a couple of months and get a sooner appointment. I was told to go away and come back in 3 months with my recent problems. Phoned up after a month, got another appointment fast, explained again the effect on my cycling, oh time heals blah blah, reitterated my situation, the doc agreed to operate. Been a month since, no op date yet, but on the list. Keep plugging at it.


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## sdr gb (11 Mar 2013)

fossyant said:


> Keep pushing as you are a fit bloke and the docs can't see beyond the fact this does affect you. You could always phone up again in a couple of months and get a sooner appointment. I was told to go away and come back in 3 months with my recent problems. Phoned up after a month, got another appointment fast, explained again the effect on my cycling, oh time heals blah blah, reitterated my situation, the doc agreed to operate. Been a month since, no op date yet, but on the list. Keep plugging at it.


Thanks Fossy, this sounds like the way to go.


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## fossyant (11 Mar 2013)

No probs. Thing is the docs just see a huge wide range of folk and the really active ones are a bit rare. Yes if you were a couch potatoe and didn't exercise much, then you'd be OK with the knee, but as a keen cyclist, that rides most days, then it's a big issue to your quality of life, and a good investment to them to keep you going.

They just aren't geared up to work with really 'fit' people. Good luck


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## S1mon (16 Mar 2013)

just get them told sorry but i used to be a big fat heffer until i lost 12 stone and found a very expensive hobby/
my gp used to blame it all on being fat guess what this happened after i lost weight gp still said you could lose a bit more im now 14 stone got a second opinion they sent me private (i could barely walk and it was 3 times its normal size


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## vickster (16 Mar 2013)

Knees are extremely sensitive to weight - I am on the heavy side and although my surgeon has never brought it up, when discussed, he did emphasise the impact of weight on knee symptoms. However, if there are mechanical issues associated with a tear, weight is unlikely to have an effect. Unfortunately, these tears just don't heal well on their own (in about 80% of cases) as the blood supply is too poor. If the tissue is stuck in the joint, most of the time surgery is needed to free it


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## shouldbeinbed (16 Mar 2013)

sdr gb said:


> I thought I'd managed to get across how much it was affecting me and was a bit lost for words when he said come back in 6 months.
> 
> I can manage about an hour on the turbo so that is keeping my hopes up.


 
I've just had my 3rd Arthro for my damaged knee, including torn meniscus, since getting run down in Oct 11. Its been 18 months of pain, discomfort, aggravation, practical difficlties and hassle I really didn't need.

I understand where you're coming from, I felt like a second class citizen and as if I was whinging about nothing in their eyes. It took the support and help of my Physio pushing me to keep complaining and her making waves on my behalf as she could tell I clearly wasn't right when the consultant was discharging me & telling me it'd settle down and to stop moaning at him.

You're lucky you had an MRI in advance, I didn't and (IMO) he missed bits; I've had a few arthroscopes in my time and was going back within days telling him it didn't feel right; apparently MRI's are very expensive nowadays and 80% of the time the surgeon sees what they expect to, so they don't do them as routine anymore. if you're one of the 20% with somethng unexpected then expect a battle to get fixed.

Personally I'd keep pushing at them and not taking no for an answer, go and ask when you can start running again - thats a much bigger issue with knees than asking when you can cycle. I asked for the consultant and physio's advice and they were happy I rode within reason all the way through my problems, there were days when I simply couldn't get on a bike, I took more rest days that usual, and I reeled the mileage back, avoided the worst slopes and was running a couple of cogs easier than I would do usually and whilst it has hurt on occasions I've got through it ok.

if he really won't budge on it, at least get him to refer you to the podiatry department to assess how you're walking and if you need inserts in your shoes to even up your gait and make walking as comfy as possible whilst the doc's faff about.


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## vickster (16 Mar 2013)

You are also well within your rights to ask for a second opinion. Do some research, look for sports focused knee specialists locally and badger your GP 

My best advice really is to not do anything that causes undue pain / discomfort. You only have two knees and they need to last a long time!


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## sdr gb (18 Mar 2013)

vickster said:


> You are also well within your rights to ask for a second opinion. Do some research, look for sports focused knee specialists locally and badger your GP


All being well, I'm going to arrange an appointment with a local sports physio for a check over so that I can be sure I have no other bio-mechanical issues. He is also able to refer to NHS consultants so he may know who is the best one to approach.

I've found a website called Dr Foster Health which lists specialists which could come in handy.

Thanks for all the replies folks, it is appreciated


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## sdr gb (18 Mar 2013)

shouldbeinbed said:


> I've just had my 3rd Arthro for my damaged knee, including torn meniscus, since getting run down in Oct 11. Its been 18 months of pain, discomfort, aggravation, practical difficlties and hassle I really didn't need.


Hope you are okay and healing well. 

I'm hoping getting a sports physio onside will help in getting the procedure done. 

Good idea about mentioning running, I'll keep that one up my sleeve for when I go back.


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## vickster (18 Mar 2013)

sdr gb said:


> All being well, I'm going to arrange an appointment with a local sports physio for a check over so that I can be sure I have no other bio-mechanical issues. He is also able to refer to NHS consultants so he may know who is the best one to approach.
> 
> I've found a website called Dr Foster Health which lists specialists which could come in handy.
> 
> Thanks for all the replies folks, it is appreciated


 
There is also a list of knee specialists on that forum I linked to, must be some around Manchester


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## sdr gb (18 Mar 2013)

vickster said:


> There is also a list of knee specialists on that forum I linked to, must be some around Manchester


I was too busy reading the forums and articles on that link and totally missed the link to the specialist search. There are a few around the Manchester area.

Thanks.


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## Glenn (18 Mar 2013)

I had my knee sorted, 10 minutes on the operating table (so they told me), a couple of hours rest, then a visit by a physio, he assessed that I didn't need any crutches and I walked out of the hospital. Somewhere I have the before and after shots of inside the knee joint. After the op I had around 8 visits to the local sports injury physio to strengthen the knee muscles. If he had kept his word I'd still be there, he said he wouldn't sign me as fit until I broke 100 at golf, 4 years later I'm still crap at the game

My op was done through BUPA using the company health insurance. From convincing my GP to getting the was 6 weeks, the total cost nearly 4 years ago was £5000+, that didn't include the anaesthetist, I had to pay for him as strangely BUPA didn't cover him.


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## MrGrumpy (18 Mar 2013)

Had the same with my knee a number of years ago, in fact nearly 10! However mine was operated on within a week ( good old NHS). I could not straighten my knee nor put weight on it for that week, however I used the bike to recuperate after the healing process. Like others who have posted, I still get pain in my knee and it swells from time to time, in fact right now its painful to the point that I`m staying of the bike t ill it eases.


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## pig on a bike (18 Mar 2013)

sdr gb said:


> Anybody else got / had a torn meniscus in their knee and did you manage to keep cycling?
> 
> I went to see the consultant this morning for the results of my MRI scan which confirmed a tear in the medial meniscus. He informed me that the usual treatment is surgery to trim away the cartilage.
> 
> ...


you need an op to back to normal rides i had same op 2 mounth off bike then built up and back to normal no trouble at all know


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## Kiwiavenger (22 Apr 2013)

I'm waiting for my mri appointment to check my knee out for a suspected torn meniscus. Can still ride short distances infrequently at present but anything over 20 miles a time or 2 days commuting sees me off the bike for a week at present!


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## sdr gb (23 Apr 2013)

Kiwiavenger said:


> I'm waiting for my mri appointment to check my knee out for a suspected torn meniscus. Can still ride short distances infrequently at present but anything over 20 miles a time or 2 days commuting sees me off the bike for a week at present!


Hope you get sorted out and are back to regular riding fairly soon.

I was only able to do 8 miles at first but lately things have started to improve. I checked my position on the bike to make sure saddle height and position were okay. A trip to a sports physio found some other bio-mechanical issues which could also cause problems down the line so I have some exercises to do to make things better. I also changed my cleats to ones with more float which has helped. I now ride using lower gears than I would normally use to help reduce the strain on the knees and I am managing to gradually increase my mileage.

The amount of discomfort off the bike is still the same and the knee hasn't started locking or giving way (yet).


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## Kiwiavenger (23 Apr 2013)

sdr gb said:


> Hope you get sorted out and are back to regular riding fairly soon.
> 
> I was only able to do 8 miles at first but lately things have started to improve. I checked my position on the bike to make sure saddle height and position were okay. A trip to a sports physio found some other bio-mechanical issues which could also cause problems down the line so I have some exercises to do to make things better. I also changed my cleats to ones with more float which has helped. I now ride using lower gears than I would normally use to help reduce the strain on the knees and I am managing to gradually increase my mileage.
> 
> The amount of discomfort off the bike is still the same and the knee hasn't started locking or giving way (yet).


 
cheers and glad your getting better.

i reckon i might have a few bio mec issues but really cant afford a bike fit or sports physio at present.


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## sdr gb (24 Apr 2013)

Kiwiavenger said:


> cheers and glad your getting better.
> 
> i reckon i might have a few bio mec issues but really cant afford a bike fit or sports physio at present.


Thanks. 

For the bike fit, I just followed some of the various guides that are available on the net as I can't afford a proper fitting session either.


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## fossyant (25 Apr 2013)

Sounds good. Physio's always find things wrong, and it's good to do the stretches. With my shoulder issues I'd let me back get very 'stiff' and immobile. A few sessions 'mobilising' the spine, and stretches, I found it easy to turn round and look right behind me on the bike - before I was struggling.

Any progress with referrals to a specialist ?


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## sdr gb (25 Apr 2013)

fossyant said:


> Any progress with referrals to a specialist ?


The physio said he can put me in touch with their preferred specialist whenever I want.

He advised not to rush into a decision as having the op vastly increases the risk of arthiritis in the knee as well as other complications that can arise from surgery. If the knee stars locking then I'll have to have the surgery but he said it could be years until this happens so if I can manage and it doesn't impede on my lifestyle, why undergo the trauma of surgery if you can get away without it.

I'm just going to wait and see how things pan out. I'm managing to increase my mileage and slowly getting my fitness back so hopefully I might be able to get away without the op for the time being.


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## vickster (25 Apr 2013)

How old are you? If under 30 and the tear is small, often the meniscus can be repaired, so the tissue preserved. Will be on crutches and off the bike for longer though to protect the repair

The thing with leaving it is it can get worse which is what happened to me and it was not repairable as I had ground the tissue away and made the tear more complex. That said my knee was locked the whole time from injury to surgery. Once it started to buckle, I had no choice and was operated on quickly. Nowadays, surgeons try to Tim away as little as possible to a stable rim, the days of sub total menisectomy are gone so the risks of arthritis are lessened

If you are symptom free and fully functioning, then yes, wait for sure


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## sdr gb (25 Apr 2013)

vickster said:


> How old are you?


I'm 35. I was told by the Dr at the hospital that the op when I need it would be to trim it rather than repair it.


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## vickster (25 Apr 2013)

Fair enough. Does depend where the tear is and how big it is. Meniscus mostly has a poor blood supply, but they should consider repair if its in the red zone I believe


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## Kiwiavenger (16 May 2013)

knee was feeling good this morning so pushed it a bit commuting in and by god does it smart now!!!

ah well, slow and plodding it is then


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## mGate (22 Oct 2014)

Hi sir gb,

just had the same diagnosis _and_ the same advice from the surgeon... was wondering how you got on? Happened to me on the first day of a lands End John O'Groats holiday - disaster.


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