Torn medial meniscus

[moosterbounce]

No disk I'm afraid, just the old fashioned prints. In pic C in the attached, it looks exactly the same as one of my pics http://www.radsource.us/clinic/0802" onclick="window.open(this.href);return false;

I wish I had the disk...Mr Moo had an MRI of his wrist (couple of ganglions) and he got a disk which allows him to spin his wrist 360 degrees and slice it any which way. Very cool. Doesn't help him try to read it though, but he looks like he knows what he's doing!!

I must say, although I need to stay off it, I wonder if that makes it "worse" as I don't use it much. It's a fine line. Swimming with "deep water running" feels brilliant though. The deep water running is a very good rehab tool as it gives full movement with no load on the joint.

I'll know more when I see the surgeon, but I have a 22mm cyst where the tear is which my doc reckons is a result of having the tear so long. I view it as a blown shock absorber or gasket with the goo inside leaking out. If you don't fix the gasket then it keeps leaking and the cyst gets bigger. Surgeon will tell me more though, but my knee started locking up about 14 years ago!! Didn't ever hurt though so it became "normal" to me. Seems it wasn't normal after all...

[winstonw]

a 22mm cyst where the tear is which my doc reckons is a result of having the tear so long. I view it as a blown shock absorber or gasket with the goo inside leaking out. If you don't fix the gasket then it keeps leaking and the cyst gets bigger. Surgeon will tell me more though, but my knee started locking up about 14 years ago!! Didn't ever hurt though so it became "normal" to me. Seems it wasn't normal after all...

very good description....it would be edifying to elaborate your health history i.e. overweight and for how long and by how much? contact sport? trauma to knees? diet?

Of my 24 clients today, 7 had stuffed knees.
primary causes
- obesity, poor diet, sedentary lifestyle
- netball
- rugby league and union
- running
- walking excessively on concrete and bitumen, in middle age, without adequately cushioned shoes
- AFL and soccer

[moosterbounce]

Ok...here's my history. Started playing hockey when I was six. Played a lot - indoor, outdoor, mixed, umpiring, grass, turf...if there was a game on I played it. I'm built like a brick outhouse so was a pretty good defender. Not many got past me and I've been known to give a good hip and shoulder too!! At my last club i played fullback but got the trophy for highest goal scorer so got around the field a bit. Also played soccer but was keeper so limited running. When I was about 18 I was told I had shin splints. That diagnosis changed to compartment syndrome a few years later. Played volleyball too when I limited hockey as it didn't hurt as much. I'm a gentle soul - have been known to make volleyball a contact sport

Ended up giving all away due to shins and paddled instead. I could never paddle a kayak as my knee would lock up so paddled a ski instead. I had a few years of no exercise (was about 25kg more than current weight) until I started cycling about 8 years ago (currently "early 40's"). Started running again a few years ago on a treadmill and this year have done a couple of mini tri's with a 2-3km run. Both legs had shin issues and ITB issues with super weak glutes. I've done lots of bush walking and snorkeling and fishing...some in not easy to reach places requiring a good hike to get there.

I'm not thin (and getting fatter the more time I spend not exercising!!). I'd like to lose 10kg. I am broad and muscly. I build muscle easily and am strong. With both legs good, I can lift my dogs - 55kg each - but don't make a habit of it. carrying 20kg dog biscuits isn't an issue.

I have no recollection of injury, however I have been smacked with a hockey stick enough to not really notice much anymore. Certainly though nothing that has caused me to think i damaged it, unlike a known rolled ankle. I've even had one of the hounds run into me before more than once which I'm sure could cause injury!!

Knee has always been noisy and had been checked a few times before age 20 by physio with no issues found. That said, in my 20s I needed to "crack" my knee to get out of bed etc which certainly wasn't normal, but to me it was. If it don't hurt, don't poke it!! Interestingly, cycling improved my knee noise and locking. If I'd not ridden for 3 days, my knee would click at every step. With riding, it was only occasionally noisy.

Doesn't surprise me if I injured my knee years ago. Personally, I think the glute strengthening exercises for my itb made my tear worse.

So that's it really. When I write it down, it sounds like I've been running from the glue factory for years!!

[eeksll]

Kind of related, I have slight aggravation underneath my knee cap, had scans and went to the physio/doc/surgeon, been doing my exercises to line up the kneecap and can now run and ride without any major issues, still haven't really cranked it on a bike, but running was causing the pain and it no longer is.

Now I want to start doing some side to side movements e.g indoor soccer/tennis. I tried and my knees where feeling a bit pinchy ... are there exercises to help me get back into this? What type of professional is best to see to show me what exercises to do? Physio? Personal Trainer?

[Dr_Mutley]

Head off and see a good physio...

Just remember, that foot posture during gait and riding influences patella tracking considerably... U can do all the strengthening and mobilising exercises u like, but unless your feet are in their optimal position during your activities, the u will continue to have patella aggravations. I find a lot of feet issues are missed, especially cleat set-ups etc, that unless corrected, will just work to undo all your hard rehabilitative work (and no I'm not a podiatrist!)

[winstonw]

Knee has always been noisy and had been checked a few times before age 20 by physio with no issues found. That said, in my 20s I needed to "crack" my knee to get out of bed etc which certainly wasn't normal, but to me it was. If it don't hurt, don't poke it!! Interestingly, cycling improved my knee noise and locking. If I'd not ridden for 3 days, my knee would click at every step. With riding, it was only occasionally noisy.

Doesn't surprise me if I injured my knee years ago. Personally, I think the glute strengthening exercises for my itb made my tear worse.

So that's it really. When I write it down, it sounds like I've been running from the glue factory for years!!

Yep there's enough heavy use in that history to bugger your menisci and compromise your cruciates.
Noisy knees often quieten down with regular cycling. the noise usually comes from dry and poor tracking knee caps through the groove on the end of the thigh bone.
WHen you start exercising, you lube the jt more, and tighten up the muscles that control tracking....less crepitus.


this bit isn't aimed at you....just a generalization while unwinding after a busy day.....
There's not a day goes by I don't try to explain to overweight people the accelerated wear they are causing their knees/backs.
It's unfortunate that many just don't comprehend the damage they are doing their bodies by carting excessive fat/weight.
I often think public health does more damage than it fixes. If people had to pay market rate to get good medical care, I have no doubt they'd smarten up their diet and lifestyles...and the AUssie she'll be right mate have another beer attitude would die a quick and welcome death. instead, we have people profoundly divorced from the reality of cause and effect.

[trailgumby]

instead, we have people profoundly divorced from the reality of cause and effect.

Funny story (in a sad way):

One of my wife's cousins is significantly overweight, some would say to the point of morbid obesity. She doesn't exercise and is amazed I ride to work into the city. "How do you do it? " She has a very slight mustache, which is common with obese females.

She and hubby (of similar build) had been trying to have a baby. The doctor told her she needed to lose weight if she wanted to conceive and carry the baby to full term, as her obesity was leading to hormone imbalances (hence the mustache) that were contributing.

She changed doctors.

[moosterbounce]

Nice one Gumby - I've heard of similar and makes me chuckle/cringe.

Yep - I'm overweight and am struggling to keep it in check with limited exercise. Swimming has increased to 4x per week (about 10km) but I recognize the additional load I'm putting on my upper body as my legs can't be fully engaged, and I'm paranoid about overdoing it and removing my only real exercise option.

I think you got me on one Winston. Heavy use indeed. I've a feeling my kneecap doesn't track properly all the time which may relate to the diagnosed mild patella chondral degeneration - just a gut feeling. when I get back on the bikes I'll be switching my mtb shoes and cleats for another set of Time rxs on my cx bike. Everything feels good on my roadie which has this setup, and the tt bike has too and seems fine, though I'll be playing with the setup of that and ensuring same distance etc behind bb so all machines give me knee the same experience. Of course, I'll see what the surgeon says too.

By the way, I hate crutches and have a new found respect for those who battle with devices such as these on a permanent basis. I'm a consultant and carry my laptop frequently. Also being a consultant, I'm expected to carry a coffee (or chai in my case) and sometimes I need an umbrella. All this is impossible with crutches. Any they make other areas of your body hurt too. I've put my case forward to the Minister for Finance for a "worked" motorized scooter but I can't see it being approved. I've already got outstanding requests for a new road bike and racing ski in the next 12 months...

[Duck!]

I had a knee job 10 years ago. The major contributor to my problem was long distance running from a young age. The long-term result was that due to imbalanced muscle & ligament development through my teenage years, my kneecaps (especially the left, because my right leg, being my "take-off" leg for starts & jumps etc. developed a bit more evenly) settled severely offset laterally, causing a lot of friction. When I began cycling more, the different muscle use belatedly addressed the muscle imbalances in my quads and attempted to pull me kneecaps back on centre. Unfortunately, the exceptionally tight secondary lateral ligaments didn't like that, so the net effect was that the kneecaps got pulled really tightly back into their tracks, further increasing the friction & wear on the patello-femoral interfaces. Ouch. To top things off, a sailing incident caused me to twist my left knee, which resulted in a small tear of the medial meniscus.

When the time came, the procedure I had was a lateral release, which involved partially cutting the secondary ligaments in order to relieve the tension & allow my patella to settle back where it should be. I also had the daggy bits of the meniscus cleaned up, but that was a fairly minor part of the process.

Now, the recovery: I was on crutches for a week, then easing into walking a bit more. I had a recumbent trike, which I set up on blocks to use as a no-load trainer, and much easier to get on & off than an upright bike on a trainer or excercise bike. Each day I'd do a session of 15-20 minutes just rocking the cranks back & forward to work the knee through its very limited range. With each session the range improved just a little bit. A little over three weeks post-op, I was able to turn full crank rotations for about 45 minutes. At four weeks I was back on the proper bike, but not pushing big loads. By six weeks I was basically riding normally. I returned to sailing in light weather conditions about 9 or 10 weeks post-op, and had some minor trouble with deep squats when crossing the boat. In normal daily use I'd rarely go to that position, and by 12 weeks I was basically back to normal and working on regaining my bike strength.

However, at large flex angles the knee remained unstable and restricted in getting the last few degrees for quite some time. In fact, it was actually several years before I could bend the knee as far back as the other one, which while not painful was awkward when scrambling around the trampoline deck of a high-performance off-the-beach catamaran. As time passed and my strength returned, that became less of a problem. The sensation of instability in a deep squat lasted about 18 moths or so. I can't actually pinpoint when I got full range of flexion back, but it was several years later! That was the last thing to return to normal.

10 years on, I still get the occasional niggles, moreso in the right 'cos that's never had the work done, but overall it's in far better shape than if I had left it alone.

[moosterbounce]

Cheers duck - this was very informative re recovery.

Mine continues to act randomly - yesterday I couldn't straighten it, and I can today but it hurts. 2 weeks till surgeon appointment - hoping op soon after that. I'm at the point where I've never looked forward so much to something I am not looking forward to!!

[Duck!]

I'm at the point where I've never looked forward so much to something I am not looking forward to!!

Ah yes, I remember that feeling. All the best with it.

[moosterbounce]

Saw the surgeon and now just have to clear my calendar for a few weeks off and book the date.

Right knee will have patella "cleaned", the tear - which was very big apparently - snipped and sewn, and the cyst removed.
Left knee will be done too. No MRI done on the left but I'm pretty sure there is a meniscal tear there too.

All up, a couple of weeks off work and should be walking that day. Physio and strengthening etc to follow, with slow trainer rides possible after 3 weeks.

Interestingly, he did show me signs of ACL damage on the MRI for the right knee, so best guess was the I had a nasty injury that damaged my whole knee and the ACL self healed with the tear not big enough to notice and I've recently made it worse. The injury makes more sense and I think I can pinpoint when it occurred...about 20 years ago!! I was cleaned up by a hockey goalie when she slid out and did a full somersault before landing. I still remember it exactly as it was my own goalie who ignored her defender (me) working the attacker wide!! Grrrr!! She hit my right leg first from the side which matches with the injury.

So that's that. I just need to schedule it, then start posting about the recovery. Having not ridden for about 8 weeks, I'm not sure if my butt will hurt more than my knees when I start again!! Hopefully a get the "rehab" right for all areas!!