# Riding with a torn meniscus?



## pmiska (Jan 6, 2005)

A good friend of mine, and riding buddy just found out that he tore his lateral meniscus during an orienteering race (running). Does anyone here have any experience with such an injury? I think he is willing to give up on running at this point, but will he still be able to ride given the lower impact nature of the sport?

Any input would be great. He's pretty down in the dumps right now, the prospect of being able to at least ride when his knee heals would be a big boost!

thanks in advance
pmiska


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## jnwarner0 (Oct 4, 2005)

*Torn Meniscus*

There are a lot of variables when one tears a meniscus. If it is for sure torn he will most likely need surgery if it is "catching" or limiting him with bending( usually greater than 90 degrees) or laterl movements. Once in the knee it depends on where and what type of tear and how severe. Age is also a determining factor. If the tear is repairable (size,severity,age) It will be reapired and the rehab will be much longer than if it simply needs to be removed a al meniscectomy. Many times a partial meniscectomy is done. If it is a meniscecomy he could be back to running in 4-6 weeks. If it is a repair 4-6 months before running. Biking on a stationary bike would be 1 week after meniscectomy and usually around 4-6 weeks with a reapir. Road biking outside would would be more along 2-4 weeks for meniscectomy and 10-12 weeks ( at least for a reapir.This depending on age and how bad it was and pedals or not. Twisting to get out would be bad at first for a reapir).Now I said running was okay but you have to realize the consequences. Once cartiledge has been damaged you will end up with arthritis, so the less impact you can do to the knee the better off you will be down the road as you will have lost some of that protection for the knee. I hope that helps. Without seeing MRI results ( which are not always conclusive) There are a lot of variables.The only way to know for sure is a knee scope.


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## sminar (Sep 22, 2005)

*Tell him to cheer up!*

jnwarner0's reply was spot on. While there's no guarantee of a trouble free post injury knee life, the odds are pretty good and getting better. I have found that attitude is key, along with a willingness to participate in the solution. Let me add some insight from one who's been down that path for a while.

I took a full body hit (playing touch football) to the outside of my right knee on Christmas eve when I was a senior in high school (1978). My knee buckled sideways (ouch! I'll never forget it!) and snapped back into place when I hit the ground. The injury tore my medial meniscus, ACL, and damaged other ligaments.

The initial decision was to try and go without surgery but the damage was greater than current diagnostic imaging could show. After months of little progress, the medial meniscus was removed in the fall of 1979. I tore the ACL completely at some point, leading to additional trouble and arthritic pain. The knee was scoped in 1984 to assess the damage and clean up the arthritic areas. I finally had the ACL repair done in 1985. The ACL repair was done by harvesting the middle third of my patellar tendon for the substitute ACL along with harvesting from my Illial Tibial Band for a lateral release / stabilization strap for the knee joint. I went through extensive assisted rehab for the last two surgeries. It was about 20 years ago today that I was halfway through my final rehab. I have been able to enjoy a very active post injury sports life despite the lack of a medial meniscus. I windsurfed 3-5 times a week for the first 5 years or so after the ACL rebuild. I ski, snowboard, surf, windsurf, backpack, mountain bike, road bike, play roller hockey, racquetball and tennis. I choose to avoid running for exercise but I will run as part of a sport. I generally avoid team/contact sports, partly because of the fear of a contact injury situation and partly because the competitveness in me might drive me to go beyond what's reasonably safe.

I lived with some residual arthritic pain, about 1 hr a day that was enough to wake me up or keep me awake, until about 8 years ago when I started using Glucosamine. Now I'm surprised if I notice any arthritic pain. Functionally my knee has been very stable. I have some habitual behavior that's been hard to eliminate: I take one extra step and stop on my "good" knee when I'm playing racquetball/tennis or cutting hard when running on the field for soccer or football (with the kids...). I developed this favoring behavior between the time of the first injury and the beginning of my last rehab effort. Part of the rehab focused on this issue and it reduced its effect, but it's easy to fall into 'protecting' mode. I do believe it's a mental thing and not a functional thing. When I ski, I can carve and use my right knee as effectively as my left.

From a cycling perspective, the only post injury / post surgical change I've experienced is I no longer ride out of the saddle. Staying seated allows me to focus on good body mechanics. When I stand and hammer my knee takes a beating, presumably from additional lateral stress / poor motion. I still climb well (for my size/weight), keep up with the group and can do centuries pain free (tired? Yes! lingering pain? No!)

I'm a big believer in 'follow the money' when it comes to orthopedic care and I think that strategy has been extremely successful for me. If you are a sports franchise owner with a multi-million dollar investment in an athlete, your likely to do everything in your power to find the best medical care for them if they get injured. Similarly, if you are a professional athlete with a potential career altering/ending injury, you'd be likely to seek out the best care you could possibly find. I proactively researched and shopped for my ortho surgeon & rehab team. The results were evident when I had my knee evaluated last year for the first time in the 20 years since the reconstruction. The surgeon had nothing but positive comments about the knee, but what amazed me were his positive comments about the surgical job. He had tremendous praise for the surgeon that did the ACL repair.

I'm also a big believer in professional rehab. If you can get your insurance company to cover post surgical physical therapy, all the better. I think the rehab has as much to do with my success as the surgery. Many surgeons will set you loose to do rehab on your own. If the injury/surgery is really minor then perhaps that's adequate. But most people don't have the knowledge, equipment and discipline to do proper rehab on their own. My rehab team was excellent. My recovery was very fast due to their excellent care and guidance. If you can't get professional rehab, do your homework and take it seriously. It will make a huge difference in your results.

Lastly, I think that attitude is key, and a great attitude is crucial to getting through something like this quickly and with the best results possible. I was greatly disappointed after my initial injury to the point of depression. When I finally chose to take on a healthy, forward looking attitude, true recovery was possible. The experience turned positive and the results came faster. I could no longer dwell on the 'what if', I had to focus on the 'how to', 'what's next' and 'let's go'.

Give my best to your friend,

Steve


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## pmiska (Jan 6, 2005)

*Thanks!*

Thanks for the feedback fellas, my friend greatly appreciates it! While he is still bummed, I can tell he is glad to hear he will still be able to ride after surgery. I agree completely that attitude is half(if not more) of the battle. I know my friend is not one to want to spend the rest of his life sitting down, he is just annoyed that he has to wait for his knee to heal! He does have youth on his side, as he is only 28, and in otherwise excellent health. I suspect he will be able to get insurance to cover some kind of physical therapy post-op, and knowing him, he will put his all into it to "get it fixed right".

thanks again!

gears
pmiska


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## johngfoster (Jan 14, 2005)

I'm a veteran of meniscectomies to both knees and currently have a re-tear in my right knee. I find that my R knee will occ. lock if I twist or bend it a certain way (internal rotation with the knee flexed @ 90 degrees) but am able to unlock it by completely flexing the knee in the same position. However, I find this does not affect my riding at all--even with twisting out of the pedals. Running will cause my knees to swell up (effusion) but cycling doesn't bother them at all. As stated above, tears in different parts of the meniscus will cause pain and problems in different parts of the knee, but more than likely he shouldn't have any problems cycling.


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## Frank121 (May 14, 2002)

*Successful surgery for me*

I had knee pain for much of a riding season a few years ago in my right knee. I 
didn't want to quit riding so waited until fall of that year to have an MRI. Showed rather severely torn medial meniscus, so had arthroscopic surgery in December. Eleven days later I was riding the bike on the road. 

A few hints: Make sure you ask around and find a surgeon who does these procedures and is successful. Ask local cyclists and runners about their experience with the surgeon you are considering. Talk to the surgeon in advance and see if he is familar with bicycling-related injuries and techniques on avoiding them. Ask him about rehab and what 
you can do in advance of the surgery. Let them put you under so you are more comfortable. Don't be like me in that the afternoon of my surgery I was feeling so pain- free I wanted to toss the crutches but that was some surgery drugs kidding me. Use the pain pills and rest for a couple of days. Be patient for a couple of months and don't push big gears or go too hard on steep hills. Keep your knee covered in warmer weather than you used to. Take glucosamine if you think it will help. Make sure your saddle isn't too low, and lots of other stuff you have read here. Finally, if you have a significant other, milk the injury for all you can, including using rehab as an excuse to ride more often! 

It was a relatively easy surgery (would say easy but any surgery that happens to me isn't easy...other folk's surgeries are easy ;-) and I would not hesitate to do it again should the need arise.


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## chrispf007 (Feb 3, 2006)

*Cheer up and go bike/componenet shopping!*

As many have stated here, cycling can still be done post surgery. I actually had a double tear in my left knee. Had it scoped, was lax about rehab (I was too young to know better) and am able to ride regularly now. I have even done the 40 mile LiveStrong Ride last year and plan to do the at least the 70 this year (altough my buddies swear I will be riding the 100).

A couple of things to keep in mind, REHAB, REHAB,REHAB and properly. Once your ready, chose your gearing very carefully. I would recommend a compact crankset or a triple - NO KNEE BUSTING GEARS and pedal with a good amount of float (I personally ride Look's w/9degrees of float & the red cleat). Then just get out and ride!


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## The Flash (May 6, 2002)

*Exact same thing....same experience....*



sminar said:


> jnwarner0's reply was spot on. While there's no guarantee of a trouble free post injury knee life, the odds are pretty good and getting better. I have found that attitude is key, along with a willingness to participate in the solution. Let me add some insight from one who's been down that path for a while.
> 
> I took a full body hit (playing touch football) to the outside of my right knee on Christmas eve when I was a senior in high school (1978). My knee buckled sideways (ouch! I'll never forget it!) and snapped back into place when I hit the ground. The injury tore my medial meniscus, ACL, and damaged other ligaments.
> 
> ...


I had the exact same experience. I do everything virtually the same as Steve stated, but I don't have any problems standing and riding. My only problem is sitting with too big of a gear on a hill. That will start some knee pain, so I avoid it. OTT, the knee is rock solid and I still squat 775lbs....

The Flash


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