General Discussion Triathlon Talk » knee problem ends my triathlon participation? Rss Feed  
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2008-05-25 10:42 AM

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Subject: knee problem ends my triathlon participation?
o.k. so, bad news as of friday. went to the orthopod. good guy. sports medicine oriented. right knee has basically no meniscus on the lateral posterior compartment. what's that mean? bone on bone with no cartilage to act as a shock absorber. what else does that mean? total knee replacement (which you can't run on either). when to have the total knee is up to me and will depend on pain level, inability to do daily activities etc.

so, basically, i can bike and swim all i want but no serious run training. i've done 2 sprint tri's so far and was hoping to continue in the sport but the choices are run on the knee til it becomes necessary to get the total knee replacement and hope that they develop a knee prosthesis that you can run on in the meantime, or just forget about triathlon and concentrate on swim and bike.

sad day.


2008-05-25 11:50 AM
in reply to: #1423557

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Subject: RE: knee problem ends my triathlon participation?

Very sorry to hear that. 

I'd say you definitely still have a few options to keep up with triathlon. 

You should ask your ortho if you would be able to speed walk on a new knee.  That might be an option.  You won't be challenging for any podium spots generally, but it'll get you over the finish line in decent time.  I'm currently fighting bad achilles tendinitis and am working on increasing my walk speed so that if I have to walk the run on my 2 races I have planned this summer, I'll be able to finish as fast as possible.

You could also find one or two others and form a relay team.  And then there's also the chance to do some aquabike races (sadly not that many of them around, but they're out there).

I don't think triathlon is worth totally screwing up your knee.  Having functioning knees will make a world of difference as you get up there in age. 

2008-05-25 12:04 PM
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Subject: RE: knee problem ends my triathlon participation?
Let me ask these questions. How old are you?? what other options were discussed?

Kara
2008-05-25 12:18 PM
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Subject: RE: knee problem ends my triathlon participation?
Something doesn't sound right. I had the medial meniscus removed and the medial collateral ligament rebuilt with a graft of my patella tendon 30 years ago on my right knee.

I've done a lot of running and triathlons, including marathons and ironmans, since then.

I would get a second opinion.

scott
2008-05-25 1:50 PM
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Subject: RE: knee problem ends my triathlon participation?
Yes I think a second opion is a must.

2008-05-25 3:06 PM
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Subject: RE: knee problem ends my triathlon participation?
I'm 50 years old and had the lateral meniscus removed 20 years ago after a basketball injury. so, basically there's no meniscus there to absorb the shock of running. That has caused osteoarthritis to form in the knee over the years.

I'm an RN so I'm well familiar with the seriousness of getting and rehabing a total knee. Believe me, that surgery would be a last resort.

my plan now is to keep in shape using non compressive aerobic exercise, drop some pounds and reintroduce running on soft surfaces to see how that's tolerated.

i'm out for this tri season but we'll see about next year. I haven't given up.

Thanks to all for the support and advice.


2008-05-25 3:14 PM
in reply to: #1423557

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Subject: RE: knee problem ends my triathlon participation?
Oh, forgot, the surgeon didn't mention other options at this point. Both compartments of the knee show signs of arthritis so apparently that limits the options somewhat.

There's a procedure where the lab can grow your own cartilage cells from your sample. They are then injected into a pouch surgically created in your knee joint and voila, new cartilage! apparently there's been some good success with it however, the cost is $44,000 and most insurances won't spring for it.
2008-05-25 4:18 PM
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Subject: RE: knee problem ends my triathlon participation?
talk to your surgeon about viscosupplementation.

Assuming you have osteoarthritis and the doc is not open to talk to you about this find another surgeon!!!

Here are some links.

http://www.clevelandclinic.org/health/health-info/docs/3300/3363.as...

http://www.hyalgan.com/default.aspx


2008-05-25 5:28 PM
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Subject: RE: knee problem ends my triathlon participation?
You're not the first person to compete in triathlons on artificial knees.  Bikergerb racewalks for the reason you mention.  One of our local triathletes walks the "run" due to a heel problem.  He donned a Cat-in-the-Hat outfit and cruised to a <13 hour IMmoo last fall. 
2008-05-25 8:18 PM
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Subject: RE: knee problem ends my triathlon participation?

Ok First of alll FYI I am a sports trained ortho myself.  Things to take into consideration 1- the ONLY indication for a knee replacement is PAIN. 2- your age 3-exactly how much of your meniscus is missing? and 4- do you already have degenerative changes?

This is what I would tell you if you were my patient......You gotta choose how you are going to use your knee miles.  Certainly the younger you are the longer you want your knee to last.  The more meniscus youare missing the more at risk you are for early arthritis.  If you already have degenerative changes I would discuss that as well.  If you have ligamentous damage in the face of the other 2 problems it also make you more predisposed to degenerative problems.  Things you can help your self are to be at a normal wieght for your height and keep your legs strong.

 Just because you have had a partial menisectomy I don't think it precludes you from running.  I think a sport like basketball or soccer would probably use up your knee miles more quickly than straight ahead running.  Now that said training sprints and olys and shorter runs are going to be smarter than training longer stuff.  Some people have terrible arthritis and run anyway.  I persoanlly would rather see someone more active and healthier all around and have a little knee pain than be unhappy on the couch.  Now if you are having incapacitating knee pain on a daily basis that is another story.  If you are pain free and happy and choose to run I mean hell its your body!!!  Maybe 10 marathons a year arent' in your future but there are a lot of options.  If you tell me where you live I most likley can suggest a name of someone for you to see and get a second opinion.

2008-05-25 8:37 PM
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Subject: RE: knee problem ends my triathlon participation?
I was thinking if you were closer to my age, that microfracture might be an option, but it might not.

http://www.steadmanhawkins.com/knee_microfracture/overview.asp

Kara


2008-05-25 8:42 PM
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Subject: RE: knee problem ends my triathlon participation?

scout005 - 2008-05-25 4:14 PM Oh, forgot, the surgeon didn't mention other options at this point. Both compartments of the knee show signs of arthritis so apparently that limits the options somewhat. There's a procedure where the lab can grow your own cartilage cells from your sample. They are then injected into a pouch surgically created in your knee joint and voila, new cartilage! apparently there's been some good success with it however, the cost is $44,000 and most insurances won't spring for it.

my hubby had this done.  It was a Workers Comp case.... they paid for it.   He's doing good, he ran a 27:xx 5K a few weeks ago.  He has good days and bad days, he is coming up on the one year mark from this surgery.  it's a slow process but worth it because he is young- 45.    He is also going on a five day 56 mile trek with the Boy Scouts this summer up on the Appalachian trail.  

His doc is here on BT.   :kiss:  !!! 

2008-05-27 10:57 PM
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Subject: RE: knee problem ends my triathlon participation?
I had my knee scoped last year to remove some shredded cartilage. The doc said I only had about 1/2 my cartilage remaining and strongly suggested that I don't run any more. I had just competed in my first triathlon and fell in love with the sport so I wasn't ready to give it up just yet. I decided to do another tri but heeded my surgeon's advice by walking instead of running - not only for my training but for the race as well.

I can't tell you that it was a resounding success. I really missed the running - which is crazy because I've hated running most of my life. I didn't feel like I received the same health benefits from walking vs. running and I felt a bit like an outsider during the race - but of course that was all in my head. Regardless, I completed the race and plan to do more.

Another option I've been considering is chi/pose/evolution running (forefoot striking). I can't speak for any of these methods because I haven't actually tried any of them yet but there are a lot of people on this site who swear by them. When you read about these methods they just make a lot of sense.

Good luck with your knee. I hope you find a solution that works for you.
2008-05-27 11:36 PM
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Subject: RE: knee problem ends my triathlon participation?

I had a car accident 20 years ago and my left patella was shattered into about 40 pieces.  I already have some arthritis and have constant pain.  Although the pain does not seem to get worse (or better) with more (or less) activity, so I continue to train and race and plan to do my first HIM in early September.  Essentially I believe it all comes down to how much pain you're able to handle while considering the potential longer term damage.

It has been a long time though since I've seen an ortho about it, so it's probably good time do that now for me.....

2008-05-28 2:50 AM
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Subject: RE: knee problem ends my triathlon participation?

My problem is that my knees pain me after a run and walking up a single flight of stairs also causes pain. Someone suggested I try wobbling(?) my knees to build strength. The first time I did that I felt my knees creaking like crazy. When I asked family members to try it, I put my knees on theirs and couldnt feel anything. When they put their hands on my knees they felt the creaking feeling.
 

So I go to my regular doctor, he told me that my knee pain might go away and just gave me a prescription for 800mg of motrin 3x per day (as needed). Ive been trying to drop my weight so I dont stress my knees. He didnt want me to go to the ortho right now because they would do a scope procedure to see whats is happening. He thought that the problem might be just me finally getting in shape and my body just having normal adjusting pains.

Im unsure if I should go and do the scope procedure, is it something that takes time to recover from? Should I wait another few weeks and see if the pain goes away? I know that I havent given a lot of medical info, hope that someone of you might point me in the right directions.

thanks 

2008-05-28 8:05 AM
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Subject: RE: knee problem ends my triathlon participation?
Sorry to hear your situation. I am not a medical person but my suggestion would be to drop weight if you are overweight and evaluate the situation after that. I see so many overweight people around me trying to get into running and injuring themselves.
Good Luck


2008-05-28 12:08 PM
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Subject: RE: knee problem ends my triathlon participation?
I was told I was done 4 years ago...totally done.

Then I heard about a new surgery for patients who lack most or all of their meniscus. I had a meniscus allograft transplant after 3 meniscetomies left me with 20% of my medial meniscus (and my OS discovered even that was torn during my pre-op MRI).

It's a gnarly surgery, and tough recovery. It's also pretty new, and I'm fighting my insurance to pay the bill, but it was worth it for me. I fit the protocol exactly (35 years old, not much arthritis). I bet your arthritis is a problem, but my docs research indicates you can go several years on an arthritic (I don't know how severe) knee once they put in a new meniscus. Take a look at the few docs who do it (find a great one, since this can be screwed up and make you worse off).

I went to the Stone Clinic in San Francisco. I'm 5+ months out and pain free. I'm holding off running for a year to let the new meniscus heal in (doctors orders), but I plan to do some sprints and maybe an oly next year if all goes well. My doc would rather I didn't run at all since I'm a bigger guy and my knees take a pounding (6'2, 225 lbs), but we're reevaluating that thought come December. He doesn't mind me returning to impact sports (i.e. tennis, basketball, etc., but he also doesn't favor the pounding of long distance running for me.

Email me if you want to know anything else. I wouldn't quite give up yet.
2008-05-29 6:07 PM
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Subject: RE: knee problem ends my triathlon participation?

Hi Rich,

I live in the Netherlands and in two weeks i'm going in for a meniscustransplantation. In the Netherlands there's only one doctor who does this kind of operation, so there's not much information.

Almost 6 years ago my lateral meniscus was removed after a ski injury, i've been living with pain ever since. Not very severe, but it's a constant nagging pain. Through the years the pain kept getting worse, so I fully stopped running and sports for the past 5 years.

At first my doctor told me there was nothing he could do for me and that i was too young for a knee replacement (i'm 35).  After some research i found this other doctor and i'm very happy that there's a solution for my problem. Although he warned me that there's no guarantee that i'll be totally pain free after the surgery.

I'm wondering; how is your knee doing right now and are you able to do everything you want  (without pain) with your donormeniscus?  Are there any limitations to what you can do? I read about someone who had this operation done and wasn't able to fully stretch his knee...

kind regards,

nathalie

2008-05-29 6:49 PM
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Subject: RE: knee problem ends my triathlon participation?
nathalie1 - 2008-05-29 4:07 PM

Hi Rich,

I live in the Netherlands and in two weeks i'm going in for a meniscustransplantation. In the Netherlands there's only one doctor who does this kind of operation, so there's not much information.

Almost 6 years ago my lateral meniscus was removed after a ski injury, i've been living with pain ever since. Not very severe, but it's a constant nagging pain. Through the years the pain kept getting worse, so I fully stopped running and sports for the past 5 years.

At first my doctor told me there was nothing he could do for me and that i was too young for a knee replacement (i'm 35).  After some research i found this other doctor and i'm very happy that there's a solution for my problem. Although he warned me that there's no guarantee that i'll be totally pain free after the surgery.

I'm wondering; how is your knee doing right now and are you able to do everything you want  (without pain) with your donormeniscus?  Are there any limitations to what you can do? I read about someone who had this operation done and wasn't able to fully stretch his knee...

kind regards,

nathalie



I'm riding like crazy, working out (rehabing a ton), and feeling really good. I can't wait to start running again...hopefully. I'm going to start swimming next week after my ride this weekend.

Good luck
2008-05-29 8:03 PM
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Subject: RE: knee problem ends my triathlon participation?
Have you looked into prolo therapy? My wife and I both had prolo therapy done on our necks (injuries from a car accident years ago) and it has helped us tremendously. She has been virtually pain free for 3 years now. I just had my neck treated this year - no more Advil needed to sleep. I know there are other BTer's who have had prolo therapy to treat knee problems - it would be good to hear their feedback. Here is a link to Caring Medical, where we were treated:

http://www.caringmedical.com/therapies/prolotherapy-info/regenerate...

Recovery from each treatment is only a couple of days. I'm no doctor, so I'm not sure it will help your situation but it may be worth looking into.
2008-11-22 3:10 PM
in reply to: #1423557

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Subject: RE: knee problem ends my triathlon participation?
An update to my original post. I've been swimming and biking only since May due to the knee being totally fried. Grade 4 arthritis(the worst), lateral meniscus ground down to bone on bone etc. In the last month or so I got a Thruster brace and started Supartz injections into the knee. The combinaton has allowed me to slowly get back into running. No one is more startled by that than me. Previously, I could not bear enough weight on the knee to jog at all. It would pinch, swell and hurt like hell. Several really good ortho surgeons have told me that eventually I'll need a total knee replacement. I agree. My local doc said just run if you can and want to and we'll do whatever we can to enable that until it's time to replace the joint which could be several years from now. So, I may still be able to participate in triathlon! I'm very, very pleased. Triathlon is a lifestyle to me. One I really missed. Cheers and thanks to all for the support.


2008-11-22 4:49 PM
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Subject: RE: knee problem ends my triathlon participation?
That's awesome! I guess "congrats" isn't out of place here.
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