Meniscal tear - need some input/advice

Hey,

I just had my second surgery, same knee, both times for a torn meniscus.  First one was over five years ago.  It took me a while to recover from the first procedure, because I had some fairly extensive damage due to a long delay in having surgery.  Once I had recovered, I was pain free and had no limitations other than not logging any more 60 mile training weeks or running marathons.

This time around I had less damage, and recovery seems to be progressing more quickly.

The answer to the first two questions is the same.  It depends on how extensive the procedure is on your injured knee.  I don't know if you follow football, but Reggie Bush of the NO Saints just had his knee scoped this past Monday, and the Saints expect him back in two to four weeks!  Joan Benoit Samuelson won the 1984 Olympic Trials despite a knee injury 17 days before.

The answer to question number three is they're probably not going to want you to run for a couple of months.  You'll be scheduled for PT after surgery.  They will try to get you to strengthen you leg muscles, regain your flexibility, and improve your balance.  They'll have you riding a stationary bike soon after surgery.  You'll probably be able to swim fairly soon (with a pull buoy).  Eventually you can start doing an elliptical trainer as well.

 Lastly, I wouldn't worry too much about losing fitness.  Once you get back into training, you'll regain whatever fitness you've lost.

Good luck!

 Ralph

I've had seven arthroscopies on my right knee (meniscus, ACL) and one on the left. Ultimately you need to know that your return to training will be optimized by doing PT stuff. How you feel after you recover from the acute trauma of surgery is hard to say. Some days I feel pretty good. I've done two IM 70.3's since my 7th knee surgery, but I took this past season off from racing to let everything calm down a little.

I don't know if I can say with certainty that it's related, but over the past few years I've developed right hip problems and I have occasional bouts with achilles tendonitis, also on the right side. So you really have to pay attention when new things pop up and avoid new injuries that occur.

Bottom line... if you want to have some longevity you need to listen to your body and learn what kind of pain you can train through and what kind of pain means STOP what you're doing. For me, pain I can't ignore and/or enough swelling to cause stiffness means stop. I always have some pain and some swelling, and I have enough experience with it to be a pretty good judge for myself anyway.

As for your questions:

1) Recovery for a menicus is a few weeks. I wouldn't run for at least a month, but ask you doc for sure.

2) I started on a stationary bike not long after my last surgery in 2005. The first two rides were very uncomfortable. But eventually it loosened up and I was good to go. I did an IM 70.3 10 months after my last surgery.

3) Swim, bike, elliptical, circuit training. Watch your calories. Burn more than you eat.

4) Hard to say. At the time my work schedule was making it hard to be consistent. But I'd say there no more fitness lost from this than from any other lay off. In fact, you may lose less because you are doing PT whereas with a normal layoff from exercise you may do nothing.

Good luck. Hope that helps.

For a partial menisectomy I let my pts weight bear to tolerance the day of surgery. My average arhtroscopy pt uses the crutches 2-3 days.  At 7-10 they are usually a little swollen but getting around OK.  at three weeks people are doing pretty good usually 6-8 weeks back to full tilt.  I would highly encourage you to go to PT.  It will help you get better faster.  I wold let you ride a sationary bike as soon as youhave enough rang of motion to make it a full revolution.  It kind of depends on how well you do post op as to return to running.  Probably 3-4 weeks if you are doing well.  I would let you swim as soon as your incisions were healed.  No breast stroke to start.  If you have a procedure other than this it changes the post op course. 

A meniscus repair.....while better for the long term health of your knee is more of a PITA inteh short term because you have to be on crutches for 6 weeks.  I'd let you swim when the wounds were healed and probab;y let you do some spinnign without resistance.  Probab;y 3 months to running.  No worries for next seson

The MRI will not tell you if it is repairable or not.  Can't tell until the time of surgery really.  The meniscus has a very poor blood supply.  Only about the outer 10% has a blood supply to it and that is variable.  Until you physically LOOK AT IT at the time of surgery your surgeon will not know for sure.  It may give you some info as to if you have an articular cartilage injury or a bone bruise.  The younger you are the better the chances of a repairable tear.  Typically only people with multiply injured knees have tears that can be fixed.  Feel free to PM me if you have more questions