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  1. #1
    Join Date
    Apr 2006
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    SF & the Ho
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    Meniscus terror - rehabability vs cutskis

    According to dr google, it seems I have a meniscus tear. No idea how it happened, just got up one morning and ouch the knee did not like bending at all. Itís improved from a real hobble a couple weeks ago to the occasional dagger getting up if I have been sitting long w it bent. Pain point is inside crevice next to kneecap although depending on whether Iím climbing or descending stairs, the pain will sometime be at the top of the kneecap area. Weight pressure doesnít seem to hurt. Itís more extending leg after a retraction into a bend. Itís definitely less hurty now, but I donít see skiing or mtb any time soon tho which is distressing. Been holding off seeing a doc just to be told rest it after an expensive mri.

    I try to avoid surgery unless really necessary. Is that realistic w this kind of tear?

  2. #2
    Join Date
    Aug 2014
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    Imaginationland
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    4,349
    I tore mine last December in a ski crash. Gimped my way through the rest of ski season stupidly, then did rehab most of the summer per doctor's recommendation. I had stability issues, pain exactly where you describe, and couldn't crouch down and get back up without heavily biasing my good leg.

    If you aren't really, really bad, I wouldn't get it cut. From what I've been informed, that fast tracks you to arthritis and there's no real guarantee that you'll be 100 percent again anyways.

    I healed up fine by late August and am pain free and uber stable again now. YMMV

    Healing vibes dood.

  3. #3
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    Apr 2006
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    Thx mang. That helps a lot.

  4. #4
    Join Date
    Jan 2008
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    truckee
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    19,185
    I tore my medial meniscus 40 years ago--no mri's back then of course. It swelled up like a grapefruit. I coudn't bend it at all. I tore it in January, No surgery. I was XC touring by April but I had to sidehill so the bad leg was the downhill leg. By the summer I was back to normal. Now that knee is starting to give me trouble, whether it's from the old injury or something else I don't know.
    As far as the wisdom of not seeing a doc--my non-expert opinion is that it's probably ok to wait, especially since there was no trauma and the knee sounds like it's stable.

  5. #5
    Join Date
    Sep 2010
    Location
    minneapolis
    Posts
    123
    same same
    meniscus tear, swelled up for 6 weeks after marathon. remains stable and functional 10 years later

  6. #6
    Join Date
    Sep 2018
    Posts
    242
    I've had three tears over maybe a 6 year span. An MRI was used to isolate pieces of floaty tissue and determine the degree of the problem. In all instances, a good (now retired) specialist used a tiny incision and a camera equipped nibbler/vacuum to clean them up. Limited use for a few weeks but able to tour conservatively within 1 1/2 months. You may have something more advanced, hope not but I haven't had anything amiss with my knees since then. Probably getting low on cartilage by now but that will be a different adventure I'm sure.

  7. #7
    Join Date
    Oct 2003
    Location
    slc
    Posts
    15,147
    Quote Originally Posted by mcski View Post
    Been holding off seeing a doc just to be told rest it after an expensive mri.
    That shit is the worst. IANAD, but AFAIK the consensus on meniscus issues seems to be that surgery is only worth it if there's instability or mechanical locking issues, which can usually be diagnosed with just a physical exam.

  8. #8
    Join Date
    Aug 2006
    Posts
    7,055
    i recommend a consultation with a physiatrist, especially one that skis and deals with sports medicine.

  9. #9
    Join Date
    Sep 2005
    Location
    Wasatch Back: 7000'
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    11,704
    I tore mine playing basketball (HORSE). It was a flap tear, and that sucks. Had it shaved, and was told that arthritis was a part of the prognosis. Boy, was he right. It seems that if you are under 35 or so many Orthopods would rather surgically repair the tear than cut it away. Repair does not always work, and there is always the risk of a second surgery (meniscectomy). After a certain age, arthroscopic knee surgery is rarely performed.
    The key is to keep your thighs strong. Strengthening the muscles around the knee may replace the need for surgery.

    Regarding MRI, I think that they are good to a point because they show a tear, but surgery is either needed, or not, that can be ascertained by manipulation and it's not until the surgeon is inside looking around until he really sees what's going on.
    ďA society that puts equality before freedom will get neither. A society that puts freedom before equality will get a high degree of both.Ē
    ― Milton Friedman

  10. #10
    Join Date
    Aug 2010
    Location
    Sierra Foothills
    Posts
    588
    I had reconstruction on both knees and a few years back got a complex tear on the posterior horn of the medial meniscus. My MO on injuries such as this, which ain't likely to go away anytime soon, is to get them fixed ASAP and move on with life.

  11. #11
    Join Date
    Jan 2008
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    truckee
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    19,185
    BTW---great thread title. Right up there with physical terrorists.

  12. #12
    Join Date
    Sep 2005
    Location
    Wasatch Back: 7000'
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    11,704
    This summer, I visited a local PC Ortho, re: constant nagging pain in medial aspect of left knee. Previously, In 2004, I suffered a flap tear of the medial meniscus which was shaved (meniscectomy). I was told that it would become arthritic. The doc was right. The PC doc took an x-ray (no MRI) and it revealed that I was bone on bone. Because of my age, surgery would likely be counter productive. He recommended steroid and/or hyaluronic acid injections. The order was submitted to ins., but it was denied. (At the same time, I was going thru a bout wherein I had my gall bladder removed ...surgery, 2 CT scans, ultrasound, etc... which cost the ins. co about $35K). I think that this is why the order was denied. I was informed that each injection would cost over $1K and would provide only temporary relief. Although the pain is real, and constant, I elected to go the 600mg Ibuprofen when the pain gets really bad, and glucosamine everyday. Also, I use an Iceman machine just about everyday. Glucosamine offers absolutely no relief. I guess that I have to learn to live with the discomfort. I have a DonJoy brace, but find it way too constrictive. Recently, I purchased a Bauerfeind GenuTrain brace, and we will see how that goes.
    One thing is for sure, I do not plan on cutting down activity (skiing, hiking), because the pain is real when just sitting on the couch or laying in bed. I didn't mountain bike once this year though.
    ďA society that puts equality before freedom will get neither. A society that puts freedom before equality will get a high degree of both.Ē
    ― Milton Friedman

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