THE CLINIC: An Unresolved Meniscus Tear

Thu, 6 Sept. 2012 - 12:50 a.m. MT
Credit: ARA Staff - American Running Association

QUESTION:

Recently I was diagnosed with a complex tear of the medial meniscus (right knee), as well as degenerative signs of my left meniscus. I am 47 years old, 6’, 235 pounds, and have been running consistently for the last 16 years, averaging 20 to 25 miles a week. I’ve completed six marathons.

 

This injury seems to have occurred when I rolled over my knee from a squatting position while fixing my house last fall. The pain affected the way I ran thereafter, and I heard a clicking noise each time I went up the stairs. After a month of NordicTrack and mini-trampoline I started back running slowly, careful not to make any sudden cutting motions. I no longer have the clicking sound, and am able to run 2 to 5 miles a few times a week—I ice the knees and take a day off in between runs. Is surgery necessary to repair this condition? Should I stop running altogether? What weight training might help?

 

William Spinelli

Cornwall, NY

 

ANSWER:

While surgery is not necessary if you can do most activity that you want to do, most folks do elect to have a complex tear removed. Flexibility and strength are the necessary components to avoiding surgery. You will need to limit your distance and total miles—as well as employ special cushioned shoes and soft surfaces. You always lose strength with a cartilage tear, so make sure that strength training is part of your physical therapy program. Ankle weights are probably not that useful at your size. If you choose to have the arthroscopy, you’ll need six months to a year to recondition the leg. The cartilage damage causes bone softening that takes about one year to regain.

 

Robert C. Erickson, MD

Canton, OH

 

ANSWER:

At some point you probably will need to address the right-side complex tear with arthroscopy. The degenerative changes in the left knee, however, may not represent a true complete tear. Physical therapy could certainly help the left knee. The risk factors that led to the right knee tear could be due to the overtime wear of marathon running, though age is really only a relative risk factor. I feel that this is only a speed bump in the road for you, and that you should be able to return to running after you have your right knee attended to.

 

Rob Meislin, MD

New York, NY

 

DISCLAIMER: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.

The American Running Association (ARA) and its Clinic Advisory Board disclaims responsibility and shall have no liability for any consequences suffered as a result of your reliance on the information contained in this site. ARA does not endorse specifically any test, treatment, or procedure mentioned on this site.

 

(RUNNING & FITNEWS® January / February 2008 • Volume 26, Number 1)





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