MCL, meniscus, mmmmm!

Seems I have a small bit of damage to my MCL and/or meniscus...most likely caused by a non-aikido sequence of events (it's a long story). It's not bad, isn't giving me problems when I train, doesn't like stairs but isn't very cranky otherwise. The worst problems are when I've been sitting still and need to get up -- it's stiff at first but then eases up -- and, weird as this may sound, when I'm lying down (it's hard to find a position where it doesn't hurt). My doctor's advice: avoid stuff that seems to make it worse, ice and anti-inflammatory, see how it goes, and if it doesn't resolve to "not a problem worth mentioning" over time, then see about getting something done. That all seems sensible to me -- I've got plenty of soft tissue injury experience to guide me. I don't have knee experience, though. Is taping or bracing at all helpful in these cases, either to prevent whatever seems to aggravate it when I'm lying down, or to help guard against tweaking it again during activity? Has anyone else had a small-small MCL/meniscus injury like this, and if so, did you get reasonable healing without intervention (and about how long did it take you)?

TIA,

Mary:

Have had both knees scoped at different points when the symptoms of the problems interfered in my lifestyle. The sooner you get your injury "fixed" the better the outcome tends to be. The longer you have some small tears, there is some more chronic damage that will occur over time in the joint.

Some things to do that can help:

Nutramax makes the best neutracellular products for joints (Cosamin DS is what I use daily).

Acupuncture and Chinese bone setting has been helpful for me.

PT is a standard, western treatment to strengthen muscles around the joint.

Good Luck!

marc

I had about the same injury last fall. I have much the same symptoms, stiffness when first standing, and that same pain that seems to be worse when laying down. Dr diagnosed it as either a severe sprain or small tear in the medial meniscus and said rest Ice Ibuprofen and time. It actually has woke me up in the middle of the night some times. Bracing helps when I need to be on my feet for a long time. Ice is a major help. Being very mindful of how I move, especially when pivoting on that leg which is how the injury occurred.

I think the biggest help for me is having my chiropractor realign it on a regular basis. That brings the most relief.

had the same problem years ago. did the normal preventative stuffs. only delay it for awhile, until my knee swelled up and had hard time walking. had outpatient scope surgery. they punched 3 holes in and around the knee. stuck in a laser scope and cut away the damage area. flushed the knee with saline solution to wash everything out. went home. rested for 3 months. signed up for a step aerobic class (no, i was not looking for ladies in tights, although, that was a bonus ) to rebuild the leg strength. have not problem since. my advice, fix it and soon or the tear will get worst and affect the surrounding area.

A few general thoughts:
1) don't rely on MRI for diagnostics as they are notoriously unreliable from facility to facility; an honest orthopedist will admit that scoping for direct visualization is the only way to get a fully accurate diagnosis.

2) If you are willing to forgo all training and other activities that might further damage internal structures, even if they don't seem to add to pain, while allowing it to heal, then do rehab like crazy, then it wouldn't hurt to take a conservative wait and see attitude before going for scoping. Some things will heal nicely without invasive intervention, and if this doesn't at least you will have tried AND it can be easier to do repairs without a lot of the initial inflammation.

I had the same problem over twenty years ago. Get the knee surgery, physical therapy and use liquid glucosamine, chondroitin, msm, collagen. It works faster than pill form.

Constant good postural alignment of the hips, knees and feet during movement will minimize future problems.

dps

I agree with Janet.

I know a few guys who have had arthroscopic knee surgery, and the results were good... One was back on the mat in three days. However, doctors don't always give the best advice. Often it will be surgery or rest/ice/anti-inflammatory. I doubt you will get good advice about actually correcting the root of the problem.

I'm not a medical professional, but I'll bet you can effectively rehab this thing... At least you will have tried.

Start to work on improving your hip and ankle mobility, and the strength of your glutes. Learning how to squat deep with good form will be a big help, as will single leg exercises.

Start improving tissue quality. Foam rolling should be a part of your daily routine. Get some bodywork when you can afford it.

Ice it after exercise.

I can recommend some resources if you are interested.

Ultimately, there is no one-size-fits-all approach.

If you do take this route, please, keep us updated.

Just FWIW. Sample of two anecdote.

Same problem here a few years ago. It wasn't bad enough to cause me any real problems, but it was annoying. One good thing for me is that my wife is in diagnostic imaging. So I was able to get pretty much any exam the orthopod wanted. But even with all that the Orthopod suggested "give it time and reassess". Over a period of a year I kept getting better, slowly but surely. Then fine. So a lot of RICE, PT and being careful about the knee for a year. And that injury seems mostly a thing of the past for me now and I avoided more holes in my knees.

Another friend of mine did the exact same thing. Seemed about same level of intensity in terms of injury level as mine. His got better for a few weeks then stopped getting better. Finally he went in for scoping/cutting/cleaning/etc., did the whole 10 yards of after care (PT, etc.) and today is just fine.

So... I think the takeaway from me is that it is complicated at best. I've had a series of knee injuries but that one seemed to heal on its own in my case. In my friend's situation, exactly the opposite. So while all symptoms/diagnoses, etc. were identical, the end results were completely different. So... Shrug. I guess I'm saying if I were in your shoes I'd probably do the RICE routine for a while, work it in PT, etc., but if it doesn't get better or seems to be taking too long to get better I'd pull the trigger with the orthopod. My experience has been that these things are so individual that there's really no way to give any definitive advice. It really comes down to how it does as time goes by. And your comfort level. And your patience. And how much you want to put up with in order to avoid surgery vs. the possibility that delaying surgery may make things worse.

All that said, I feel for you and I hope you get better quickly. I spent much of the year I was recovering wondering if I did the right thing, if surgery would have gotten me back faster and stronger. I still don't know if I made the right decision.

Oh, I'll also add that in the time period I was carefully training with an injured knee I think I started compensating for it and that was part of the genesis of some back problems I have now. Or at least one additional factor. So in another way I'm still paying for continuing to train with an injured knee over a long period of time with an injury elsewhere that is even more difficult to address... Fate sometimes seems to have a sense of irony...

Thanks again, y'all. It sounds like there are no typical outcomes: if you do the wrong thing, it'll get worse, but what the "wrong" thing is, no one knows until after the fact. Grreeeaaaat...

I don't have any idea what "other activities that might further damage internal structure" are, or what PT would look like (appointment with primary care is in five weeks...yeah, gotta love that world-class US healthcare system), it's tax time, I'm not made of money, I can't go out and spend a small fortune on bodywork, whatever that means. And yeah, maybe I can just vaguely bumble around applying ice and trying to "rehab" it without any idea what that means, but I have just spend the past nine months getting over another medical problem, and I'm really disinclined to twiddle my thumbs on the vague hope that maybe it'll magically get better on its own.

Human bodies are stupid stupid stupid.

Mary Malmros wrote: Thanks again, y'all. It sounds like there are no typical outcomes: if you do the wrong thing, it'll get worse, but what the "wrong" thing is, no one knows until after the fact. Grreeeaaaat...

The whole time I was injured I was constantly questioning myself as to whether I was doing the right thing. And even after the fact I *still* don't know. Maybe if I was scoped I would have healed up quicker and better. But it is one of those things. The injuries are so complicated and each body is so different that you just can't know. And even after it is all over with there is a very good chance you'll still not know whether you did the right thing.

Sometimes the right path is obvious. The knee is painful all the time and simply doesn't work. Okay. Easy. Or the knee gets better quickly. Easy too. Unfortunately these types of injuries are often somewhere in between. My wife has taken all sorts of exams of people before and after. When I ask her about which path in her experience seems to be the best one she just shrugs. It is simply a question that isn't amenable to an answer.

Cherie Cornmesser wrote: Being very mindful of how I move, especially when pivoting on that leg which is how the injury occurred. I think the biggest help for me is having my chiropractor realign it on a regular basis. That brings the most relief.

Cherie gave me too good an opening -

If the biggest help with your knee is someone realigning it from time to time, why not learn how to realign it yourself and then learn how to KEEP it aligned?

I see there's at least one AT teacher in your (Cherie's) area:
http://alexandertechniqueguide.com/a...nique-lessons/

I've had AT students of mine report the disappearance of knee pain that they thought was structural, after they'd had AT lessons for a while. Apparently in those cases the problem wasn't structural after all but a matter of using the knee joint in an ineffective way which irritated it.

What I''d like to add though is that any trustworthy AT teacher is also going to ask if you have seen a doctor. If there indeed is structural damage, AT can certainly help you adjust your movement to that, but it won't magically heal anyones cartilage.

Pauliina

Mary Malmros wrote: Human bodies are stupid stupid stupid.

hey! don't blame the designer, but the users.

see, even god made mistake. he/she/it didn't realize we, human, could produce better idiots than his/her/its idiot-proved plan.

think of it like a car. if it doesn't go, take it to a car mechanic and fix it. if it makes loud squeaky noises, have it look at and deal with it or it will stop at some point.

fyi, for my case, went to the doctor. doctor ordered X-ray. doctor said i was fine, nothing broken, nothing wrong. i pointed to the swelling of my knee and said "you called that nothing wrong?" doctor ordered MRI. MRI shown tears. the rest was history.

Pauliina Lievonen wrote: Cherie gave me too good an opening - If the biggest help with your knee is someone realigning it from time to time, why not learn how to realign it yourself and then learn how to KEEP it aligned? I see there's at least one AT teacher in your (Cherie's) area: http://alexandertechniqueguide.com/a...nique-lessons/ I've had AT students of mine report the disappearance of knee pain that they thought was structural, after they'd had AT lessons for a while. Apparently in those cases the problem wasn't structural after all but a matter of using the knee joint in an ineffective way which irritated it. What I''d like to add though is that any trustworthy AT teacher is also going to ask if you have seen a doctor. If there indeed is structural damage, AT can certainly help you adjust your movement to that, but it won't magically heal anyones cartilage. Pauliina

Thanks Paula I might just look into that.

I see a chiropractor and massage therapist on a pretty regular basis for more than just my knees. I have a lot of old chjronic injuries and a very physical line of work and play. They do a lot to help keep me in tune while I keep doing things like trimming hooves and aikido to put it back out of whack so I don't foresee myself not needing to continue and since I am there anyway having my knees realigned is no biggie.

I will say that now at the 6 month mark that I am not having nearly as much pain or weakness int he knee as I was earlier nor does it get as out of alignment as it did at the start. so it is healing and improving. I forgot to mention that my chiro also did several treatments of ultrasound on the knee in the early stages and that did help a lot.

My knees have a lot of old damage even before the more recent injury thanks to an incident in my younger days when I was thrown by a horse hard and landed flat on both knees on a hard packed surface. They actually feel better right now than they have in years.

I totally feel your pain on the insurance thing. No way can I afford to have my knee scoped or the MRI my Dr said would be the next step of it did not improve over the first few weeks. I have insurance but its pretty bare basics and even just the co pay would have been beyond what I could manage. My chiro/massage therapist is not covered by insurance but I was lucky to find a licensed practitioner who will take me as a cash patient and he is really reasonable in his fees. I don't know how I would continue to manage without him.

Phi Truong wrote: hey! don't blame the designer, but the users. see, even god made mistake. he/she/it didn't realize we, human, could produce better idiots than his/her/its idiot-proved plan.

Yeah, that's true. I just had to have my cranky moment there. Thanks for listening, alls.

I think it will be ok. I did some education by google, and it seems like most people think that most of the time, surgery isn't needed for an MCL. I have no idea what the deal is if it's meniscus instead (or in addition). I have been taking a regular schedule of ibuprofin for the past couple of days, and it seems much, much better. I don't mind the pain or discomfort much, but I can't help wishing for the magic blueprint -- stop laughing! -- that would tell me just what I can do without damaging it further. How do you know where the edge is? You go over it. I've got enough injury experience that at least I think I can avoid simply roaring right over it, but I also know that there will be tweaks and setbacks. So: less aikido (hopefully not no aikido, but if necessary...), more gym, more bike.