Know Your Meniscus Part 1
Late last October, my husband and I were doing an outdoor work out at our box in California. It was a beautiful fall day on the Central Coast of Cali. We were finishing part C which was five rounds that contained the movement 100 double unders each round. That is a total of 500 jump ropes passing the rope twice under your feet in between each jump. We were on the last round and I felt a quick pull on the inside of my right knee, medial. As I was completing those last reps, I had managed to step on a grade that was declining with one leg. Even though it felt odd and I probably should have quit right then and there and went for an MRI, I finished my last round, took a few days off and slowly tried to work through it.
When the fourth month mark came and I could not feel any improvement, I decided to have a retired Chiropractor who practices a form of physical therapy called Feldenkrais method take a look at me. He had me perform some movements and he palpitated several regions of my knees and leg area. It was in his opinion I had just torn some fibers, He gave me some movements to practice on my own and asked me to come back in ten days. I did what was asked of me and had no improvement. I had even asked him if maybe I should stop working out until we get to the bottom of this. He suggested I stay active in what I was doing. He knew it was CrossFit. I saw him one more time before we moved to Tennessee and I had no improvement but nothing had gotten worse.
During our moving process we took two weeks off from working out while we were addressing the move. The injury at this point was about six months old. Prior to taking those two weeks off, I was suffering with mainly just edema in the knee. It was hard for me to fully bend that knee without feeling pain. That was it for symptoms. The edema was causing me to loose the range of motion in that leg. Even getting down on the floor to do my nightly stretching was painful and aggravating. After we were moved into our new home I joined a gym and started my CrossFit routines again. I was surprised at how little to no pain I had and no edema. Apparently the rest was good for me and my injury. I though perhaps I had worked through it.
Shortly after restarting my work outs, I was pumping out some attempted unbroken power cleans and I happen to step on some uneven flooring and tweaked that knee again. I knew exactly when it happened and how. This time the reinjury was little more aggressive. I had more than Edema. I had a different pain that occurred when I made a sharp sudden move mostly to the right or raised that knee in a jump. Even coming down on it I felt was not safe at this point. That scared me. I continued to nurse my knee through several months, hoping it would heal, but it never did. I had a feeling that if I did not stop working out, I was going to blow my entire knee out soon. That nightmare frightened me enough that I decided to bite the bullet and see a sports medicine orthopedic surgeon. This is where things get very interesting and the learning curb starts growing and gives me purpose to share this journey with you.
Many of you may recall my full hamstring detachment in August of 2015. Unfortunalty the highly respected experienced orthopedic surgeon misdiagnosed me twice. I did not have enough experience or common sense myself to ask for an MRI. Because of the misdiagnose, a simple surgery that needed to be completed within 14 days after the injury turned into a marathon surgery four months later with grim results. If only I had gone for second and third opinions, the result may have been better.I am not trusting the western medical field much as this point. My other dilemma was I had just moved to a new state and had not obtained a primary care doctor. Many of the orthopedics surgeons require a referral. The head coach at our gym had a knee surgery done in the past and she gave me her name of her orthopedic surgeon as she was satisfied with her experience with him. I thought to myself, " I have got to get three opinions!" I did not want to repeat my previous experience with my hamstring. Thankfully, where I work out, one of my work out buddies happens to be a emergency room physician as well as a anesthesiologist. He knows and works with a orthopedic surgeon and was kind enough to help me to go in and see him. I was able to secure a third opinion with a orthopedic surgeon who also specialized in sports medicine injuries in Nashville. This was a family referral and doctor three came highly recommended.
My first appointment with doctor A lasted approximately five minutes after waiting beyond my appointment time by one hour and twenty minutes. He asked a few questions, examined my knee/leg and ordered the MRI. I waited over two weeks for the MRI clinic to call me for scheduling. I waited five days for them to call me which is what I was told to do. Once they did not call me within the five day window, I called and left three messages. After two weeks had passed, the scheduling department called me and scheduled the MRI within a few days. After completing my MRI I was able to get my own copy within minutes but without the radiologist report. Once returning to doctor A for his diagnosis after he reviewed my MRI, it was highly suggested surgery. I actually let him schedule me a surgery time in six days. I was told the surgery was a very quick and easy process. The surgery itself would last between 20-30 minutes. He stated he would go in and smooth out my meniscus. He told me I had a torn flap that was catching. When he stated that, I felt like that made some sense to as what I was feeling intermittently on certain movements. Post surgery would be down one day and walking soft for first week and back in the gym by week two. He was quite convincing and spent a lot of time with me on this appointment. I did ask several questions which he had no problem answering. He told me he was surprised that I had zero arthritis in that knee. My knee was that of a 16 year old. He found that interesting due to my age and level of past and present activity. I left his office feeling like I was in good hands and surgery was the only recourse here.
The day prior to my scheduled surgery, I met with doctor B. Doctor B was much younger and had a completely different personality and opinion. There was no rush in the appointment and he was very interested in my past history and wanted to know every detail of this current injury. He took the time to go over the MRI report and view the MRI with us. I asked him if he could see a flap in the MRI and he stated nope! He took the time to explain the MRI and suggested I had the knee of a 30 year old with no arthritis. He told me surgery was not a good idea with this type of injury as he felt like it would not be successful. He said he did not like doing surgeries unless he felt the outcome would be better than the current situation. Wow, food for thought. I honestly had not thought of the surgery not being successful nor had doctor A mentioned that possibility.The statement going in and smoothing out the meniscus actually means going in and cutting out the cartilage where the tear occurred. The meniscus is cartilage people! The cushion between my tibia and femur, the upper and lower bones in my leg. Do we not need that cushion of meniscus? So I have a small medial tear in my cartilage. Cartilage provides us with cushioning. If they go in and cut out the tear, will that not leave me with less cartilage(less cushioning)? Doctor B stated the side effect of removing cartilage is arthritis. I also read this on the internet. Would that mean I would need a knee replacement later? Doctor A did not mention this. Doctor B suggested I give it at least six weeks rest and allow it some time to heal on its own. What? Is that possible, because if that is truly a viable option, I am in. He told me to just do upper body work outs. What woman does not need more work in the upper body area? I know I do, Game on. After leaving his office, I felt a deep sense of gratitude and relief. There was also some guilt feelings as to why I did not give it that much rest directly after injuring it. Live and learn again, I am not bullet proof. I called and canceled my surgery! I also let them know why I was canceling my surgery, difference of opinions and I would be obtaining a third opinion.
Doctor C was the eldest and most experienced of all three. He was very polite and not in a hurry. He also wanted to know my story and further educated me concerning this injury. He went over the MRI report and MRI disk with me, teaching me even more. He also drew me a drawing which really helped me understand the injury better as well as the anatomy of my knee. He complimented me for keeping my weight down, staying active , following a good diet and developing muscles that do the work, rather than the knee. I appreciated that acknowledgement. There is must attention and time paid to nutrition and fitness in my life. It is nice to get a pat on the back once in awhile. My particular tear is very small tear but is not in the best place is what doctor C stated. First and foremost, its easy to tear it further because of where the tear was located as well as the direction of the tear. The longer the tear, the more removal of cartilage. We know, less cartilage the more opportunity for arthritis. He also stated that circulation is a big problem in that area which makes it extra difficult to heal. Not exactly what I wanted to hear. He did not object to taking the six weeks and allowing an opportunity for a healing. What he was concerned about it once the six weeks where done and I started training again, if the pain was there, the opportunity was there for further tearing which again would result in removing more cartilage. He was pro surgery as quickly as possible after the healing time if it was still bothering me. He wanted to cut that out while it was small. That certainly made a lot of sense to me. Well now I have a lot to think about. I did a lot of research and decided if I am going to give the time to heal, I am going to do everything else I can to increase circulation , keep the edema down and promote healing.
What does that include? For supplements I picked collagen, a joint formula and I was already taking MSM. I like to use some of Dr. Mercola's supplements because they are clean, reasonable in price especially when you work your way to a premiere member. I need to enlist a massage therapist and chiropractor in my new region. Getting prayer on that knee if mandatory. Maintain a solid upper body work out program and nutrition program. I did all this and started my healing calendar. The edema left me very quickly and having that gone made my life easier in so many ways! Initially after the edema dissolved, I was still having pain when I had a sharp movement, mainly to the right. However over time, I have noticed this less and less. I am into my six weeks at this point and I have decided to give it more time due to such fantastic improvement. When I do start to bring the lower exercise back, it will be a very slow process. That time frame will be part two of this article. I am feeling very comfortable with my upper body work outs and doctor C thought rowing and biking would be okay for cardio. Swimming would be an option, but I say no to chlorine most of the time. So stay tuned for part two. By the way, tearing your meniscus if very common in my age group and often caused by a simple fall. I hope to post a new recipe next week. The fall veggies are here!
Love and Peace,