Climbing knee injury -- torn meniscus cartilage -- Need help

Yesterday, I was climbing in Eldo, doing a high-step twisting kind of move and my knee "popped" and then locked up. I was able to get in to see an orthopedic doc who quickly diagnosed a meniscal tear/displacement which will require arthroscopic surgery. I'm trying to find other climbers who have had the same injury (apparently its common for climbers) so I can better educate myself about this. I'd really appreciate the opportunity to talk with someone in the Boulder/Front Range area who's gone through this before. Thanks, Jeff

Hello,

I trust my kids and my life with this guy: Kevin Rechlin at Duggan Chiropratic:

2439 Broadway St # 100, Boulder - (303) 443-1553

His email is: kreichlin@comcast.net

He will charge around $55 a visit. He takes care of cyclist for the tour de france and stuff so he is no joke.

I crawled into his office before crying for my mom and he help me big time.

Kevin

Jeff,
I had a similar injury 7 years ago, though I sustained it while playing soccer. I tore my acl/mcl and tore meniscus. I also had athroscopic surgery, primarily to repair the torn menuscus. I have found the biggest key to keeping my knee functional and pain free is regular PT/weight training. I got scoped in December and was able to play basketball by the middle of March. I slacked off on my PT after that and my knee gave me continual trouble until I began weight training again. I have kept up a pretty consistent regimen for the last 4 years and have had no further issues with my knee. I run, bike, climb and snowboard regularly and, granted my knee gets sore from time to time, but I am able to do what I want without prohibitive pain. I cant really offer any advice in terms of what specialist to see but I hope that info helps. Good luck with your recovery. I am sure you will be back at it and full strength in a couple of months. If you have any questions feel free to drop me an email through the site. Take care,
Kirk

Paz Ramirez wrote: MAybe getting a doctor to fix everything is not what it's all about??? . . . What if the surgery made it worse???

Certainly a good point, and I should get a second opinion at the very least. However, I suspect that in my situation, surgery will be necessary if I want to rock climb again. When my knee popped yesterday I was on 5.8 - 5.9 terrain -- nothing too crazy, but it still required a high-step/turn the hip and knee out kind of move. When you're above your pro as I was at the time, you do what you have to do to make the move. It was pretty scary to have my knee suddenly lock up like that. I had to make a few more moves up until I could get a good piece to lower off from. I really don't want to be in that situation again. And now that I've torn the meniscus this badly, from what I've researched so far, it's unlikely I'll be able to avoid repeated displacements unless I give up any and all activities that could put a twisting force on the knee -- climbing, skiing, even working (carpentry and building).

I could definitely feel that something was very wrong inside the joint, and at this point, 24 hours later, my knee still won't straighten and I can't bear much weight on it.

But I appreciate the warning not to just charge ahead with surgery without considering alternative therapies and getting multiple opinions, and I will certainly do that. Thanks

First off get at least one additional medical opinion. Find out if your doc is paying for a Lexus or giving you the straight story. If you have a tear and displacement it WILL NOT heal. Putting off surgery will only lead to further damage. A meniscal tear is an outpatient arthoscopic proceedure and usually easilly recovered from. If you really need surgery DO NOT put it off! Become informed.

Jeff

Friend of mine had that happen on a boulder problem 2 feet off the ground. He had the surgery, layed low for about 6 weeks and is back to climbing. He hasnt missed a beat. buy a hang board, get the surgery and come back strong. gl.

Jeff,
I recently had a knee issue during a run in Leadville. It swelled up huge during and after the run. I saw a local orthopedic surgeon and had an MRI done. It shows a meniscus tear. However, after icing the knee for a week or so, it came back around and hasn't been bothering me during runs or climbing. But the orthopedic surgeon I initially saw still recommended surgery.
I went for a second opinion with another well-respected doctor around here and he suggested I do NOT have surgery given how it's feeling now. I'm holding off and I'm happy for now. He said I could always have surgery later if it got worse. I prefer that suggestion.
The point? A little bit of time (1 to 2 weeks) and a second opinion did me wonders. I'm glad I didn't jump straight to surgery. Some doctors go straight to surgery while others are more cautious and, shall I say, realistic.
No matter what you do, I wish you a speedy recovery and return to climbing. I know how it feels to be out for a while.

I tore my meniscus 5 years ago surfing, 3 weeks before I was to run the '02 NYC marathon.
( Classic screw up) After the MRI etc, I had the surgery and was lucky to get a great sports training-therapy guy for rehab, who worked with me on advanced exercises until I was strong. I have incorporated the leg work into my regular workout ever since and I have not had any problems. So get another opinion and if they both concur, have the surgery because you want to come back 100% and feel confident.
(I ran the NYC Marathon in 2003 and it was fantastic.) Good luck.

Jeff,

I had a torn ACL and some minor meniscus tears in '96. I did have surgery, as the ACL was a complete tear.

Some things to consider, as I understand it. Anyone can provide feedback if this is not accurate:

- The meniscus is extremely avascular tissue, promoting the tendency for it to not heal
- I think a typical approach to minor meniscus tears is to cut out a smooth area to remove the tear. This may prevent the tear from increasing in length. However, that section that has been cut out is not going to grow back, and it may promote deterioration
- On the other hand, some small tears can/may repair on their own; however, again -- very avascular tissue.

Just a couple thoughts.

BTW, my out of state Dr. who did the surgeries prior to my moving to Colorado, referred me to an acquaintance -- Dr. Jordan Stoll (Lousiville/Boulder). I saw him when my knee was acting up, and he seemed pleasurable and knowledgeable -- the exact opposite experience I had with another doctor in the same practice.

Hi Jeff - I've had two knee surgeries for meniscus tears. As I understand it (that phrase could begin all of my sentences as I am not a doctor), there are two surgery options: (A) repair the tear, or (B) remove some meniscus. The location and severity of the tear, and your age, have some influence on what your doctor will recommend. Cartilage is largely avascular, so it doesn't heal well, and thus if you go with route (A), there's no guarantee the repair will work, which may mean another surgery at a later date (this is particularly true if the tear is in the thinner sections of the meniscus where there is almost no blood supply to promote healing). On the other hand, (B) may lead to arthritis later on in life.

My first injury was ten years ago. Prolonged highstep on difficult terrain in Eldo. Stood up, and my belayer 50 feet below heard the loud POP. I was able to continue climbing for the next 3 months (I figured I had just popped my knee like a knuckle popping when I first injured it). In the last month, my meniscus flap would tuck under itself, and I couldn't straighten out my leg. Happened to me 3 times in the middle of a climb, and on the last, I could do nothing to get my knee to work again -- it remained stuck for a week. So I saw a doctor, and after a week on crutches with a stuck knee, I had surgery (A) with Dr. Lindsay (Univ. Hospital, he did a lot of cutting on the CU football squad). He said because I was only 30 years old, it was in my best interest to do the repair. My mom (who was 67 at the time) also had meniscus surgery that year, though her doctor removed the torn meniscus as there really wasn't much threat of arthritis developing in the remaining years of her life (she's still alive and well, and hikes/snowshoes all over the place, and her knee is doing fine).

Rehab is much longer with option (A). I was put in a full leg brace for 30 days (no bending of the knee), and my leg atrophied big time. 6 weeks of PT to get range of motion back (it never returned to 100%, but it got to the point where I didn't notice much difference). Then I was told to do many weeks of weight training, which I opted out of (I just did my own training, and did fine). After a year, I was back to normal (I returned to climbing almost immediately after PT, though it took some time before I was climbing without noticing my knee).

Ten years later (this summer), I was on 5.3 terrain in the North Chimney approaching the Diamond. Highstep, followed by a sickening tearing sound in my knee. I continued to Broadway on a stuck knee, rapped off, and hobbled out 6 miles. Had surgery (B) five days later (late July '07) with Dr. Cavanaugh in Longmont (4000+ knee surgeries). The tear occurred along the stitches of the old repair -- so that lasted ten years. A piece of meniscus was removed (I had a "bucket-handle tear," and I think the handle was removed), and the doc said my knee looked great inside. He expects I'll live to a ripe old age with no arthritis problems. I had a tear in the right, lateral (outside) meniscus, and was told that's better than an inside tear (the inside piece bears more weight). No leg brace this time around, and I could use my leg as pain allowed (no climbing or hard athletic activity for a month). I still had atrophy in my leg, though not nearly as bad. After the stitches came out (8 days), I was told to weight train -- if after one month I couldn't get my quads back to reasonable strength, my doc was going to order PT. He gave me the green light when I saw him at the end of August.

It's been two months since surgery, and though I've returned to climbing, I think I may have overdone it. My IT-band (? -- runs from butt to knee on outside of leg) is still quite tight and sore, I still have scar tissue lumps (doc says those will take some time to go away), my range of motion is 5-10 degrees less than normal, and there's a chance I re-injured my meniscus (haven't returned to the doc to find out). I don't blame any of this on my doctor; I'm pretty sure he did a fine job (though as with most non-climbing doctors, I always feel like they really don't understand what I do out there on the rocks, and what I'm going to be doing to my knee when the doc says "go for it.") My typical mode for the last 25 years has been to climb through pain (I think a lot of climbers do this), though at age 40, I'm beginning to rethink that game plan. I'm going to be feeling mighty stupid if I need another surgery in the coming 6 months -- my hope right now is that I'm still in recovery mode, and that my knee is fine. TIme will tell. I guess the moral of this paragraph is to take it slow in the recovery phase; it's not worth it to reinjure yourself.

You'll be back to climbing quicker with surgery (B), though if your doctor suggests surgery (A), I'd follow that advice (I believe the decision is often made on the table depending on what the doc sees, so you may not have much voice unless you discuss it with your doctor prior to surgery). I've been pleased with both surgeries despite my current problems -- email me again in a month if you're curious about my progress. Good luck with recovery.

Okay, 1st off, if you choose a surgical route LISTEN to your post op therapist AND FOLLOW the directions of your PT. Climbers are notorious knuckleheads and tend to push through pain often to their own detriment. Realize YOU WILL RECOVER! But pushing to get there too soon is a recipe for a 2nd surgery. With surgery, unlike sex, drugs and rock and roll, more is not better.

So here in brief is my story...

In 1980 I was serving the US in Africa when I experienced a severe trauma to my right knee. Essentially the knee was violently bent completely backwards and my own foot split my lip. That has to be one of the grimiest sounds I have ever heard. The injury thoroughly demolished my acl and mc, severely strained the pcl and lc, tore muscles from the bone and worst of all burst the sinovial lining like a water balloon. Had I been a sports star on a field of play I would have been in surgery that day. However I was just a climber and since this was a life-style threatening but not life threatening injury I had to wait and get by the best I could till a US military MD could get to country for a diagnosis. Four months of regular agonizing dislocations passed before the Doc could arrive. After his analysis I had 2 hours to gather my things and board a plane to DC.
two days later I was meeting with a ortho surgeon. My heart sank further and deeper as he traced a line down my leg indicating his intended incision. At 6" I was uneasy at 12" I was nauseous. When he finally stopped drawing the damn line was 24" long and I was apoplectic. My life-style was over. The rug under my dreams, hopes and aspirations was yanked away for ever. Needless to say I had no choice but surgery.
When the Doc saw me post operatively he stoically explained that what he thought would be a 2-3 hour surgery ended up being closer to 12. The damage to my knee, including the burst sinovium, was "vastly
more significant than anticipated" Those were his exact words. He explained that the 4 month delay had caused such debilitating atrophy that he couldn't be sure how successful the surgery would be. He also somberly stated that I couldn't rule out subsequent surgeries in the future but as I was young (23) and fit I should do well.
Boy was he ever right. The lag time between injury and surgery had allowed my now reconstructed sinovium to become diseased with a rare condition called pigmented villonodular sinovitus or PVNS for short. Over the next 10 years I endured 12 surgery & recovery cycles. I continued my life-style when I could and as best I could but I was in pain every step every day. Learning to crawl, walk and climb again became a career.
Fifteen years ago, having no other viable options left to me other than fusion or amputation, I had a total prosthetic reconstruction done. I have been pain free ever since and have not had any additional surgery. 12 surgeries in 10 years compared to 0 surgeries in 15 years AND NO PAIN now that is success. And yes, though I took off a long time in self imposed retirement, I still climb, hike, pack and adventure. The biggest pain is getting through airport security with a pound of metal in my leg and compared to learning to walk that is only an inconvenience.
So I guess my point is if you need it DO NOT put it off. Delay causes decay. Get it over with and get on with your life-style.

Thanks to all of you for the information and encouragement. My knee is more swollen today than yesterday, so I'll be on the phone first thing tomorrow morning to get a second opinion and then go from there.

i had the same injury on my left knee. a "bucket tear" sucks until its fixed. i waited like a year before surgery, because it would heal and feel fine. then bam a particular angle and it would lock up and hurt. i had the cartalige removed from the injured part of my knee, now it's feels brand new. the doc said i might have problems when i am older, oh well it's all in the game yo! get it fixed soon.

Jeff,

My fiance had this same injury back in June - while climbing as well - same twisting motion resulted in torn meniscus. He had arthroscopic surgery on July 5th to remove the meniscus (essentially the whole thing) and he was back climbing in a month (though easy stuff til it was stronger). He would recommend to stick to your rehab schedule and do many knee strengthening exercises. He also now always uses ski poles on approaches and descents. He's a little slow on the descent, but it's not that bad.... He also has a partially torn and healed ACL, but has no problems with that....

Definitely get the surgery - it will feel a ton better later!!! Given that your tear is bad enough of course!!!

Jeff Chapman wrote:Yesterday, I was climbing in Eldo, doing a high-step twisting kind of move and my knee "popped" and then locked up. I was able to get in to see an orthopedic doc who quickly diagnosed a meniscal tear/displacement which will require arthroscopic surgery. I'm trying to find other climbers who have had the same injury (apparently its common for climbers) so I can better educate myself about this. I'd really appreciate the opportunity to talk with someone in the Boulder/Front Range area who's gone through this before. Thanks, Jeff

I've had the surgery on both knees. The first was complete, open knee lateral meniscus removal in the late 70's. The second was arthroscopic and snipped around a tear.

My take: If you're knee is locking up often enough to be a bad inconvenience (like swelling that takes a while to go down every time it happens) or pain, have the surgery done. It's a very common orthopedic procedure. There are lots of people around who can do it.

Jeff Chapman wrote: Yesterday, I was climbing in Eldo, doing a high-step twisting kind of move and my knee "popped" and then locked up. I was able to get in to see an orthopedic doc who quickly diagnosed a meniscal tear/displacement which will require arthroscopic surgery. I'm trying to find other climbers who have had the same injury (apparently its common for climbers) so I can better educate myself about this. I'd really appreciate the opportunity to talk with someone in the Boulder/Front Range area who's gone through this before. Thanks, Jeff

5 days ago my day off didn't go as I had planned.. I went on a 1/2mile down hill at Lizards mouth with a friend and I fell straight off of a 6' bolder on my back.. It took over an hour of extreme pain, cuts and bruises and adenallelin to get back up the mountain; threw brush and climbing up rocks with a very hurt leg, but we made it back by me litterally crawling up backwards on my butt and hands unable to move my right leg. The doctors at the hospital said I have a severe sprain in my right knee and possible ligimate tear in it as well. I went to a specialist the next day to make sure I didn't tear anything, but I tore my lateral meniscus. I am extremely lucky that that is all that happened to me from a fall like that.. I am sore all over but still very thankful I am ok... I'm going stir-crazy but thankful still. I don't know how long it will take to heal. How long ago was your accident and did you heal? That said if I don't heal within 6 weeks then we will talk about surgery. :(

I had a very similar injury in the early 1990's - my doctor initially told me to live it, as it turned out I couldn't live with it, as my knee would lock at the most inopportune times, on lead, before a big climb etc. I eventually developed a somewhat comical procedure to unlock the knee, and of course each time it locked it tore the meniscus a little bit more. Eventually i asked to see a specialist and he told me it was time for my suffering to end. I had arthroscopic surgery, and a good recovery - although the surgeon told me there wasn't much of the cartilage left and expect trouble in 20 years - which was about 10 years ago. It's been doing very well all these years and hasn't stopped me from climbing, skiing, hiking etc. Of course it never locked again after the surgery. Hope it helps.

Bro, i just had my 4th acl/mcl surgery In March, from skiing, and let me tell you , shop around. You do research when buying a car why not do it for your medical. It is a business, the mri scans are of different quality and the price ranges vary, shop around in almost every step. Same with Pt, the only advice I’d give for the PT is yes follow the protocol to a tee, they have it in a book and you can request it. This may sound bias since I’m a strength and conditioning coach but I’d couple the pt with a strength coach, bring the surgical report with you, if the coach is worth his weight he’ll know exactly what to do. Mostly it’s listening to and respecting your body. For me i was climbing throughout the process(top rope with brace) just for mental health mostly, i started leading again in the gym around 4 months post op, outside in 5, bouldering inside the gym around 5 months post op , outside around i was back to climbing 5.13 on lead in less then 9 months and I’m most proud that I’m back to bouldering v8 outside in less then 10 months time, this isn’t a challenge everyone is different but if you put the work in you can get back to what you love fairly quickly. If you need any help or direction in your rehab/prehab id love to help, just shoot me a message. 

Had this happen; if you like to boulder really advocate for having a repair and not a removal of the meniscus.