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Torn and Repaired Meniscus - thoughts/input - When can i climb again?!?
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Trying to revive this post and get some insight from people. Had a meniscal repair on a large bucket handle in the left medial meniscus when squatting of a high step climbing. I was doing one of my summer mountain guide courses and I think stiff knees, a lot of mileage and 40 degrees contributed to the injury. Got surgery 2 weeks after and followed he standart path: 6 weeks non-weight-bearing as prescribed. At week 7 I had a bit of a scare on the bike when it forced my knee into flexion too much and I didn't have the range of motion yet, but the physio I was seeing right after my surgeon didn't explain any of the exercises or how I was supposed to progress them. Waited a week to get back on track and everything went smoothly from that with my new physio. Biking was a blessing, even when I my knee felt stiff, biking seemed to losen everything up. I was doing pretty deep squats without assistance and progressing to one legged exercises (around 13 week) and was super stoked on my progress. I was even running 1 minute on 1 minute off and my knee wouldn't get swollen at all. The only thing that has been really annoying is a big piece of scar tissue that's sitting right in the back of my knee and it was somehow attached to my hamstring tendon. Yawning and stretching gave me tremendous nerve pain. That was until 10 days ago when biking started to make my knee click and pop like it never had before. Since then I've been struggling with the squats again and the worst is when walking or sitting for too long. In my mind there is 2 times when I could have re-injured myself: One day getting of the bike my foot got somewhat caught in the pedal and it kind of twisted my knee very slightly. I felt a very brief pain but got of the bike slowly and didn't think much of it The second was walking back home I slipped on ice and had to stop myself with my injured knee in like a bulgarian squat position. I'm hoping that is just my knee complaining because I'm doing too much (increased workload and activity by about 50%) but at this point I'm ready to hear that I have re-injured the meniscus. I haven't lost mobility or range of motion but the knee is overall sore every day and there is a click when I bend it past 90 to do a squat, even with ball assistance. Before this I was on the path of becoming a mountain guide, climbing my first 8b and doing my first expedition, now I'm pretty frustrated, sad, and it feels like it will never get better. Not trying to ask for medical advice or anything but just curious on everyone's process and if you had any setbacks along the way and maybe you can help me see the light at the end of the tunnel. Cheers, Jaime |
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Well, that’s a bummer! Worst case: you’ve retorn. But, you could also just have a small effusion altering the course of your patella, which can click, pop, and hurt. I had similar symptoms for a while off and on after my meniscectomy (not a repair like you had). Depending on how much it’s hurting/inhibiting you, maybe talk to your surgeon and or PT, and see if you should get re-imaged/evaluated.. Meniscus repair has such a long recovery. But, you will get through it. If you’ve climbed 8b, this isn’t going to hold you back long term! Also, if you are going to be a career guide, injuries will happen.. Hopefully not bad ones, but they will happen! Figuring out how to deal with them is just part of the game, guide or not. Good luck and hang in there! It really will get better. |
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My doctor told me If I re tore mine after repair i wouldn’t be wondering if it had happened. I would know and it would be much more painful than the original tear. I had my surgery about 17 months ago and am now back to climbing harder than I was pre surgery. I had a few scares while recovering from my surgery I didn’t take it easy enough and started climbing 5 months after the surgery. Luckily it didn’t backfire on me, but I had lots of weird pains and tweakyness in the knee from time to time till about 1 year out. After that it seems like it gets better everyday. Good luck and try to get the knee as strong as you can till you can climb again. Also make sure your rolling your leg out or getting some type of massage for your knee. One of my scares was just my leg being so tight in the back that it was making me think I retore. |
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I'm 16 weeks post-surgery now. I don't think I've had any significant set backs. I've been increasing activity gradually and slowly. I had one brief scare where my knee was caught and twisted as I was stepping down. There was some pain that went away over 5 minutes. I've also had lots of weird pain, sensations, clicking, etc. I think most of those have eventually gone away. One thing I remind myself of is that the surgery is somewhat invasive. A large incision in the joint capsule, stitches through the meniscus into the joint capsule, plus a couple of portals. So there's plenty of healing that has to happen, it's not just the meniscus. FWIW, a buddy of mine recently rehabbed an ACL repair. He was regularly doing too much activity including falling off his bike several times. He always seemed to be in a balancing act between doing too much and just enough activity. His knee would regularly be swollen and painful after he over did it. I *think* he's back to 100% now though. I'm definitely concerned about re-tearing mine too. I asked my surgeon about this scenario. He said if that did happen they would just remove the tear in a follow-up surgery. Not great for long-term joint health but at least I'd be back up and running in only 4-6 weeks. |
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Just to add a data point, I had a meniscus repair fail and had to do surgery again to remove the repair. The surgeon said that when the repairs fail they make a huge mess and you have to take out most of the meniscus on that side. I was out for a little over a year all said and done as the repair failed somewhere between 6 mos and 9 mos out, then had to reschedule surgery etc. 4 years later and I regularly climb and run with zero issues, so I'm in the anti-repair camp. I know lots of people without knee pain well into the their 60s who are active and had their meniscus removed decades ago. |
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Had a bucket handle meniscus tear and repair in early my early 30s. Had fun top-roping during the required weeks of leg immobilization with no ill effect - was an interesting and fun challenge climbing with one completely straight leg. |
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Throwing my story in here as well... Tore my meniscus about 12 weeks ago. Was recommended surgery (by a surgeon... Go figure) that felt rushed. He wanted to get me in the next week. I was nervous and in pain so just went along with it. Luckily there was a delay that gave me time to consult a PT specialist. In the original surgeon consult, there was zero mention of the words "physical therapy", however the PT doctor highly recommended trying PT before surgery since the surgeons would always be there, but you can't get un-cut. Did 6 weeks of daily PT regiment and was climbing light again at that point. Now 12 weeks out I'm almost back to my pre injury grades and feeling swell. Everyone's situation is different, but I was told by the PT doc that if you can walk and your knee isn't entirely locked up then PT first is the way. There's tons of new, credible studies out showing zero difference in long term pain management and rehabilitation between surgery and PT in meniscus tears. The potential long term complications of surgery to repair are well documented also. I can anecdotally say that I'm very glad I didn't get surgery as I believe I'd still be doing heavy rehab now instead of climbing. |
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Thanks everyone for the response and support. I have an appointment with the surgeon next week and see what he says. Knee is improving lightly and both physiotherapist I've seen weren't worried about a re-tear on the meniscus although one suggested my knee cap was displaced and that was causing the swelling, but I'm still not convinced. I gained a lot of flexion in the last few days and I'm 4 inches from touching my butt with my heel, which is encouraging. Also the swelling seems to have gone under control although I still get it every day and the knee feels sore. The things that worry me the most is a painful section in the back of the knee that coincides with a pretty big piece of scar tissue but also sits over the meniscus so I can't really tell which is causing the pain. Also my knee makes a clunk noise every once in a while where it seems to fall back into place and I've heard of that being a precursor for a re-tear. All I can do now is keep going and rehabbing until one day I can climb without pain. On the plus side, my fingers are stronger than ever and I achieved physical benchmarks like: 1 arm hang on the 20mm edge with a 10lb kettlebell on my other hand One arm pull up on the BM 2.000 middle rung, 2 finger pocket and 3 finger pocket So maybe I can just forget about using my feet all together haha. |
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I had two partial tears, one on my medial and one on my lateral meniscus. I got surgery and the doctor ended up doing a partial meniscectomy and took about 25% of each. They told me I can run after 4 weeks but can’t climb for 3 months. This doesn’t sound super right so I’m going to be doing physical therapy, biking and stretching with the intention of introducing climbing again in 4-5 weeks and back off with any pain or discomfort as needed. The plan is to start with top rope and go from there, I will post an update in a few weeks. For reference I am 25 and tore it about 1.5 months ago climbing in Indian creek and it took about that whole 1.5 months to see a doctor get an MRI and get surgery. No climbing pretty much that whole time.
Thanks all! |
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I have a partial medial meniscus tear from exactly 3 weeks ago (from an aggressive dropknee) that I have been rehabbing without surgery and it's recovering well. I now have full range of motion and deep squatting at 150% BW feels completely fine. I can pistol squat on the injured side with a little band assistance, and deadlifting at max feels fine. I've started toproping (thinking that landing on a pad or taking a lead fall is still risky), and besides some right leg weakness and stiffness (and avoiding any kind of rotation of the injured knee), I feel fine. I am definitely in the school of rehab first (without surgery) for meniscus tear unless there is chronic pain and limited range of motion. |
Cole Smith wrote: My last knee surgery was a partial medial and lateral menisectomy, as yours. He went into the surgery thinking it might be a full repair bit I was lucky. Also had in same surgery limited synovectomy and chondroplasty of medial femoral condyle. For reference, I was 69 at the time of surgery. My knee surgeon told me he typically returns his "athletes" to full activity as dictated by pain by 6 weeks, but since he got such a good report on my progress from my PT, he cleared me to return at 4 weeks. I was very careful, especially with high steps, but had no trouble climbing at 4 weeks and after. The thing which was hard for 4-6 months was approaches and descents, actual climbing was not an issue. Just general swelling and pain if I overdid it on long uphill approaches with a full climbing pack. I experienced the same thing 25 years ago with the other knee surgery. Interesting note, I sent my PT a video of me climbing a route in the gym and asked her if any of the motions concerned her, and she said the only thing that bothered her was when my foot rotated inward. She said knee is fine when foot aligned straight on or rotated outward - in fact these two motions are used with leg press training - but that rotated inward puts a lot of stress on the knee. Good luck with your recovery. |
Fan Y wrote: If you do need surgery for it at some point, I'll note that I had my meniscus repair done at the orthopedic practice in Mammoth and they did a fantastic job of it. Ski towns can be a good place for knee surgery. They were very athlete-focused as well in terms of recovery timeline expectations, so that was nice. Being in the Eastern Sierra you'll fortunate to have that resource. That said, trying to rehab without surgery (as you plan to do) is a good approach. Mine was a different situation and surgery was required immediately. Tore it on a highstep in the ORG, huge bucket handle tear, and knee was locked at a 90 degree angle. Getting out of the gorge with a locked knee was interesting. Had surgery in Mammoth less than 48 hours later. That was many years ago when I lived in Bishop. Knee recovered 100%. |
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A lot of good advice and stories here. Very similar acute injury as Jaime from a high step. The only thing I would add is there is a huge difference between and menisectomy and meniscus repair in terms of recovery time. My repair was worse than an ACL, menisectomies are a much shorter recovery. I had my repair surgery over 2 years ago, it took me about a year to be fully confident again bouldering. Rope climbing was quicker. Started easy bouldering in the gym without falling about 6 months post surgery. Started rope climbing again about 7-8 month later. I didn’t feel fully recovered until about a year and half later after a ski season. I have full range of motion but still have a lot of tightness when I have all my weight on it at the end of the range, I don’t think this we’ll ever go away. During the recovery I tore my right meniscus but not nearly as bad, probably because I was favoring it. I might not need surgery on it ever but it does get swollen and hurts from lots of up hill, downhill, or skiing if not properly conditioned. Make sure you get a good PT, and keep doing the strength training after you are done with PT. I started mountain biking to build more strength. |
Dan Smee wrote: Counter data point: had a meniscus tear (felt knee lock) almost 15 years ago on a drop knee. PT was all about rehab w/o even an MRI. Did a few weeks + climbing & trying to stretch until it got worse one day. Finally had MRI (bucket tear) & surgeon was pretty matter of fact that trim was the only option. Watched the surgery live on the monitor w/ block anesthesia (can feel the knee being manipulated but no pain. I highly recommend it for the curiously minded). I often wonder if more of the meniscus could have been saved or even repaired if I had the MRI first, but I was a grad student @ the time so definitely felt the financial pressure (though in hindsight I should've bitten the bullet), that's US health care for ya. 4 weeks later things started to become normal, though I did loose a bit of ROM even today (knee flexion). I don't hike a lot nor run much & the knee hasn't bothered me. Strength isn't an issue: wasn't the dominant leg & can pistol squat almost as well (+60-70% BW @ my strongest). My take: get an MRI asap, then do your own research based on that. Everyone's biased toward their own profession. |
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I don’t get when people come out and say that the surgeon that did the procedure recommends, let’s say 4 month recovery time, and then they proceed to say I’ll disregard that and do my own thing rehabbing the leg, arm, whatever. What is that month, or two, really going to do for you? Can’t stop climbing/biking/skiing or whatever for a month or two in order to heal properly and get longer use of that leg/arm. I messed up my knee 10 years ago skiing, probably had a partial tear on it (didn’t do an MRI, X-ray didn’t show anything). Did rehab and all was good for about 8 years and then my knee started locking up. This time did the MRI and it showed I had a partial meniscus tear, had surgery and it had to be repaired. Two years in now, all is good but it’s always on back of my mind how I’m using my legs now. |
Cole Smith wrote: I’ve had a couple partial menisectomies, and the last one this year. I went climbing two weeks after surgery and started running three weeks later. It depends how strong you are going into it and obviously top roping 5.7 outside is not the same as bouldering V6 inside. If you can run, you can probably climb, but like others said, be careful on high steps and drop knees. |
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Update: Swelling and pain have disappeared and surgeon said he's not worried about the meniscus... There's still a big chunk of scar tissue attached to my hamstring tendon that is causing stiffness in the medial/anterior side of my knee but other than that walking, biking and even running feel fine and don't cause swelling. I'm also pain free when squatting and doing 1 legged exercises. However there is still contradiction between his and physio's advice on how I should proceed to push it, so I'll be my own judge and play on the conservative side... My main worry is a very loud pop that happens every once... No pain whatsoever but it causes stiffness after and I have a friend with a 50% meniscectomy that also gets the same loud pop, so it makes me wonder if something in there isn't functioning properly. In terms of activity I started bouldering on very low terrain were I can fall directly on my ass and top roping without highsteping while maintaining my one-arm pull-up and fingerboard training. Please keep sharing your stories here! It really helps to read through everyone's process :) |
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Hello all, for anyone interested I have an update as well. 4 week post surgery update: still having some stiffness and minor swelling/scar tissue that’s built up but the knee is 80% functional now. I have done some climbing, with all climbing below my typical on-site grade and I have just been able to test out the waters. As many people mentioned, I have been avoiding any drop knees, high steps, heel hooks or anything that twists the knee in a weird way. But consensus is that listing to the knee and backing off with any pain has been a successful way to proceed. Thanks for all the advice from everyone! |
Jaime Navarro wrote: Hi Jaime, I’m really sorry to hear about the challenges you’re facing with your knee after the meniscal repair. It sounds like you’ve been through quite a journey with your recovery, and it’s understandable that you’re feeling frustrated and concerned. It’s encouraging to hear that you made significant progress initially, with deep squats and running without swelling. It’s a testament to your commitment and the hard work you’ve put into your rehabilitation. However, setbacks like the ones you’re experiencing can be really disheartening, especially when you’ve been so close to achieving your goals. The clicking and popping sounds, especially after specific incidents like twisting your knee or slipping, can be quite unsettling. It’s not uncommon for scar tissue to contribute to discomfort, and the increased activity level might also be playing a role in your current symptoms. Sometimes, the body needs additional time to adapt, particularly when resuming activities that put stress on the knee. Given the issues you're describing with pain, stiffness, and clicking, it might be beneficial to revisit your physio or consult with a specialist to reassess your knee’s condition. They can provide insights into whether these symptoms are a normal part of the healing process or if further intervention is needed. It’s crucial to address any concerns about potential re-injury or complications to ensure you’re on the right path to recovery. In the meantime, managing daily discomfort with a product like this might offer some relief. While it's not a replacement for professional medical advice, it could help ease the soreness and support your overall comfort as you continue your recovery. It's clear how much you care about your climbing and guiding aspirations, and it’s natural to feel disheartened when progress seems slower than expected. Remember, recovery is often non-linear, and setbacks, while challenging, don’t necessarily mean you won’t get back to where you want to be. Keep focusing on the progress you’ve made and the steps you’re taking to address the current issues. You’ve already shown incredible resilience, and that strength will help you navigate through this phase. If you need more specific advice or just want to share how you’re feeling, don’t hesitate to reach out. You’ve got this, and I hope you find the clarity and support you need to get back on track. Best of luck with your recovery and climbing goals! Cheers |
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Jaimie you described the noise your knee makes as a clunk. Does it feel that way too? Like as if something is shifting or clunking back into place? In what positions or circumstances does it clunk? Many years before my repair I had a partial meniscectomy which was successful. However, several months after surgery I started developing a clunking and locking sensation in cross-legged positions. It got worse and worse over time. 17 years later and it completely tore on a high step. I believe the original surgeon missed that the posterior horn was not properly attached after the meniscectomy. This never showed up on any subsequent MRIs or dynamic ultrasound. I also had a long term baker's cyst in the back of my knee. Post repair it was causing significant pain and stiffness. That was a little disheartening as I'd never had pain out the back of the knee. It was preventing me from getting full range of motion. I had that drained which instantly fixed those issues. The fluid inside was extremely thick and my provider needed an assistant to help draw it out. I guess that most of the excess fluid in the cyst had been absorbed after the repair but there was still some very dense fluid that was not breaking down. |
