Meniscus recovery...

Discussion in 'Health & Fitness' started by jk175d, Jul 7, 2013.

  1. jk175d

    jk175d Semi-Pro

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    I had surgery for a torn meniscus on one knee. the type where the torn part is removed, not repaired. A week and a half later the knee feels great, I have 100% full extension, and can bend it nearly full without noticing any discomfort. Basically no pain except for tenderness at the incision points. So I'm very pleased.

    However, I do feel like I still notice a nagging sense of "you better not plant and twist or you'll tweak it". My initial injury was 8 weeks before surgery, in that time period I experienced the same thing, where my knee basically felt 100% for almost any activity except tennis. And I had that same nagging feeling, sort of a hint of impending trouble should I try tennis. And sure enough the two times I tried to play I tweeked my knee within a few minutes and was done. (presumably the loose tear catching and tugging)

    So I feel like that sensation should be gone post surgery, since there is no more loose material. But as I said, I kind of have that similar sensation, like my knee is telling me "don't plant and twist"

    Of course it may simply be that's because it's only a week and a half out of having part of my meniscus removed, and I also may be paranoid after living with this nagging feeling for 8 weeks. But I'm curious if any others who've had the surgery know what I'm talking about and might be able to reassure me that this is simply part of the recovery that will go away in time.

    I don't intend to try to play until cleared by my Doc, which will be 4 weeks minimum. And I've been doing PT daily.
     
    Last edited: Jul 7, 2013
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  2. NE1for10is?

    NE1for10is? Semi-Pro

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    It took me six months before I was able to play tennis again and several more months than that before I had full flexion again (with yoga), although I had a minor heel surgery at the same time, so recovery probably took longer for me. It's great that you're doing your PT. Definitely keep it up. I've heard of people playing a few weeks after surgery, but I would make sure all the internal swelling has gone down before you do any hitting, which usually takes longer than you think it should after any surgery.
     
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  3. RogueFLIP

    RogueFLIP Professional

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    It's too soon after your surgery to not have those feelings.

    "Typical" recovery for meniscal removal is about 6-8 weeks...good that you're not having pain, but trust me your knee is still healing....

    PT? As in physical therapy? Or physical training?

    Either way, get the legs as strong and flexible as possible, come back to tennis slowly.

    Listen to your body....

    Speedy recovery.
     
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  4. Rattler

    Rattler Rookie

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    Physical Therapy! Ask your Dr about it....it worked wonders for me...I had most of my meniscus removed and was told that I would never run again, let alone play. That was almost 15 years ago, and with the help of physical therapy I am able to run and play tennis every day.

    BTW my recovery took a good 6 months, I was on crutches for two months following my surgery.
     
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  5. jk175d

    jk175d Semi-Pro

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    Thanks. Yeah, listening to my body for sure. And as I said, even if I feel great I'll wait at least 4 weeks and until my doc says go. I happen to have a follow up appt with him at the 4 week mark.

    But also I'm asking about a specific feeling in my knee, it's not pain, it's more of as I said, a hint of "better not plant and twist" which I associate with the loose meniscus flap that is now removed. It's this specifically I'm wondering about. If the flap is gone why do I still feel this? Or is it simply because of the "wound" to my meniscus from the surgery and that will go away as it heals?

    I'm just concerned because before the surgery, my knee felt pretty much 100% except I still could tell from this feeling I'm describing that I wouldn't be able to play tennis without tweaking it again. So it's disconcerting to have this same feeling after the surgery.
     
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  6. RogueFLIP

    RogueFLIP Professional

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    Hippie answer: Your body is telling you to don't plant and twist. Again, the "bad" part of your knee might have been removed, but it's still healing. So, your sub-conscious knows this and its still sending you the message to please sir, don't plant and twist.

    If your intuition is telling you that, I'd probably listen to it. When it's ready to plant and twist, you'll know it.
     
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  7. Chas Tennis

    Chas Tennis Hall of Fame

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    I have had that feeling. The injured knee felt fine but if you told me to run across a grass field I would not do it.

    1) 1999 Right Knee Meniscus Injury - I gave myself 3+ months off to recover from a medial meniscus tear. My Dr thought that the odds were 75% I would need surgery and 25% I would recover. After 3 months, I knew it was not improving. I had arthroscopic surgery that removed 30-40% of the medial meniscus. With my time off from running and all heavier leg exercises, my legs were very weak. It would have been a big mistake to start tennis. With the stresses of tennis my weaken muscles might have put my knee in a bad position.

    2) 2011 Left Knee Meniscus Injury - Torn lateral meniscus at the lateral root. The Dr (same) thought that I might recover. He said to take a few weeks off and to ease back and try it. I had that same uneasy feeling and did not want to start back after a few weeks. I took off 3 months. My legs once again had lost strength. I started back very gradually running on a rubberized track. It felt pretty bad at first. Over 1 month it gradually improved.

    As I began tennis again, I requested a posture evaluation and received PT for my posture. My rectus femorus was tight and short and my gluteus medius was weak despite years of playing tennis. The PT helped with these issues and my posture improved. My knee aligned better and I became aware of some of my posture problems and how to correct them.

    After the 1999 surgery, I started doing some gym leg work, presses and calf machine, - strengthening the knee is very important. I could feel the muscles, tendons and ligaments around the knee hypertrophy and support the knee joint better.

    Each time when my meniscus was being treated, the MRIs indicated other cartilage problems under the patella (knee cap). These issues were not the focus during my treatments for meniscus injuries. I recommend that you get the written report for your MRI and read it thoroughly. Identify each term and its condition. My attention is on Patellar-Femoral Chondromalacia, a very common chronic condition. Cartilages do not have many nerves. They can be injured and inflamed and the pain can be low or absent. It is important to head off this type of injury, if possible, because once the cartilage is worn through to the bone, and pain becomes certain, it might then be too late to avoid chronic joint injury and serious arthritis.
    http://www.aafp.org/afp/2007/0115/p194.html

    Tennis is very stressful - I would not start back playing tennis without some leg muscle conditioning at a track or gym (continue your PT). For my 2011 injury, I used a rubberized track and would walk 80 yard and then run 80 yards. After 3 months off, my legs needed the re-conditioning badly.

    There are several issues such as posture that could increase your knee risk in the future. Suggest that you research and discuss with your Dr whether a thorough posture evaluation could be included in your PT. You should get a Trendlendberg Test as part of your evaluation. It takes a medically trained person to evaluate this test and your posture. Also, the PT exercises have to be done as instructed by a medically trained physical theapist.

    My knees usually feel good. I play a lot of tennis and they don't restrict how I play. The meniscus areas generally feel fine but the area under the patellas tend to get achy with a lot of tennis. Feels better when I do the following stretch. I believe what is said applies to me and that just playing tennis does not stretch the rectus femorus. A life style with too much sitting can shorten the rectus femorus. http://www.mrtherapy.com/articles/article3.html

    I've posted on these points in more detail.
     
    Last edited: Jul 14, 2013
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  8. jk175d

    jk175d Semi-Pro

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    I'm happy you've recovered well. I actually didn't need crutches or pain killers after the surgery. I walked around the house gingerly for a couple of days but not bad at all. I was surprised. I feel like today, a week and a half after surgery, I could jog around the block or ride a bike no problem. (not that I would yet) it's still just the feeling that planting and twisting would cause the exact same sensation as before the surgery. Hopefully I'm just paranoid and by the end of July I won't have this feeling.
     
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  9. ollinger

    ollinger Legend

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    ^^ ^^^^^^^^^
     
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  10. Chas Tennis

    Chas Tennis Hall of Fame

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    After I had my knee surgery, my knee remained visibly swollen for a month after surgery. I believe that the arthoscopic surgery itself injects water into the knee. I don't know if the swelling was simply the residual water from the surgery or whether there was also swelling from the incisions, probably some of both. Extra fluids in your knee might might make it feel less secure...?

    In any case, my knee was not normal for some time after surgery.
     
    Last edited: Jul 8, 2013
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  11. NE1for10is?

    NE1for10is? Semi-Pro

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    It takes months for the swelling and scar tissue inside to go down. That's probably what you're feeling.
     
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  12. jk175d

    jk175d Semi-Pro

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    a quick follow-up a week later... now at 17 days post surgery. I still have a little bit of that sense I spoke of, that I better not plant and twist. But it does feel a lot better, and the PT which I've been doing daily has made a big difference. I have much more confidence in my knee and the surrounding muscles feel stronger. I can do extended time on the stationary bike with no discomfort.

    I'm still going to wait for the 4 week mark before I try to get on the court. But as of now anyway, I feel pretty sure I'm on track for that.
     
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  13. jk175d

    jk175d Semi-Pro

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    almost at 4 weeks post surgery. Been doing the PT every day, and icing the knee. Mostly stretches and various leg strengthening exercises. My knee feels noticeably more normal every day. At this point it just about feels 100% but I still get a hint of tenderness once in a while. I saw the physical therapist again today and she upped my routines to include impact and maneuvering drills. My knee felt fine throughout. I think I'm ready to get back on the court but I'll wait till next week just stick to my original goal and to give myself a week's worth of the impact drills first. I'm optimistic though!
     
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  14. jk175d

    jk175d Semi-Pro

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    5 weeks post surgery today. I hit for the first time last night for about 15min. The only problem I had was 3 months of caution has me instinctively moving (or not moving) in a protective way. My foot work felt terrible but I couldn't get myself to trust the knee enough to move normally.
    Part of my caution is that the physical therapist had me doing some impact things last week for the first time. Nothing hurt while doing them, but in the ensuing few days my knee felt more tender and was somewhat inflamed. Though it felt fine again by the time I hit last night and I have no I'll effects today from the short hitting session last night.

    I guess each trouble free time out will increase my confidence in the knee and get me back to normal.
     
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  15. adventure

    adventure Banned

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    I thought you were supposed to wait a bare minimum of two months before even attempting to jog.

    Yet, you are already back with high impact sports (high torque starts and stops) just 5 weeks after surgery.

    No wonder meniscus surgery patients have such terrible results.
     
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  16. jk175d

    jk175d Semi-Pro

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    There is such a wide range of meniscus injuries and recoveries. There is no one size fits all "supposed to" timetable. I'm strictly following my doctor's recommended course of action.
     
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  17. Posture Guy

    Posture Guy Professional

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    yep, at a week and a half there is still inflammation within the knee, and healing still taking place. Be patient, and keep working.

    I slipped on a wet court early last year and tore my right medial meniscus. Was doing light running a week later, hard running at 2 weeks, started some lateral movement and stabilization shortly after that and was back on the court at about the 3-4 week mark. Knee still didn't feel perfectly "normal", but it was close. By 6 weeks I couldn't tell the difference between knees.

    Best of luck with your recovery.
     
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  18. jk175d

    jk175d Semi-Pro

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    I've heard such recovery stories, that's always encouraging.
     
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  19. jk175d

    jk175d Semi-Pro

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    another follow-up...

    It's now been a little over 7 weeks since the surgery. Over the last 3 weeks I've been out just rallying maybe 4 or 5 times. Each time I felt a little more comfortable and less worried about reinjuring. Last night I finally played some points, I played 3 sets of doubles over 2.5 hours. Playing points and reacting to the ball normally helped me get past the unconscious protective movement. I think I mostly moved pretty normally. And my knee felt fine the whole time. I iced it after, and this morning no soreness. Maybe just a hint of being a little stiff but that's it. So I am feeling very relieved and comfortable now that I have been repaired and am ready to go!
     
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  20. tennisnut09

    tennisnut09 Rookie

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    I will have the surgery this Friday (torn lateral meniscus). Your post gives me hope. I am so happy for you. Can I ask how old are you? your age range is OK. I am 45 and it may take longer to recover from this type of injury.
     
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  21. Posture Guy

    Posture Guy Professional

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    I don't think you directed the question to me, but FYI, I'm 52, was 51 when I had the experience above. You can come back from this very quickly if you do the right things.
     
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  22. jk175d

    jk175d Semi-Pro

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    I'm 45 too. ...and a solid 4.5 player. I'm also pretty fit and was accustomed to playing 5 or 6 times a week which I think has helped with my recovery. And the doctor said everything else about my knee (cartilage, bone surface, ligaments) looked perfect, so I'm sure that also has worked in my favor.

    I started hitting (cautiously) after 5 weeks and now after 8 weeks I'm back to singles and am close to normal. My movement has mostly returned, I'm not "afraid" of running down shots anymore, but I can tell I still hesitate to make a quick first step to my right (pushing of my repaired left knee).

    So my advice is do the PT as much as you can, and otherwise work out to stay fit or even get stronger during your down time. And LISTEN TO YOUR KNEE! Be patient about coming back. Good luck!
     
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  23. tennisnut09

    tennisnut09 Rookie

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    Thank you so much for your advice! I also injured my left knee. I will let you all know how it goes.
     
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  24. tennisnut09

    tennisnut09 Rookie

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    day #2 after the SX. Feel like I am doing well and also feel like the knee is not locked anymore. Should know more in the next few days. Anyone can let me know when did you start the PT after this type of injury? Any specific training that I should know. Did you wear any protective equips when you started physical training on your knee?
    Why my DR did not mention about the PT? He said this SX does not cut thru muscle and may not need PT. Should I request for PT?

    Thank you!
     
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  25. NE1for10is?

    NE1for10is? Semi-Pro

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    What is SX? Did you have arthoscopic surgery?
     
    Last edited: Sep 1, 2013
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  26. Posture Guy

    Posture Guy Professional

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    tennisnut....I started going my own rehab on the knee the minute I woke up in recovery. No joke. Nurses were like "what are you doing?"

    "Getting closer to being back on the tennis court", was my answer.

    The surgeon didn't give you exercises to do post-surgery?

    In my opinion, surgeons who don't prescribe either home exercises or physical therapy after this surgery are being negligent in patient care. It's correct, they didn't cut muscles. But in many people getting this surgery, one or more quads tend to shut down and you absolutely want them firing as quickly as possible. There is swelling in the knee that will inhibit full flexion and extension. You want to be working on that immediately. Additionally, a therapist should be doing manipulative therapy on the knee to assist in draining the inflammation from the joint and restoring mobility.

    Your recovery will go faster if you do these things, and take longer if you don't. Surgeons should know this. Personally, I would not use a surgeon for ANY knee surgery who didn't advise this kind of protocol. My recommendation would be to demand a script for PT, then go find a great PT who is also certified in manipulative therapy. I would not use the PT the surgeon recommends, necessarily. It does not sound to me like he understands, frankly, what PT should be doing in a case like this. And not all PTs know how to do manipulative therapy at a high level.
     
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  27. tennisnut09

    tennisnut09 Rookie

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    Yes, repaired the torn lateral meniscus.
     
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  28. tennisnut09

    tennisnut09 Rookie

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    Wow!!! that is what I thought. I will call my insurance tomorrow. I think they provide 6 PT sections or more. I also call the doctor to request a refer to PT.
     
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  29. Posture Guy

    Posture Guy Professional

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    Good luck, hope you end up with a great PT who helps you get back on the court as quickly as possible.
     
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  30. jk175d

    jk175d Semi-Pro

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    I saw my surgeon 5 days after the procedure for a post-op meeting. At that time he said let's get you started on some PT. I set it up and when straight from the Dr's clinic to the PT facility. I ended up only actually going to see the PT four times. But each visit she would give me a variety of specific stretches and strengthening exercises which I could easily do at home. I was very diligent about doing PT every day. Like I said earlier, it was a huge help in recovering well and being ready to transition back to the court. As was just doing upper body and core workouts while I was unable to play for a few weeks. I was motivated by the thought that I'd be stronger when I returned than I was when I had my injury. I play with a OHB and the 4 months of workouts have made my backhand feel better than it ever has (I returned to the court 5 weeks after surgery but it was almost 3 months prior to surgery that I couldn't play but was working out instead)
     
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  31. Posture Guy

    Posture Guy Professional

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    just an fyi, as I said above my surgeon had me doing exercises the day of the surgery at home, and he had me at the PT's office that next morning for assessment and manipulative therapy. The longer you let the inflammation stay in the knee, the longer your recovery.
     
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