Meniscus Injury

[jickman]

Hey everyone,

I want to share my situation right now and hopefully to get some feedback if any of you had a similar situation. My case goes back to February 2015, when i injured my knee from training. It happened while i was doing a overhead jumping smash (these smashes takes alot of lower body strength!) i landed and felt my knee hurting. Overtime, i went to see a (PT in training - school ones) which thought it could be a slight ACL strain because everytime i do a sudden pivot i feel something not right or moving. Overtime, the injury subsided. I can fully move my knee in all directions, was not lock, but just when i ran it didnt feel about right. Carrying on forward in July I played badminton and on a match where i did a slight jump smash, this time i felt it. My knee was locked and swelling and i felt quite alot more pain than my first injury.

This time I went to a real physio therapist and he quickly knew it was a medial meniscus tear. He recommended me to get MRI to see how severe the tear was. His early suspicion was that the injury i had before was also a small meniscus tear or misplaced which cause extreme pivot and twist to be irritating.

Fast forward a week after, he noticed a substantial improvement and does not think I need surgery because of the speed of recovering. Overtime my knee has been improving every week to now having pretty much full range motion except when I try to extend my knee extreme straight I still feel the same slight pain. I've got the "go" to play badminton to test my where my range lies.

I do feel I've gained alot more mobility and to the point almost back to normal but I feel I can easily injure it again. Now the problem is, the PT does not believe I need surgery. But on the safe side i want to get an MRI to see the true condition of my knee. From injury until now its been 7 weeks, should I wait and trust my PT that all i is need more strengthening on my knee and i'll be back to good? Or should i just schedule a MRI and see a ortho doctor to be more confident on the outlook of my knee? I'm pretty sure on the safe side is to get an MRI and know what most people would recommend. Just want to see if any of you had similar experience, and ended up just continuing on with non-surgical treatment and eventually heal back to 100%. Or you took an MRI and ended up with arthroscopic surgery. Should I give it more time on the phyio treatment?

Sorry for the long story, but i feel like i have to give some background context to make the whole story clear.

Thanks

 

[VegiSmash]

Why not get an MRI while waiting it out? It is just additional info without having to commit to surgery (I had surgery for medial meniscus tear, recovery was excellent).

 

[visor]

Agree, never hurts to get an MRI. Only problem is the wait time for booking.

Even if there's meniscal tear, if it doesn't lock on you or cause pain with squatting, then surgery is not indicated.

But one word of warning, any further injury to it (ie pivot with weight), can make the tear worse by extending it further like a rip thru a piece of cloth...

 

[jickman]

Agree, never hurts to get an MRI. Only problem is the wait time for booking.

Even if there's meniscal tear, if it doesn't lock on you or cause pain with squatting, then surgery is not indicated.

But one word of warning, any further injury to it (ie pivot with weight), can make the tear worse by extending it further like a rip thru a piece of cloth...

I can definitely see your concern which is always my concern right now. I'm going to continue strengthening my knee especially my VMO and wait until i get my MRI booking. Definitely after physio my knee feels more stable than my first injury. I'll probably play a bit but without doing any jumps. Anyone have recommendation on braces?

 

[Cheung]

I agree with getting an MRI. There is no urgency so the waiting is irrelevant.

Some people like to know what is going on within their knee (actually most of us would!) and it does no physical harm.

I think the OP would like to know his risk of re-injury with the meniscal tear.

 

[jickman]

Exactly what Cheung mention. I'm playing at a low intensity level and if I know if I scale it up and I can easily re-injure it I rather not take that risk. What lead me to discussing my situation here is that I read few recent article that arthroscopic is not helpful. I want to know given my age and I want to stay active. ( I'm 23 BTW).

 

[visor]

You'll just have to scale it up gradually.

And one word of caution : don't play too hard when you're near exhaustion (eg. end of the session), because that's when footwork gets sloppy and injuries have a higher chance of occurring.

And psychologically, you'll just have to gradually overcome that fear of that round the head jump smash in that rear backhand corner that originally caused you the injury.

 

[Cheung]

Exactly what Cheung mention. I'm playing at a low intensity level and if I know if I scale it up and I can easily re-injure it I rather not take that risk. What lead me to discussing my situation here is that I read few recent article that arthroscopic is not helpful. I want to know given my age and I want to stay active. ( I'm 23 BTW).

If you are moving without pain and have full range of movement and strength, no surgeon is going to go into your knee to fix anything. But, what he can do is tell you and explain to you more about the injury.

MRI will tell you the damage. The risk of re-injury is very subjective because what can you do? If there is an injury, do you change your lifestyle so you never do anymore high intensity sports? Do you stop skiing? Do you not go ice skating? It's even possible to run down the stairs and tear your meniscus! I definitely know that can happen because it happened to me. The knee swelled up and I was limping around for two weeks. I did get a MRI, and I did have a tear. Hmm, the ortho surgeon told me not to do anything because I could still walk around but I was worried I wouldn't be able to play high intensity badminton. After taking some time off, I started playing properly again. I did get back to singles for a while. Due to various reasons, mainly time to train, I only play doubles now. I could have given up the game but I didn't and I still got a lot of enjoyment out of the game, playing hard badminton and getting the odd lesson here and there.

In short, I didn't let the injury restrict my lifestyle. I did do some skiing and snowboarding (prefer the snowboard) post injury and survived If I am going to be injured, I will make sure it's because I was doing something worth doing rather than just walking down the stairs.

 

[jickman]

If you are moving without pain and have full range of movement and strength, no surgeon is going to go into your knee to fix anything. But, what he can do is tell you and explain to you more about the injury.

MRI will tell you the damage. The risk of re-injury is very subjective because what can you do? If there is an injury, do you change your lifestyle so you never do anymore high intensity sports? Do you stop skiing? Do you not go ice skating? It's even possible to run down the stairs and tear your meniscus! I definitely know that can happen because it happened to me. The knee swelled up and I was limping around for two weeks. I did get a MRI, and I did have a tear. Hmm, the ortho surgeon told me not to do anything because I could still walk around but I was worried I wouldn't be able to play high intensity badminton. After taking some time off, I started playing properly again. I did get back to singles for a while. Due to various reasons, mainly time to train, I only play doubles now. I could have given up the game but I didn't and I still got a lot of enjoyment out of the game, playing hard badminton and getting the odd lesson here and there.

In short, I didn't let the injury restrict my lifestyle. I did do some skiing and snowboarding (prefer the snowboard) post injury and survived If I am going to be injured, I will make sure it's because I was doing something worth doing rather than just walking down the stairs.

Hey Cheung, if you don't me asking. We're still able to play at the same level after? I know jumping is a big no no for torn meniscus. I'm just really concern how likely am I to tear it again playing Badminton. I experiences a tiny pain when I try to extend it full straight. The feeling it's more like really tight with a little pain.

 

[Shuffler]

Exactly what Cheung mention. I'm playing at a low intensity level and if I know if I scale it up and I can easily re-injure it I rather not take that risk. What lead me to discussing my situation here is that I read few recent article that arthroscopic is not helpful. I want to know given my age and I want to stay active. ( I'm 23 BTW).

If we're reading the same articles, I believe the studies have shown little value for individuals with chronic knee conditions (arthritis, etc.) to also have arthroscopic surgery. I think there is still value for those with traumatic injuries to consider surgery.

My experience is actually quite similar to yours, jickman. Tore my medial meniscus playing badminton on March 1st of this year. Started pt about 2 weeks later. Got hinged brace which I quite like (Breg brand. something like this: http://www.braceshop.com/breg-shortrunner-knee-w-adjustable-horseshoe.htm). Got MRI in June which confirmed tear. Also returned to badminton in June. I continue to play, and with increasing comfort/confidence. Considering trying to play without brace soon as knee is feeling quite stable and totally free of swelling.

My experience in short:
- 3 months of no playing
- 5 months (and counting) of PT exercises
- 5 months until swelling and limited motion fully resolved
- No plans to seek surgery at this point.

Not an easy route, but worth the effort.

My biggest problem know is that I can no longer honestly blame my poor play on my bum knee!

 

[Cheung]

Hey Cheung, if you don't me asking. We're still able to play at the same level after? I know jumping is a big no no for torn meniscus. I'm just really concern how likely am I to tear it again playing Badminton. I experiences a tiny pain when I try to extend it full straight. The feeling it's more like really tight with a little pain.

[MENTION=37254]jickman[/MENTION]

I am not an elite athlete and since I am getting older, other physiological factors stop me from playing to the same level.

But, post injury, I did play and train singles. I reached the last 8 men's singles of HK annual championships over 35's. I lost to a former national player (ex full time).

Just this year, I entered the men's doubles of the same age division and again got knocked out by ex full time players in the last 8. And this time, I am giving away a lot of years!!

Your tightness might be due to some medial collateral ligament damage if it is at the back of the knee. Basically, I had medial meniscus tear and medial collateral ligament damage. I would get a reactionary tightness in my hamstrings. Sometimes it would really hurt. My medial collateral ligament damage was undiagnossd until I saw an experienced Sports physio. After her treatment and doing the exercises and stretches, things got good enough for doing my jumps in singles (not super high). And, I haven't reinjured the knee!

 

[Accordaz]

don't play too hard when you're near exhaustion (eg. end of the session), because that's when footwork gets sloppy and injuries have a higher chance of occurring.

This is an advice every player should take to heart.

If you're exhausted, the whole body works slower / worse. It is not only the legs or the feets. It is also the trunk which doesn't work appropriate anymore. A good working trunk is extremely important for the balance. The worse your trunk is trained or exhausted, the more your legs and feets have to work / balance out your movement(s).

My ACL injury was somewhat of typical for a fast&furious-minded player: Overhead-Jumpsmash *lol* I've jumped in semi-final of a men's doubles tournament in the rear court area from the forehand- to the backhand-side while doing the Overhead-Smash. The crack was pretty loud and audible :crying: Oh gosh, I' fell on the belly at first before I turned myself with the back to the bottom. Not a nice memory in my life...

Well, the adrenaline I had gained a point before was also an account why I've done such a incredible (and stupid) shot. Next to the belief in myself that I'm still a young sporty person who still can play while totally exhausted on the first tournament after 3 weeks (vacation) without doing any sports

Oops... Sorry for my long story.
[MENTION=37254]jickman[/MENTION]: I highly recommend you to get a MRI appointment. Trust is good, control is better.
You may recover fast and think it's good. But there is a chance that it isn't that good and you're damaging your meniscus more... So, is it worth to recover faster and pass on the MRI? I don't think so.

Ortho doctor: Trust him/her in regard to facts (which a MRI brings), recovery / surgery recommendations; The doctor is/should be the expert.
Physio therapist: Trust him/her after the choosen solution. After a surgery or after the decision of strengthening without surgery the PT knows your condition much better than the doctor. The PT has a lot more experience in walking through the recovery with patients.
These are recommendations based on my own experience. Not all doctors make the right decisions, sadly. Example: A colleague of mine was advised to strength her knee instead of a surgery. She had to pause two seasons, because it was a wrong decision from the first doctor she attended.

An ACL rupture can also be existing without knowing it, I've heard. And if you're not a kid, you have no chance that a ACL will recover by itself, since the ligaments are ruptured. Well, I hope it isn't the ACL in your case.

I hope you get well soon!