Hi,
You came recommended by my strength coach. I am a 52 yr old female. I have been running, hiking, and doing triathlons for about 15yrs. I have mostly focused on strength training for almost 3 yrs. now. One year ago 04/25 I fell at an event doing box jumps (I did finish the race). MRI said I have a tear of the medial meniscus of the right knee and a bakers cyst. I had surgery two weeks ago. They did take a piece of the meniscus out. While in surgery they found that I also had an ACL tear and very little cartilage. They drilled holes up into the femur to allow the bone mallow to drip out and form a barrier between the tibia and the femur. They left the ACL tear alone. Along with the bakers cyst. I was told by the doctor that I would certainly need a knee replacement and have arthritis down the road. I was basically told that the more I do the sooner that will come. I e running, heavy lifting etc…I should also mention I am a mail carrier. I walk about 6-8 miles a day. I have 5 yrs before I can retire. My question is what can I really expect realistically out of this? Obviously I have to work. Will my extra curricular actives speed up a knee replacement and arthritis? Do I need to find a new hobby or cut back to make sure that I can work? WillI I be able to get back to my old self?
Hi there,
Thanks for joining the forum, though I wish it were under more pleasant circumstances.
Regarding your post operative prospects, I think it’s likely you’ll do well given your exercise history and motivation to continue. One of the biggest reasons people end up being limited (and in many cases, have continued pain) is reduced activity. I do not think it’s reasonable to suggest you would be speeding up your time to decrepitude by exercising. Whether you end up needing a knee replacement is a separate question, which will be guided by symptoms. There’s a similar story here, the better (fitter) you go into surgery, the better you do afterwards. If you do end up needing a knee replacement, you’re likely to recover relatively quickly and do well overall.
Still, I can appreciate that the narrative here wasn’t great. “Look, you have all these things structurally wrong with your knee. You’re gonna need a knee replacement!” It’s only logical that your take-home message would be that your knees are pickled and it’s because of what you’ve been doing to them. The old wear and tear argument. We - and the existing scientific evidence - know that’s not the whole story.
We cannot give you medical advice here, but generally speaking, avoiding challenging, progressively loaded resistance training would be a bad idea. Same thing with conditioning, though managing the total training load around any symptoms and your personal capacity (ever-changing) is important.
For peace of mind and structured guidance, it may be beneficial for you to consult with our pain and rehab team. You can reach out via support@barbellmedicine.com.
-Jordan
Hello, I would agree with Jordan that this would likely be better suited as a consultation to speak through your entire history, both medical and training, and get a plan in place. From the brief description though, it does sound like you are crushing attempting to stay fit. I would disagree with the comment that you would certainly need a knee replacement as well and if that should happen to be the case, as mentioned above, the stronger and more fit you go into the procedure, the better individuals tend to do post. You likely had the recent procedure to continue living your life how you want to and there are certainly steps to help facilitate it that do not involve additional procedures. It sounds like you had a meniscectomy and a microfracture so there may be some short term restrictions as the microfracture heals, but those restrictions lift as you get into the later phases of rehab.
To your specific questions, plenty of athletes continue doing their sports after these procedures and do so for a long time with minimal to no issues. It is always impossible to say what any one person will experience, but I will say there is certainly plenty of hope to returning to prior levels. There are no contraindication for running, hiking, or triathlons long term after surgery. It is probably better stated regarding the expectations of what is the plan for returning to those activities. To your point, it is going to be some work and some patience as well. That being said, there are plenty of paths that lead to you continuing sports and I would encourage to to aim for that return. It would likely be high yield to make sure you have guidance for that path, from someone who has helped athletes return to sport before. Meniscectomies tend to be relatively straightforward from a rehab process and the microfracture often depends on the location and size. They can have a few hiccups through the return to sport phases, but still can succeed.
To the question about the extra curricular activities, participating in them will not speed up the need for a knee replacement. It is more a question of how much, how often, and how hard you are doing the activities that would make them beneficial or problematic. There aren’t bad hobbies so much as occasional bad plans to get back to doing a hobby. I absolutely think you have good potential for getting back to your old self though.
I will say this, with the amount of walking you need to do for your job, it is worth paying attention to any residual swelling that is occurring as things settle down and you return to your activities. That, combined with symptoms tends to be the best guideposts for if someone is doing a bit too much too soon. It is titrating the activities you need to do for work, with the activities you want to do for leisure. If you want some assistance, Charlie, Cam, or myself would be more than happy to help through the process.
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