I’m a former runner though I bike, swim and lift weights too. Last spring occasional knee stiffness went from bad to worse when an MRI showed a non-displaced tear of the posterior horn of the medial meniscus.
Physicians and physical therapists told me to stop running and be happy I can bike and swim, but I haven’t seen a medical specialist who is a pure knee guy. At age 57, I know the “tear” is a degenerative process, not an acute injury. Is this the end of running for me?
Thank you, Alan
The management of degenerative osteoarthritis of the knee has changed a bit over the last decade based in part on a 2002 New England Journal of Medicine article comparing knee “clean up” procedures against a sham knee procedure. There was no difference in outcomes for pain or function between sham, arthroscopic debridement, and “wash out” lavage of the knee joint. From my perspective, the degenerative, age-related tears that are in the long axis of the meniscus do not seem to show benefit from the surgical intervention and, at least across big groups of patients, should be avoided. Tears in the radial axis of the meniscus that are catching, locking the knee, and causing knee swelling may be a different story and may be similar to the traumatic tears seen in younger athletes with surgical intervention.
So what is an older active person supposed to do? The usual advice is to look for alternate activities that feed your exercise needs and do not flair your knee pain. I am in your age group and have had to make similar decisions. I shifted my focus away from running to inline skating, Nordic skiing, kayaking, and rowing, reserving running for travel to get outdoors during conferences and out of town meetings. This worked well, until I tore my ACL in a downhill skiing accident and added to the underlying meniscus damage. Now I have had to drop running from my activity list and I have rediscovered my bike and walking, and I use the hotel fitness centers on a regular basis.
Although I had a strengthening routine that I used daily prior to the injury, I have really beefed up the program up with the help of my physical therapist with more emphasis on glut strength and keeping the core muscles strong to give me better control of my gait. I also look for alternate ways to strengthen the legs and core, like side stepping up stairs and waking backwards on my walks.
So, it seems that your physicians and PT are guiding you down the accepted pathway for osteoarthritis changes in the knee and that you have some activities that can fill your fitness needs. “Be happy” seems a put-off at times, but then again biking and swimming are not the worst alternative. I have friends with similar knee findings who choose to run with the pain. I cannot say that they are accelerating their path to total knee replacement or not, but I, like your providers, recommend they find other activities that do not cause them so much difficulty.
I hope this helps.
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