UKC

So it looks very likely that I have knackered my knee.

As a bit of background, I had a meniscal repair on a bucket handle tear on my right knee medial meniscus back in 2009. My left knee has been playing up for a fair while now, had an MRI earlier in the year which showed an oblique tear in my medial posterior horn? Desperate to not have more surgery due to heading to Yosemite in September, I carried on training and everything was fine. After the Cuillin Ridge a few weeks ago it was feeling a bit tender and then on Monday I think I properly knackered it bouldering indoors.

I am now having some pretty painful 'locking' in the joint which I have heard people talking about but never experienced before myself. Am I right in thinking that the locking is most likely due to a loose piece or a flap of cartilage getting stuck in the joint? I am getting a little concerned that I fly to America in 7 weeks time.

So my questions are...

Are there any kind of exercises I can do to help right now?
Is surgery the only answer?

Help!

In reply to maybe_si: The answer is here: http://www.bbc.co.uk/programmes/b061tfmp

In reply to maybe_si:

I would say surgery, now. If you're locking (been there), there's a very good chance you've got a flap, which is less likely to heal conservatively - and given your timeframe, more likely to still be a major issue in 2 months time.

I've had 3 arthroscopies, one on right and two on left. The first one was for a flap which kept locking and I was fine well inside a month - probably a fortnight, but I was being cautious. With the other two procedures, it was a week or two each time, but they were just trims and I've since come to realise that they *probably* weren't necessary.

What does make a huge difference, though, is trimming any excess weight. I've got a grumbling cruciate on the left, and the severity of grumble is usually associated with how lardy I've got; I'll be doing some trekking this summer, so just lost a stone and the pain is mostly gone.

I think if you leave it, you run the risk of a ruined Yosemite trip.

In reply to maybe_si:



Having torn cartilage in both knees, my understanding is the locking is due to either floaters or part of the torn flap. If the former, there is a thought to leave alone and wait and see, or operate if it is really bad enough (had that on my right knee which I believe had both floaters and a torn flap). The floaters can apparently disappear over time and this is why I understand orthopods only want to operate if locking is significant. If the latter, ie torn only, again it will depend on the extent of the flap and how much locking and whether it will heal or detach. Therefore surgery is not the only answer to mild cases or so I'm told.

Exercises are strengthening ones, flexibility ones, and stretching is important. Best get a good Physio for that, but mine gave strength, stretching and proprioception excercises. Rehab excercises were identical for operated knee and non operated one.

Knowing what I now know, I have doubts that I would have agreed to have the right knee operated on at the time. Of course there were other negative spin offs that cloud my thinking - ACL found to be not working and having stretched everything else during the op it took two years to get fit enough to be back in the hills and four years to fully be able to use the knee again without a working ACL, and now OA is present. On the other hand the left was left alone, and after the initial problems it healed itself although it also has OA!

It is not the previously torn cartilages that cause me any restrictions now hence why I would have doubts of an op, but unfortunately the OA does. Of course the right may have in medical terms been significantly worse and "needed" an op, but who really knows!

The big question for you is can you function to a level that suits you by leaving alone? That's what I would ask myself now if I could wind the clock back! If the locking is too frequent or severe, then your in a no win as leaving alone even if it may cure itself may well stop your holiday, as could an op (depending on what is found) if it was done now. Can you keep fit enough to go on holiday and postpone the decision?

Sorry not particularly helpful reply. Someone qualified will no doubt answer you questions with more authority.

In reply to maybe_si:

When I had a similar locking issue (after riding 650 miles) I rested completely for a week, by which time it was much better, doc gave me anti inflamatories to help, and 2 years later I'm happily riding shorter distances up to 100 miles with no issues. doc thought essentially that inflammation was causing the torn bit to stick out more into the joint.

whether this works for you probably depends on your exact tear though.

In reply to maybe_si:

This is all great thanks, anyone else??

In reply to maybe_si:

Sounds like what I have.

Tore mine when I broken my knee cap many many years ago I was nnever operated on as I was a kid at the time and I don't think it was the done thing back then.

Jump forward 20+ years and my knee has the tendancy to lock without any warning due to a floating particle within the knee joint. This happens on a fairly irregular basis but when it does the pain is incredible. Most notably it happened on a sport route in Kalymnos at a knee bar rest and I felt it go. Tried unsucessfully to free it on the route and eventually came down where my climbing partner helped me manipulate the joint and free it with an audiable clunk that made me heave and nearly pass out.

My advice. If surgery is on the table get it done. I still haven't been given the option.