FlashBazbo

I've been diagnosed with a degenerative meniscus and arthritis in my knee. Until this year, I rode 7500+ miles per year and raced gravel races including the Dirty Kanza 200. Very rarely any knee pain at all, and never severe. This year, after a shoulder reconstruction, I got back on the bike only to experience severe knee pain for the first time.

The knee only hurts when I'm on the bike and it begins gradually but the number of miles before the pain begins keeps dropping. A couple of months ago, I could go 50 miles before the onset of severe pain. Last weekend, I made it 6.5. I can walk and do anything else without any pain at all. The knee never locks or catches or gives way or pops.

I've got a great surgeon and his recommendation is just to "clean out" the knee. But the medical studies I've read indicate that surgery, with a degenerative meniscus, works pretty well for day-to-day mobility (which isn't a problem) but doesn't really -- statistically speaking -- do much for higher-effort mobility (like running or bike racing). I hate to risk pain-free walking (and endure months of surgery rehab) if the surgery isn't likely to help the cycling issue.

Has anyone else had a degenerative meniscus (without a big tear -- just a worn out meniscus) on which you had the joint "cleaned out?" Did it help your problem? What was your experience?

I love cycling but, if the surgery isn't likely to help the problem very much, I may as well hang it up now rather than waiting until after surgery to hang it up. I realize that people who had to give up cycling aren't likely to be on this forum, but what are your experiences?

FBinNY 

The fact that you can walk without issues is a good sign. If you can do so for an hour or more, and/or go up and down stairs OK is even better. Under those conditions, you should be able to ride without issues also, since, cycling (done right) is easier on the knees than walking, and certainly easier than running.

It is possible that you're pushing high gears, have you changed anything in the last year or so, including shoes? Don't give up yet, try some experimentation, spin lower gears, make a small adjustment in saddle height, try riding with street shoes on regular pedals, etc. and see if anything improves things. If so, that will point a direction for further research and possible resolution of a fixable problem other than your knee.

BTW- I had/have a meniscus issue in one knee. Because I was managing OK the surgeon suggested passing on any surgery and taking a wait and see, except no bike riding. I tole him the bike was the only time the knee didn't hurt, so he said ride the bike and see what happens. So far so good, Periodically I have pain walking and serious pain going down stairs (up is fine), but these pass with some ibuprofen.

deapee

I had to give up running from an ankle fracture. I just feel lucky that I can walk fairly normally. I switched my focus to cycling, which is like the one thing I can do without it bothering me. That being said, sometimes we have to make switches to accommodate our bodies. When first coming out of the fracture, I spent a lot of time on a recumbent stationary, and it felt easier on the joints overall...maybe there's some geometric differences there that shift the pressure from the knees (so maybe look into a bent). Worst case, swimming might be fun to get into.

I like what FBinNY says also -- that cycling should be easier on the knees than walking and running -- maybe you need a professional fit -- maybe a slight cleat adjustment or a fore/aft is all that's needed. I'd be willing to bet that if you found a person that would do the fit, you could come back a few times to give concerns and get tweaks.

Either way, unless a professional athlete or a restriction severely limits daily mobility, I'm pretty against surgery...but that's a very personal decision, and one that I wouldn't attempt to make for you.

1989Pre 

I do not know if my knees are "degenerative" as-such, but I tore my meniscus 2 years ago and I am riding just fine, with the help of an ace bandage. I might even splurge and get a knee brace, if I need to. I am in your corner about being suspicious of surgery. Don't let them mess with your knee. Doctors are bozos.
I wouldn't believe, necessarily, either your diagnosis or prognosis, as well.
Your shoulder surgery may have mis-aligned a few things, so I suggest therapeutic massage in combination with polarity therapy. Definitely use natural remedies.
Right now, try an ace bandage to see if that helps support the muscles of the knee. It will not only help prevent pain, but it will give the knee the rest and muscular development that it needs to heal.
You're not finished yet.

1989Pre 

Yep.., I had to give it up from the meniscal tear. I am elated about it, because I saw how much I had to lose and could have lost (my mobility). All the cycling and fast walking I want? I absolutely have no problem with that. I loved running, but if something threatens to take my legs away, I draw my line.

FlashBazbo

Thanks for the quick input. We've tried different intensities, Zone 1 short easy flat rides, athletic shoes on platform pedals, changed pedal types, up/down vs. back/forth pedaling technique, and video analyses of my pedal stroke. We've adjusted cleats and saddle to try different fits and I changed cranks from 175mm to 170mm. I've done physical therapy. Extended rest. Anti-inflammatory drugs. We've even tried, "Maintain your normal intensity and duration" for awhile in the interests of science. Still, the only place my knee hurts is on the bike. (Yes, I know that bike riding is generally lower impact than most activities, but it appears my meniscus wear /arthritis is in a location where it doesn't impact any activities except in that motion -- specifically coming over the top of the pedal stroke. For me, at this point, cycling is the worst thing I can do. It makes the problem worse. And I'm not sure how trimming out more of my meniscus helps that.)

Maybe there's just a limit to how many cycling miles my knee could take.

deapee

I'm going to have to agree with you. I think the only thing surgery can really help is removing excess scar tissue (and obviously some other bone growths that interfere with how the bones slide in their joints, as well as other obvious surgery-requiring issues with soft tissue, etc) -- but I'm pretty weary of anything a doctor says, for the simple fact that if they never recommended surgery, they'd never perform surgery, etc. That being said we also know when all other options have been exhausted and a problem interferes with our daily lives -- or the thing that we love.

I know I have a scar tissue problem in my ankle joint now, and I also know that the whole joint is tightened up a bit. I've also noticed that hammering on it does create inflammation, but there is a marked, but small, improvement following a rest period. I *don't* think that your knee is a good example of that for many reasons, which are probably pretty obvious, the most important being that I suffered an acute injury which marked the onset of the condition.

Well I'll be following along, hopefully you find some relief.

Biker395 

This thread is depressing.

I've had meniscal pairs trimmed in both my knees. So far, so good.

peterws

You mentioned shoulder reconstruction. Sound serious enough to keep you off the bike for some time on its own.
You gonna have to give this more time to get back into things slowly. Bit at a time, but regular, stop before serious pain develops. Shouldnt have to tell you that last bit. . .I been doin that wi my foot lately and its coming along. Slowly!

berner

I would give some sort of an elastic brace a try since such a remedy is comparatively inexpensive. When my troublesome knee acts up, I tape it up. Kinesiology Tape | KT Tape The tape can be left on for several days, even while showering and is comfortable. There are numerous videos on you-tube on how to use it.

loky1179

I'm pretty sure I have a meniscus tear in one knee. Please don't say they come in pairs

hanknstein

Have you tried Glucosamine/Chondroitin? It works for me. I have 2 bad knees & had to give up running, but have been able to cycle regularly. If you knees hurt only when you ride, then you can probably tweak your positioning. Some days when one of the knees are bothering me, I back off the pace & after 15 min - 1/h hr, the discomfort goes away.
Good Luck!

JohnJ80

I'd follow the recommendations of an orthopedic surgeon in conjunction with a sports medicine doctor. I'm sure that between the two - especially if the surgeon is state of the art AND works with athletes will come to a good solution. Might also want to get your PT in there as well. Having a family of athletes, I can tell you that it's *very* important to work with specialists who have experience with athletics.

While I don't know how it applies to cycling, but I do know of several world class athletes (skiing) who have aged and gotten full knee replacements and swear they are better than the original equipment. But again, the experts on this would be the MD team above.

J.

RonH

See a sports medicine doctor. I've had meniscus tears repaired in both knees (2007, 2010) by a sports medicine doctor. After the surgeries he told me I could ride till I was 100. Got 29 years of riding left.

dachshund

I have arthritis and it creates bone spurs. At 58, after riding most of my life, my left knee would swell and hurt after any activity. I had worn away the cartilege, and my ACL was shot as well. I probably had more damage than you, but my only option was a total knee replacement.

I got this diagnosis in February 2014. I scheduled surgery for December, got a joint fluid shot to give me some time, saw a physical therapist, and rode through the summer and fall. Now - my knee didn't hurt while riding, and our conditions are different. But I was able to start riding a few months after surgery, and I'm back riding hills and distance now. So if you have to have surgery, it may not be the end of cycling.

Can you get a couple of more opinions?

FlashBazbo

UPDATE: Yesterday, I had an appointment with my surgeon and got good news! It turns out that the person who called to give me my MRI results and set up the appointment gave me the wrong results! (I wonder who received MY results!) It made for a very awkward first 20 minutes of our appointment. We were on completely different pages. My surgeon is the #1 sports medicine guy in Nashville. He's the head team physician of the Tennessee Titans.

New diagnosis: Possible flap tear in the meniscus combined with a lesion on the underside of the kneecap. The tear doesn't show on the MRI because the knee is stationary. He believes the flap opens during the pedal stroke and irritates the lesion by rubbing / snagging across it. He wants to clean up the meniscus tear and repair the lesion under the kneecap.

Prognosis: He said, "You want to ride a bike 7500+ miles per year and race in ultra-endurance gravel races. We are going to make sure you can do that." He said to expect 2 or 3 days of limping post-op and to be walking normally after that. He also said I should have 15 more years of ultra-endurance cycling on the knee, once it is repaired. That's obviously very good news.

Surgery happens in 3 weeks. And I'm looking forward to it. Very glad this was a false alarm.

dachshund

Great news!! Congratulations!

sgtdirt

both knees scoped for meniscus tears, that was about 5 years ago. hasn't slowed me down at all. give it rest for a day or two, then ease into walking on it.

FlashBazbo

I'm curious. For those who have had a meniscus tear repaired, how long were you off the bike before they would let you start easy riding again?

sgtdirt

at the time, i wasn't biking that much. i did run on it - more like fast walking- about three weeks after. at the physical therapy office, i road the stationary bike as a warm up. i had the procedure done in the winter so i wouldn't be miserable wanting to get outside and be active. being inside and snow bound, made me focus on recovery more so than anything else.
i thought that having my knees scoped was going to be the tip of the downward spiral. wow, was i wrong. like i wrote before, it has no effect on ANYTHING i do. i workout with weights just as hard and ride even harder. only on very, rare occasions will they swell or get stiff but what the hell, i'm over 50!

get the surgery and move on. if you're in good physical shape, you'll be on the bike in short order.

Biker395 

A few weeks or so. I think it's faster for cyclists. I surprised my PT a couple of times.

1. The sessions always began with 15 minutes of cycling to warm up. Hey, I figure as long as we're doing that, I'll ride my bike to the therapy session. Got a sideways look with that one.

2. Once I was making significant progress, I asked the PT if I could ride my bike that weekend. He thought for a second and said "Sure."

Monday afternoon, he asked me how it went.

"Great! We started riding up Little Tujunga, went over the pass to Acton and came back around Little Tujunga ... It was great!"

Holy crap ... How far did you go?

80 miles and about 8000 feet of claiming.

"How does the knee feel?"

"Great!"

"OK ... We're done. I'm signing you out after today's session."

JohnJ80

For me, it was 5 days. I had a small tear (15%) from the side (radial). So no big deal. The time off is going to depend on a lot of things but most especially the severity of the tear and the type of damage. Horizontal and "bucket handle" tearing is a bigger deal. Google it - you'll see how widely the extent and type of damage varies.

J.

mrx8

Have you tried switching to flat pedals? My knee pain went down significantly when I switched back from clipless to flat pedals. Even pulling up on power straps on flat pedals aggravates my knees, so I stopped. I'm still struggling with some knee pain, but my 2c is that flat pedals are another variable to consider switching up.....

FlashBazbo

UPDATE: I had knee surgery Friday. Lots of cracks in the bone, swollen / rough lining under the kneecap, and a big tear in the meniscus. I've been walking fine since the surgery (and always did before the surgery). A little swelling and not much pain at all. The surgeon told my wife, "if he was cycling on that knee, he's a pretty tough hombre."

Thursday is my follow-up appointment. Can't wait to find out how this goes.

loky1179

So, how did it go?! We want to know.