Knee Pain
 

After 75 years of trouble free service, my right knee has failed me. The pain is severe, making it necessary for me to take Aleve. After the MRI, the doctor called me explaining the situation. Torn Meniscus and arthritis. My first treatment will be gel shots. If that does not work, and I want to be pain free, a knee replacement will be necessary. I am now able to walk with discomfort. I biked 20 miles a few days ago. Afterwards the pain was severe. I would appreciate feedback, and if possible, cheering up.

I know a rider with bone on bone in both knees. He takes a lot of ibuprofen when he wants to ride, and rides in a low gear at a high cadence. So is the severe pain from the meniscus or the arthritis? I've had a torn meniscus and yes, the pain was severe. I had an operation to snip the meniscus, no more pain. My knees seem to have relatively normal cartilage. Is your doctor an orthopedic surgeon? If not, get an appointment with one for evaluation. Do you know how you tore the meniscus? Since the pain was sudden in onset, my guess is that it's the meniscus tear. And how bad is your cartilage?

This doctor is not a surgeon. 6 years ago I had the meniscus snipped off on my other knee. That doctor as well as my present one said that at my age, they only do surgery if the meniscus tear is in the joint. The MRI found significant arthritis.

I don't know that this will be particularly helpful, but I was a runner for more than half a century and had to give it up because of knee problems. X-rays and CT scans show advanced arthritis in both knees. I had almost constant knee pain, even when lying in bed, which interfered with my sleep. So I gave up running and started cycling almost five years ago, and I have minimal knee pain since then. I think the cycling actually helps my knees by flaxing them without the impact of running, or even walking. (I get knee stiffness and soreness even from long walks, but not from cycling.) Are you sure the cycling is hurting your knee, or could it be other activities? Meanwhile, I know many people who have had knee replacements and are doing well with them so if it comes to that, it's not necessarily a bad situation. In my case, I feel that cycling has kept me from having to have a knee replacement.

I am not really sure since I also do a lot of walking.

At the extreme risk of starting a big fight, I'll suggest you might take a look at getting shorter crank arms. 165mm are what I use and they allow me to get more aero comfortably. Possibly the shorter cranks will not require as much range of motion for your knee.

However, with a pending knee replacement, you might find out that you wish you'd had it replaced years ago. My brother-in-law recently had one replaced after years of putting up with the pain and that's what he wishes he'd done. Though he doesn't cycle, so I've no reference for that.

​​​​​What about looking for another doctor or surgeon - one who's willing to consider your current and preferred lifestyle, rather than just your age.

WTF? But they'd do a TKR? Money, money, money. After my snip, I was back doing group rides (in the back) in about a month. That was maybe 20 years ago. Maybe a surgeon who deals with athletes? We've not normal people.

If you can avoid knee replacement, and you're athletic, avoid it!

Knee replacement (TKA) is very good at reducing pain from osteoarthritis, but it does very poorly at improving knee function. In particular, range of motion of the knee joint is almost always reduced after surgery--even following months of rehab therapy.

"This study indicates that, preoperatively, individuals with unilateral knee OA [osteoarthritis] have deficits in strength, ROM [range of motion], balance, and function compared to healthy adults. Following TKA [total knee arthroplasty], deficits in strength, ROM, and function became dramatically worse at the 1-month time point, despite initiating a standard rehabilitation protocol the day after surgery. Patients recovered to preoperative levels by 6 months after TKA in all measures except knee flexion ROM. However, they still exhibited the same level of limitation that they did prior to surgery, compared to healthy adults."

Bade et al, Outcomes Before and After Total Knee Arthroplasty Compared to Healthy Adults, Journal of Orthopaedic & Sports Physical Therapy, September 1, 2010

As I previously stated, my first treatment will be gel shots. I need to reduce the pain. I doubled up on the Naproxen and that provided for a much better night. I really don't want to use that long term.

Yes, shorter crank arms reduce range of motion at the knee. I put 155mm arms on my wife's bike when she started having knee problems.

My experience is not as serious as yours but maybe helpful in some way. I had fairly unsuccessful torn meniscus arthroscopic surgery at age 20, that was 52 years ago on a knee and now have osteoarthritis in hands, wrists, knees and just recently coming on in the lower back. I can still ride my bikes but with more work on stretching and have focused on reducing vibration, tires, anti-vibration gloves (not cycling gloves), fames/fork, more compliant wheels, saddles, & bars (carbon). I keep rides in the 20 to max 25 mile distance every other day and find generally no negative effect and if a granddaughter drops in I can take a ride on a rest day with little if any negative effect. On bad hand, wrist days I now ride a recumbent trike. It is great for the hands/wrists and back and is too early to be sure but may not be easier on my knees. When I get a flare up I have found what is best for me is a day or two at the most of indomethacin and I am right again. Never found much help with the over the counter NSAID pills and none with the NSAID creams.

I had a problem with seatpost slippage. I wonder whether that could be a factor in my knee pain. Today I walked 2 miles with little pain. The last time that I stopped the Naproxen, the pain returned and I had a unpleasant night

Low saddle definitely can cause knee pain.

I have trouble on the titanium frames and aluminum posts so use carbon assembly paste or if that does not do the trick a little valve grinding compound mixed in grease stops the slip.

You should definitely see a sports orthopedist. They are more likely to understand what you want. If nothing else, get a second opinion from one. I'm currently recovering from meniscus tear arthroscopy and should be back on the bike in a few weeks.

I am 65 and have severe osteoarthritis in both knees. I have been cycling for decades and rarely have had any pain in my knees. My old doctor used to look at my x-rays and comment on how he cannot understand how I am not in constant agony. I have always believed that my cycling was my physical therapy and kept me pain free.

Late last year, I tore some meniscus in my right knee. I had pain and swelling and a bad limp. Fortunately, six weeks of physical therapy worked wonders and I was quickly back on the bike. I'm still struggling a little bit with mountain biking, but road and gravel cycling are fine.

My orthopedic doctor retired, and I recently saw a new doctor. My right knee is much better, but not 100%. I was told I have too much arthritis to consider arthroscopic surgery. When I told the new doc that I am currently riding 2 to 3 hours (or more) without pain, his advice was to ride my bike as much as possible (along with a few other exercises). He said biking is the best thing I can do for my knees.

The advice I would give you is to see another orthopedist, preferably one in the sports medicine arena. Hopefully, you can get some short-term pain relief from physical therapy (if a surgical repair of the meniscus is not possible). I would push back on the TKR until you are certain that it is your last option.

+1

I had a buckethandle flap tear and another. The flap could lock my knee when biking, but biking was better than full load bearing exercises.

i did therapy- wasnt healing. Did prolotherapy with Dr. Hauser and finally got it sorted/stabilized. At the same time found celiac
disease was behind my poor initial recovery and snow healing. In time, a dietary change and the massive amount of walking a lawn route supplied me with debrided the tears, while prolo fortified the osseo-ligamentous connections and stabilized the joint, alleviating the pain

My wife tore a meniscus as well, and prolotherapy helped resolve her’s.


celiac disease>leaky gut>incompletely digested proteins deposited in joints and other tissue>Immune response>arthritic pain.

Yesterday I had occasion to walk up and down steps. Now I am getting considerable aching. I did a 11 1/2 mile ride today with little pain. I will have to stay off steps. My doctor is not a surgeon. He will send me to one if he thinks it is necessary. i am scheduled for gel shots. He said that meniscus surgery for somebody my age is only necessary if it in a joint.

Hopefully, the jel shots work. Keep us updated, and take care.

Thank you for your kind words. I just called the doctor. I explained that I was in considerable pain. The gave me an appointment for tomorrow morning.

Best wishes to all of you -- knee problems can be a witch with a b. I have been fortunate -- two lateral patellar dislocations, the first in high school, the second at age 45, good recovery.

There is no one-size-fits all solution, but I think the best way to get aerobic exercise for anyone with knee problems is cycling in a low gear (low gear ratios have even become fashionable in the Tour de France :) ), making sure seat height and foot rotation (toe-in/toe-out) are correct for you.

I saw the doctor today. I walked out with a cortisone shot and a prescription for PT. He said that I can resume cycling Saturday. What I don't understand is why is PT necessary when I do a lot of cycling.

To remove laxity in the joint…to help stabilize the joint by building surrounding and stabilizing muscles, through the knees full range of motion, to help prevent further injury.