Death of a runner... rebirth of a what?

Hi folks. Have been a many year poster on RW forums but mainly keep myself tucked up in various marathon threads. Got the news this morning from my sports doctor after an MRI scan, that my left knee cartilidge looks to be in very bad condition - long term wear and tear the likely culprit. I'm due for an arthroscopy on 15/6 and will have a fairly big segment of meniscus that has become detached, removed from the knee.

The surgeon will tell me after the op what my chances of running again will be, but the outlook is bad. My feeling is, even if I can run again without pain, just doing a 5k jog round the park once a week is not what I want or am used to. I've been running close to 4,000km/ year for a few years now, training 6-7x a week. If I try to go back to that, then surely I am just asking for trouble in the long term? I can't bear the prospect of becoming an unfit lardy arse.

So my reason for coming over to TW forums, is to ask you what are the possibilities for a person with meniscus damage, of being able to be competitive and do hard cycle training? Right now i can't guage it because I can hardly walk, never mind ride a bike. Can you do high mileage bike training with a dodgy knee (assuming expertly set-up bike etc)?

Does the all-round balance of swimming, riding and much reduced running give a formerly decent runner a chance of being able to run, without the risk of becoming a cripple before the age of 60 (any age really)? Thanks for any help/ advice/ pointers to relevant info sources.

Tricky  
Sorry to hear this, mate - I personally found your dedication to running and great results inspirational. I hope things turn out to be more positive than you fear - or at least that someone here can give you some decent advice.  

TD, so sorry to hear your news. I think from no medical background just gut that yes, tri might well be the way to go.

Frodo, Puffy - great to bump into you guys here. Hope all is well.

I see many hits on the thread and few posts, so maybe I need to ask a better question...? Does anyone have experience of bike riding after a meniscus operation? Did anyone move to doing triathlons as a way of minimising health risks from sustained high impact exercise?

Grasping at straws at the moment. Would happily accept some apocryphal stories/ secondhand opinions. Thanks.

No meniscus damage for me (yet?)

I came to running as an ex-rugby player who needed something with less impact than rugby and cos kids left me no time for long walks so I had to run to get it done quicker. Ran happily for a few years and started to realise that at my weight (16 stone) I may not last the long course in running. I was running marathons and ultras but the long course was another 40-years!

Ta Da - Triathlon - the ability to have three overuse injuries instead of one!

I switch focus between running and triathlon a bit depending on season. However if you think you shouldn't run due to minor niggles you can bike and swim instead. Keeps you fit, fills the time (so other things don't), and is enjoyable.

Also gives you multi-discipline fitmess that lets you pick a more varied choice of events and/or social outings. I have a few friends that bike but don't run.

So yeah my move was planned injury avoidance.

As for the meniscus damage speak to the doctor, be open with him that you need to do this stuff. Also conside physio advice as to rehabilitation.

Good luck

M.eface

I've had the arthoscopy procedure done on my right knee about 6 years ago after a beach volleyball injury!! I know it's no big deal in it's own right so am not worried about that. Am also very aware that the medical help is top notch - I am going through a Sports Lab at a university hospital and they are very familiar with dealing with sports people up to the highest level (I don't pretend to be there!), so they know what we are like (psychologically a bit weired and obsessive perhaps)....

So I just wonder if anyone else can confirm that cycling is more kind on the knees. What about hill climbing and stuff like that - plenty of force and exertion needed through the knee joint?

cycling is definitely kinder on the knees as you haven't got the impact that running has.....aslo you do not have any of the twisting of the knee that happens when running as your body stabalises itself............but whether the pressure of cycling competitively hard will have some impact I cannot say.......

I hope it goes well and recovery is swift..

Tricky, I have never been anywhere near the level of competing or dedication that you are coming from, and I have not sustained such a serious injury, but if it helps, I can re-iterate what has been said above.

Since moving from running 5-6 times per week, with ongoing "over-use" injuries in both my achilles and one knee, the niggles have all cleared up, and I have been injury-free for about 12-18 months concentrating on 3 sports rather than one.

It was actually my physio who recommended giving it a go. She said that 2 non-impact sports. mixed up with running (which I still love), would give me the best bet of maintaining fitness and strength, without doing long-term damage to my body.

And its great fun. I have become even more obsessive than when I was a runner, there's loads of cool kit, gadgets and equipment to faff and ogle over

I'm good, thanks Tricky

Just had a thought - I know you always do things "the right/best way" as it were, so make sure that extends to splashing out for a really good bike fit/consultation. Getting the measures/fit just right will help ensure there is no undue pressure on your knee (I only say this because I have got it wrong in the past and aggravated an old knee injury by sitting too low on the bike, but I only really discovered it when I started riding for more than 4 hours).

cycling will definitely be easier on the knees than running as you don't have the impact or twisting forces to contend with - the knee works in a more linear fashion and without the impact. 

my missus has had arthoscopy ops on both knees (one of them twice) and still successfully runs and does tri (she'd done 3 IM and is a GB a/g nat champ currently), so it's not the end of the world.  she does suffer more with "creaky" knees now but that may also be age related and not solely biomechanical

cycling will help to srengthen the muscles, tendons and ligaments around the knee which will help it's stability and this will help when hill climbing - it's not the meniscus that suffers on hill climbs, it's the rest of the knee that takes greater forces.  building your leg strength and choosing the right gear to climb in will overcome any issues.

build slowly after the op and you'll be fine.  

oh - and never trust the word of just one general medic who says "never run again" - seek advice from a sports medic who will have more knoweldge based on experience of working with athletes

Worth giving it a go - I do a lot of cycling and my left knee is not in great shape due to cartilage damage    I wont say it never plays up due to cycling - it does - but I can get 6000 miles in a year without too many problems and I do road racing at 3rd cat and veteran level.    I should say my knee has been like this a long time and doesn't seem to be getting any worse - in fact it no longer locks or clicks half as much as it used to 4-5 years ago.   

The good news is if you do want to get into cycling as a competitive sport there is a growing racing scene for the over 40s - google LVRC - and the races are far better than the normal lower cat british cycling races - better standard of riding and more aggressive racing - and a lot cheaper !   I know guys well into their 60s racing and there are some older still turn out - you race in 10 or 15 year age groups with results classified by 5 year age bands within that.

Hi TD - over last 7 years I've had 3 arthroscopies, 2 on L, 1 on R, one of them felt pretty sizeable.  Also had an injection last year to deal with build up of calcification on the tendons beneath the knee.  Rehab is slow and frustrating but I did Marathon des Sables last year and continue to compete, albeit slowly, at ultra multi stage events. Entered Stratford mara recently, forced to do the half as mara was cancelled and still pulled out 1:45 with little or no speed work training.  If you really want to continue running and are prepared to continue with rehab exercises and do everything you can to help, make sure trainers are good, need for orthotics?, run off road wherever possible I would say, as long as you can, do!  Good luck, wishing you all the best. Penni x

Wish you good luck, and I agree, tri is the way to go. I'm having a titanium hip joint implant next month in a sports clinic and the specialist tells me I will be able to start swimming 3 weeks after and start run training in about 6 months. Also, one of our tri club members had an arthroscopy done on his knee a few months ago and he is back to full training and competition.

Oh mate got nothing to add that hasn't already been said but just wanted to wish you luck. Don't consider it a end of something just moving on to something new and exciting.  

Ultra Titanium Wolf?

Just as a practical aside, it was my knee that made me give up 1800 mile/year marathon training, (and foot) and I have now found that long range cycling can slightly aggravate the knee. It's much better if I keep a high cadence.
In context, a 5 hour ride is less aggro than a 10 mile run!

The foot's fine now, thanks for asking.

Frodo - great advice about the bike setup. One of the great things about living here in Belgium is that the whole country is bike nutty. There's plenty of guys doing that sort of work for pro-teams and committed amateurs, so they might even let me in. I know the geometry has to be spot on to safely do lots of distance. Thx.

FatBuddah - got it with the slow building. Not making any assumptions that running muscles will makle me capable of cycling. At the moment I can barely walk so I reckon there will be a heap of atrophication going on in the next month, so will have to be very careful in my rehab. Big mistake to get to eager. BTW, the doc didn't say "never again". He's a sub-3h marathoner too and he appreciates the significance of my issue. He said i could possibly do another mara next year if i was pain free. The issue for me is that if I can't understand what has caused such wear and tear, there's no way I want to risk crippling myself. So if I acn turn down running intensity by combining with other sports, that could be a great solution. Am still v. concerned though. I can hardly walk right now and I keep falling over. I hate this feeling of weakness and vulnerability.

bbplodder - funny about ogling over the gadgets and stuff. I've been tough on myself for a few years to resist the attractiveness of it all but given the prospect of losing my running, I think I'll change quickly. The new bathroom might have to wait a (little!) bit.

Penni - it's really encouraging that after some difficulties you can still do an event as tough as MDS. I've always been spot on with running shoes and keeping them well looked after, mileage logged. No need for orthotics, I'm quite light on my feet and fairly neutral in balance. Do you have any ongoing concerns about wear and tear? I never worried about it before. Mr.Wolf's titanium enhancement stories send a cold shiver down my spine.

Cake - cheers mate. Much appreciated. I don't want to be over dramatic but running is something that people would say defines me and how people relate to me, so to suddenly face the prospect of losing it is tough. Good to know other people can relate to it.

Blisters - nice to see you here too. Glad you are keeping up your athleticism and I'll bear the high cadence thing in mind.

Any other tips/ advice/ insights more than welcome. I've got loads to learn. Thanks everyone.

Tricky... the graphs you can draw are AMAZING!! 

Hi TD, just caught this thread.You really do need to take a "wait and see" approach at the moment, because it's only when you have had your arthroscopy that you'll know the real state of your knee - MRIs are often quite misleading.

It sounds rather as though your symptoms at the moment could be mainly due to your meniscal tear. If the torn bit can be resected tidily, leaving you with a smooth, stable remainder of menisucs, you could be in great shape. You mentioned that a fairly big segment will need to be removed, but that can be hard to tell from an MRI. If there's a lot of damage to the articular surface, or the meniscus is in tatters, you'll probably still be better, but only partially. Still not worth writing anything off yet.

Having said all that, I "switched" to tri nearly three years ago because my knees were getting too sore with marathon training, and anyway I wasn't getting faster. You're forced to run less in order to fit in bike training, and I think that has given my knees more of a break. My philosophy is to use and abuse my knees now, and worry about the consequences later. That may be reckless, but it might help you to add the perspective of a 48 year-old orthopaedic surgeon to all the advice you've already got!

Good luck .