I had the results of my MRI scan last week and the news was good. I have two symmetrical tears in the medial meniscus cartilages of both knees, and will require one or two arthroscopic operations (keyhole surgery). Now comes the bit where I explain this as I understand it, and my medical friends tell me that I’ve got it wrong. Nonetheless, here goes.
The meniscus cartilage is a rubbery fibrous mass which acts as a spacer/cushion between the thigh bone, the shin bone, and the fibula. I have splits in the posterior horn on both legs, which is the bit at the back of the inside of the knee. As a result, there is some effusion (liquid) on the joint, and possibly some minor internal bleeding. There is some soft tissue strands in my intercondylar notch, which is a gap between the thigh bone and the tibia. These strands can affect movement of the knee. Similar damage in the left knee has resulted in a baker’s cyst. There is some evidence that a baker’s cyst can be connected to deep vein thrombosis and pulmonary embolism, which is interesting but not necessarily relevant in my case.
The damage was probably caused by years of football and cycling, and exacerbated by twisting the knee during a couple of charity boxing day games in 2008/09 which I should probably not have played in. I also worked in a heavy manual job for 11 years which would have compounded the stress on the knee joints and of course, carrying 18 stone will not have helped.
So how is all of this good news? Well, cycling is often recommended as a recuperative exercise for this specific injury. The rest of my knee is in good condition, and arthritis and ligament damage have been ruled out which means that the orthopaedic surgeon was able to pinpoint my problem and suggest an operation which could help me recover. There is a clean split in the middle of the cartilage and the suggestion is that they will remove the top half, and partially repair the damage, even though it will reduce the cushion between the bones. It may help, it may not.
I at least felt that I could move on in the knowledge that cycle training may be painful. But that it is not causing any more damage to my knee. So the big news is that I got on the exercise bike last night for the first time in months. After the initial soreness the pain eased and I was able to complete a tentative 25 minute session. On my second session I covered 10k in about 50 minutes. I am only spinning, and not putting any downward pressure on the joints. Where I used to train for an hour at 110 watts, I am currently spinning at just 40-45.
But at least I felt like doing it. The biggest barrier to my return to training since suffering the clots has not been knee pain, it has been lethargy and fatigue. The fact that I’m back on the bike at least suggests that physically, things are at least starting to get back to normal. I have no more pain in my lungs and am breathing easily.
With two operations on the horizon, I now have no choice but to lose the weight which has crept back on since my general grogginess and boredom led me to indulge in some comfort eating. You really don’t want to undergo general anesthetic when you are obese. It’s dangerous and raises the risk of airway complications significantly. They may even refuse to operate, which would not be good. But at least I’m back on the bike which is a huge positive. Those Alps seem a long way away with just 75 minutes of spinning under my belt,, but my target to ride the Alpe D’Huez in the Summer of 2012 is back on track.