Cortisone shot for Meniscus Tear?
My sports doctor (he’s also in our triathlon club) suggested getting a cortisone shot a few weeks out from my first race, and then possibly surgery this fall. My appointment is tomorrow and I’m trying to decide if I should get the cortisone shot or not. Either way I’ll still go and talk to him about the options, and I hope to see the MRI.
A not-so-brief history…
In August of last year I was in the pool sharing a lane with someone. The lane next to us opened up, so I moved my gear over, then went under water and pushed off to get under the lane line to the other lane. I believe this is when I tore my meniscus. At the time I didn’t have insurance, so wasn’t about to pay for an MRI. I had a few friends (physical therapists, doctors, etc) diagnose it as a Meniscus Tear. It hurt for a few weeks, but I was able to swim, bike, and run. It bothered me the most when I walked down the stairs in the morning, but quickly went away. I was less than a month out from IMWI when it happened, so I just kept pushing on with my workouts with just a little bit of backing down.
It seemed to be pretty much back to good until a few months ago. I was in yoga and as I went to cross my legs at the end of class for “namaste”, I felt pain in my knee and I couldn’t even come close to crossing my legs. It was only sore for a few days this time.
A few weeks later I was back on insurance and got an MRI. The results showed…
1. Complex tear involving the anterior horn, body and posterior horn of the medial meniscus.
2. Ganglion cyst adjacent to the PCL.
3. Small-to-moderate sized Baker's cyst
It’s been about a month since I’ve felt pain when walking down the stairs in the morning. I can’t fully cross my legs, or bend my knee, but it’s pretty close. I feel it sometimes when doing breastroke, but that’s not something I do regularly. If I’m doing yard work it will sometimes lock up and I’ll have to sit on the ground for a bit until it works its way back to good, but there isn’t really any lingering soreness.
Lately my hamstring and calf on that side have been pretty tight, to the point that my hip will start to throb after running. I’m not sure if it’s related, but when the injury first happened, my hamstring and calf really seized up for a few weeks. I’m mostly curious if the shot would make my hamstring/calf issue better or worse, or do nothing at all.
Any thoughts or suggestions would be greatly appreciated!
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Sorry about the knee. I just found out this morning I have a meniscus tear. I haven't been able to shake the pain though. One question i'd ask is if you wait, will it get worse? My big concern would be making it worse. But since you don't have pain, I suspect (with all the reading I have done, i'm no expert), that you could probably get away with just doing knee strengthening stuff and flexibility exercises. Basically my doc told me, if it hurts, don't do it. But of course, i'd ask your doctor what they think.
I emailed my doctor to see if I could take a look at the MRI and discuss a bit more about the shot before getting it done. He said that was fine. I’ll know more in a few hours.
Do you know if yours is medial?
I do think strengthening the muscles is the key. The things I've read about the medial tears is that there is a greater chance that it heals on its own because there is better blood flow. But that it doesn't always heal. So, its probably worth doing therapy, but in several months, if its not fixed, then surgery would fix it. The surgery recovery is 4-6 week and then you can start doing bike/swim and build up the strength. I had part of my other knee meniscus removed 20 years ago and its doing fine (actually stronger since I started doing Tri's 3 years ago because the muscles are stronger). So, from my non-medical opinion, if there is a tear, its comes down to how quickly you want to get back. Its always worth trying to not have surgery, but after 2-3-4 months, of not healing, then it may be time to do the surgery, just so you can move on. And if you do therapy, i'm not sure what the reoccurance rate is (as in your case). If its not the meniscus causing the pain (i think we both have cyst's or bursitis), then my doc said that they react well to shots. He said he has some people come in every 4 months for a shot for hip bursitis and they are fine for several months.
@Dewey- glad the shot helped. Do they have you doing any strength and streching stuff? Does cycling hurt?
I can already tell it's better. He said it could take up to a week, but I can cross my legs fully now. Before my left leg was not able to come all that close to my body. I can also come much closer to sitting on my ankles.
Still not sure if I'll do surgery this fall. If it doesn't bother me this summer, I'll probably just wait it out until it is worse. As I've heard else wear, they used to go in and remove the meniscus, but now they can just go in and clean it up a bit, so it's much less invasive and less recovery time. One person I talked to when I first had the issue in August said I could be back to good in a week post-surgery. Forgot to ask my Dr. what he thought on timelines.
@Peter - how did the appointment go?
@Dewey - I didn't realize stretching played a role in it. In August when it first happened, my hamstring and calf seized up pretty bad and I had it worked on a few times by a PT friend. That really helped out with getting me back to swimming, running, and cycling. A week afterwards I could also tell something was "off" when I would stand on the bike. I had my second RR that weekend for IMWI. It's pretty hilly so a good amount of standing. Since I didn't know exactly what was going on, I called it a day and only did one lap of the course. I think my knee has always been at least slightly swollen below my kneecap on both sides of it, but it's not all that noticeable.
I do have locking, but not often. Usually when doing yard work and are bending down a lot (pulling weeds). He said the locking might not be from the tear, but could be from the cysts moving around and getting into the joint. Hopefully the shot will take care of that. Only time will tell...and more weeding.
I had a grade 4 Mcl tear and what they called a "partial acl tear" my neighbor who is a sports medicine doctor said either it's tore or not when it comes to your acl. I did massive pt and after about 2 weeks my quad muscle started firing again with a little electrical stim assistance. Amazing how much muscle size you loose in very little amount of time.
I swear I was in PT 3x a week and lifted some sort of legs 4x a week.
I still had what they call a catch when doing the ACL tear test but one of the other doctors felt there was no stop and what was catching was my itb. I got lucky and had no meniscal tears. They say it's very unusual to have that much derangement to a knee and not see a meniscal tear. Guess the 250 pound dude landed on me just right.
I was in a brace for 5 weeks then slowly let loose. No issues with running, swimming, or biking but with lateral movements my acl reminds me it's torn.