This article is based on my own experience of having meniscus surgery (for knee pain) and judging when to return to exercise.
The main point of interest is that pain is not always a good indicator of whether it’s OK to exercise. After my surgery I was hoping to be able to return to running and playing sports but despite stretching and walking I found that running continued to be painful in the exact same area that I had pain before surgery. This was particularly discerning as my meniscus tear was the result of continuing to sports despite having pain in my knee. 6 months later I had another MRI which revealed no damage and little scar tissue. So what to do? After another 6 months of prevaricating, having osteopathic and other treatments I decided that the pain must be a memory type pain. In other words I was experiencing pain in exactly the same way because my body remembered the pain that I had before. Although, this time the tissues were not actually being damaged.
I decided to adopt a very strict and precise running regime to see if I could run and increase my range without increasing the pain afterwards. As I experienced pain more or less straight away I started with 5 minute walking, 25 meters running and then 5 minutes walking. This caused immediate pain (in the running bit) in my knee which lasted during the second walking bit. I repeated this every second day for a week.
In week 2 I repeated the pattern with a 50 meter run in the middle. What I found was that the pain I experienced after the running did not increase!
In week 3 I ran 75 meters and had the same result with no increase in pain from the increased distance.
Week 4 I ran 100 meters and again had the same experience with no increase in pain.
From about this point on-wards I became very excited about the possibility of being able to run again and had to be very strict with myself as it was tempting to just see what would happen if I ran 1, 2 or 5 Km! Instead I followed the rule of adding 25 meters every run until I got to 500 meters. After this point I added 50 meters for every run. And then I just kept going generally following the rule of adding no more than 10% for each session.
So far I have managed to get to 7.5 Km and will be doing the local Park Run (Preston Park) when I have a free Saturday morning. Also the reaction I get from running is now less than I originally for from running 25 Meters!
What are the lessons I have learnt from this?
- Pain is not always an indicator of what you should be doing. In my case, running did and still does cause some pain or discomfort. But as I ran more, the pain subsided. However, pain does sometimes indicate that you should stop. This was the case when I injured myself.
- When you return to exercise follow a plan and stick to it. You should start very gently and increase systematically. This allows you to monitor what is going on. It’s surprising how quickly you will be exercising a good amount if you keep upping your workout every time.
A word of warning though. I managed to tear my meniscus by running on a painful knee. In hindsight I should have known better. For one thing the pain was quite sharp and was stopping me in my tracks. The fact that my meniscus was damaged could have been diagnosed by proper orthopaedic testing and then I could have avoided surgery altogether. So, it may be worth consulting a qualified Osteopath (or other) to determine whether you can return to sport.
Finally, as I am writing this in January when so many people try to return to sports and exercise and there is plenty of information about the best way to achieve this (for example Dr Michael Mosely on BBC) I will just say it is possible even if you have to start by running 25 Meters. The thing is to start and make consistent progress.