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Thread: Walking Para, looking at left medial meniscus tear, what options?

  1. #1
    Senior Member medic1's Avatar
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    Walking Para, looking at left medial meniscus tear, what options?

    I am a walking para. L1 Burst, S1 para complete. For several months I have been having knee pain in left knee. Since October is has been increasing and finally had a doctor appointment today. When I walk, the weakness in my legs is causing my instep of the left foot to rotate inward putting pressure on the inside of my left knee. Doctor examined today and thinks I have a medical meniscus tear. He is sending me to a orthopedic specialist to be evaluated further. Have any walking paras had issues with their knees from the way they are forced to walk due to weakness in legs? If so what treatment has helped. I really don't want surgery if it can be helped, but I don't want any more damage either from walking differently. Are there certain questions I should ask and how do I know they are taking my entire situation into consideration? I need them to realize that this is not just a knee. This is going to effect everything from my back, hips, si joints, knees, legs, ankles, mobility, etc. I don't want to end up with someone who only looks at the knee and not the entire picture of what is going on. Any info would be great. Thanks.

  2. #2
    I think it is too early to say. You have no idea what is going on yet. You haven't even seen the correct doctor or had an MRI. One step at a time.

    Yes, developing joint problems/pain syndrome as a walking para is common due to the way many will walk with AFOs/crutches/asymmetries etc... You will probably want to be followed by your physiatrist and a PT once you get a diagnosis/treatment plan to re-evaluate how you walk and to build up quad strength etc... to support your knees.

  3. #3
    I had/have this condition, diagnosed by MRI about three years ago. The orthopedic surgeon recommended arthroscopy and repair, but I'm almost completely paralyzed on the left side (where the tear was seen), and do not have the ability to rehab a post-surgical knee - I need to preserve my capacity to ambulate with crutches and KAFO, and an operation might have destroyed the little movement potential that is still present in my left leg. So I opted not to have the surgery, and since that time the acute meniscus tear pain has completely subsided and I'm back to "walking" in my usual way. Yes, we have to make major adaptations in the ways we move in order to accommodate our injuries and their sequelae, but in my case the operative notion is: Less is more.

    A medial meniscus tear will typically be visible on MRI, so as hlh says, wait until you have a confirmed diagnosis before you start making plans for treatment (it's possible that you have a sprain or some minor injury that - while painful - is not significant overall). If you do indeed have a medial meniscus tear, and if you are able to adequately rehab the knee after a surgical procedure, make decisions on that basis.
    MS with cervical and thoracic cord lesions

  4. #4
    Senior Member medic1's Avatar
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    Thank you for the responses. It is early to know exactly what is going on. Went to my family care dr first as I have to drive several hours each way to see my physiatirst. I have an appointment on Monday with the Orthopedic surgeon, and am thinking I will get the MRI/treatment plan. Will follow up with physiatirst and see what he recommends from there. Again, thank you for the replies, as much as it sucks its kinda nice to know what options are and if others have delt with the issue.

  5. #5
    Senior Member medic1's Avatar
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    Update. Did several months of Pt. No definitive answers. Could be small tear, could be bone spurs, could be plica syndrome, could be arthritis and could be my VM muscle shut off. Most of the pain has gone away. It only bothers me occasionally with a deep bend or if I overuse my leg/knee. I am keeping up with exercises and I am leaning towards the VM muscle shutting off. I had iontophoresis and had a really bad reaction, so no more of that for me.

  6. #6
    I'm glad to hear that most of your pain has resolved - great update!
    MS with cervical and thoracic cord lesions

  7. #7
    Yes, very good news. Thanks for the update. Keep up with the exercises if you can.

    My dad has pain in his left shoulder this week, and every time a joint starts to act up, it sends him/us into a roller coaster. The life of walking para/quad is filled with episodes of pain/injury/panic...

    Good luck to you!

  8. #8
    Quote Originally Posted by hlh View Post
    My dad has pain in his left shoulder this week, and every time a joint starts to act up, it sends him/us into a roller coaster. The life of walking para/quad is filled with episodes of pain/injury/panic...
    That is so true! Many pain episodes resolve on their own, but it can take a long time and the fear factor is huge. I have done a lot of damage to myself by seeking treatment too soon, whereupon overzealous PTs made things worse (in some instances, permanently). The "tincture of time" can work wonders, but it's usually impossible to know what you're dealing with initially. And so often, there seems to be little correlation between pain intensity and actual danger - some of the most painful episodes end up resolving nicely in a few weeks or months, seemingly without structural damage; whereas milder pain can point to something worse than it seems. The cycle is infuriating and frightening and you never get used to it, because sometimes the odds are in your favor, and sometimes s--t really does happen.

    Well, here's hoping that your dad's shoulder will settle down without any complications, hlh - and that your knee will ontinue to improve with exercise, medic1!
    MS with cervical and thoracic cord lesions

  9. #9
    Look into PRP. I'd see if you can find who treats the Packers. This has become something they use to speed healing.

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