Meniscus Root Repair Rehab & Recovery by Emily Socolinsky, SSC | September 11, 2019 On Wednesday, February 20, 2019, I had a meniscus root repair surgery on my left knee. My MRI showed an extensive radial tear adjacent to the medial meniscus root insertion, as well as evidence of high-grade chondral loss involving the central trochlea. Bottom line, it was pretty clear from the MRI that if I wanted to be out of pain, surgery was my only option. Once my doctor started the procedure, it was obvious that this would not be a simple surgery. There was a large grade 4 chondral defect involving the central aspect of the trochlea, approximately 30mm in width by 25mm in length. Multiple large loose bodies were removed from my knee joint, the largest of which measured approximately 20mm. There was also proliferative synovitis present throughout the patellofemoral joint, including the medial and lateral gutters. Examination of the medial compartment revealed a complete radial tear proximally 1cm medial to the posterior root insertion. In layman terms, I had completely torn my medial meniscus from the bone, and it had to be sewn back on. This was going to be a complete root repair surgery: toe-touch weightbearing for four weeks, six weeks in a brace and crutches. The Injury: What came first, the Brazilian Jiu Jitsu or my awesome dancing at a wedding? I don’t remember how or when I tore my meniscus. I started Brazilian Jiu-Jitsu about four years ago. The left knee was feeling great up until about a year and a half ago, when I started noticing some pain. Then, in January of 2018, while warming up in class one morning, a sharp, nauseating pain shot through my left knee, which made me start limping. I put a knee brace on and made it through class, but by the time I drove home I could barely bend my knee. I finally decided to make an appointment with a knee specialist. Upon examination, the doctor told me that I most likely had a meniscus tear, and that I should get an MRI. I hung on to this MRI referral for a good month or so, because the knee was starting to feel better, and I was still able to train and attend my BJJ classes. At the beginning of April, I was dancing at a friend’s wedding when I suddenly heard and felt a loud pop in my left knee. The knee buckled and I thought, “Shit. There goes my knee again.” It hurt like hell. I limped from the wedding venue to the car, and then from the car to my house. But the next day, I woke up and literally ran down my stairs. There was absolutely no knee pain. No swelling. Nothing. I decided right then and there I would not get the MRI. Why would I? My pain was gone. Later that summer, the left knee began to bother me...again. I was training one afternoon, and I noticed some swelling, not too much, but enough for me to start keeping an eye on it. Then, in September, at the Charm City Strongwoman Contest, I sprinted into the gym from the outside looking for one of my volunteers. The next day, my left knee blew up to the size of a grapefruit. My calf swelled up into my ankles. It took almost a week and a half for the swelling to go down, but there was still considerable swelling in my knee. I kept training, modifying my squatting as needed until I could get back to proper depth. The swelling started to go down, but there was now a lump behind my knee that felt like fluid. I did a little internet searching, and diagnosed myself with a Baker’s Cyst, which I discovered was pretty common with meniscus tears. In January of this year, I finally decided to go back to my doctor to get that MRI. I could no longer deadlift from the floor, and was having trouble squatting below parallel. BJJ was also becoming more and more of an issue, and the warm-ups were now next to impossible. “Definitely a Baker’s Cyst,” my doctor said when I saw him. “And most likely, a meniscus tear.” A week later, I got my MRI results and I was told that this was going to be a very long recovery, but I had other plans. My Rehab I opened my gym shortly after taking up strength training in earnest to help address my back pain, and have been working for the past eight years to help others embrace their true potential and strength. Had I not been training all these years, I would not have had the slightest idea of how to rehab my knee after surgery. Prior to Starting Strength, I would have simply gone to physical therapy, done my exercises like the therapist told me to do, and that would have been it. But now I know more about the body, about rehab, and about what being stronger really means. What was going to help my knee? Continuing to train, moving it as much as I could, bearing weight as much as I could tolerate, not sitting around, and NOT just doing PT exercises 1-2x times a week. I was going to rehab myself, and keep training as normally as I could. My surgery was at 8:30am Wednesday, February 20. When I returned home around 1pm that day, I sat in my living room for a bit, emailing and texting people to let them know I was alive and well. After about two hours, I got up, crutched into the kitchen, brewed a pot of coffee and made myself some pancakes. That was day one. On Thursday, February 21, the day after my surgery, I went to work, in my brace and on crutches. A friend of mine picked me up, and took me to the gym, where I coached my clients, sometimes sitting, sometimes standing. Then I trained. It was press/bench day, so I set up for some seated presses and dragged a stool over to prop my left leg up while I benched. I did a few jungle gym rows, and finished with planks. I got a lift home, and returned to the gym later that evening for more coaching. I think my clients thought I had lost my mind, but what else was I going to do? Sit at home on the couch and watch T.V.? I have two good arms, and a good leg. I wasn’t taking any pain medication either, so I was alert. Two days after my surgery, Diego took me to my first PT session. The therapists were a little surprised to see me so soon after my surgery, but I really wanted to know how much range of motion I had post-surgery. They moved my knee a bit, and I had decent ROM, better than expected. Later that day, I trained. Single leg deadlifts on the good leg, reverse hypers, and dumbbell bench. The following Tuesday, I saw my doctor. I asked when I could start driving, and he said when I was off my pain medication. When I said I was not on any medication, he said when I could bend my leg 90 degrees. Diego has an automatic and it was my left knee that was incapaciated, not my right, so the next day, I hobbled into his car and practiced driving around the block. It was glorious. That night, I drove myself to the gym. I consulted with SSC and DPT Darin Deaton prior to my surgery and then afterwards, when I discovered it had been a meniscus root repair. Darin helped me understand that it was going to be a very slow recovery due to the nature of the surgery, and to be patient. I asked him about biking, and he told me that he allowed his patients to start biking two weeks after surgery. Two weeks to the day, I got on my spin bike at the gym and did what I could do. It was tough, and it hurt like hell, but I took it slowly. After about five minutes, the wheels were spinning. I have now biked five to six days each week since my surgery. As a result, two weeks after surgery I was able to start driving my car, which is a manual. I sat down and put together a training program with exercises I could do, and trained four days a week as normal. I decided to continue with my usual four day split with two upper body days and two lower body days, although I did also incorporate a few extra upper body exercises as my lower body work was not that intense. Here is what my training program looked like from 2/21/19 (day after surgery) to 3/21/19: Mon Tues Wed Thurs Fri Bench-one leg SL Deadlifts on good leg PT stuff Seated Press SL Deadlifts on good leg Seated press Reverse hypers Bench Reverse hypers Tricep work Seated DB press Push ups- one leg DB bench - one leg Curls SL hip thrusts DB row Step ups - good leg Seated Sled pulls Ring rows Seated Sled pulls Chin ups Bike Bike Bike Bike In between the big lifts and the accessory work, I did some of my PT exercises: leg lifts, quad sets (quad squeezes), heel pumps. I was still taking aspirin to prevent clotting after surgery, and I also tried to put as much weight on the left leg as I was allowed, and then more. I walked around the gym with the crutches, and without the crutches. At my third visit to PT, I was told that I had completely broken my PT protocol, and was better for it. “It helps to be strong,” my PT remarked. Towards the middle of March, I was finally given wall slides (mini squats) and step ups for the left leg by my physical therapist. Instead of wall slides, I opted for high box squats. I switched out the single leg deadlifts for trap bar deadlifts on mats, and added low step ups on the left leg. I was also allowed to bear weight on my leg while in the brace, which meant no more seated presses. Unfortunately, I was still not allowed to bend my knee completely, so I was still doing all benching on one leg. At the end of March, my doctor told me I could take my brace off completely, and use crutches for another week if I needed to. I chose not to use my crutches anymore. My training program between 3/22/19 and 4/21/19 looked like this: Mon Tues Wed Thurs Fri Bench - one leg Trap bar DL PT stuff Press Trap bar DL Strict Press Reverse hypers Bench - one leg Reverse hypers Triceps work Strict press Push ups DB bench - one leg Curls Step ups DB row Step ups Step ups (R/L) BW box squat BW box squat Chin ups Bike Bike Bike Bike I switched from trap bar deadlifts to barbell rack pulls, continued to lower the box for squats and switched from single leg deadlifts to RDLs. From April 22 until May 1, my program changed again, slowly becoming more like my regular training. I continued to lower the box for squats, and started to add weight. And slowly, I started bending the knee more, and eventually took the box away from my bench. From 5/2/19 - 6/15/19, my program looked like this: Mon Tues Wed Thurs Fri Heavy Bench Squat Bike - Steady state Heavy Press Squat Volume Press Deadlift Volume Bench Deadlift Tricep work Back ext. Push ups Reverse hypers Curls Strict press DB rows Pause bench Bike Bike Bike Bike And from 7/1/19 - Present, my program now looks like this: Mon Tues Wed Thurs Fri Heavy Bench Squat Bike - Steady state Heavy Press Squat Volume Press Pause Deadlift Tempo Bench Heavy Deadlift Tris/Curls Strict press/Rows DB rows Pause bench/Rows Bike Boxing drills Boxing drills Bike I am now adding 10 pounds a week to the bar for squats. Eventually, as I get into the mid 100s again, I will start adding five pounds a week. I was adding 10 pounds a week for deadlifts but have now switched to pause deadlifts on Tuesday and add only 5 pounds a week to the heavy deadlift. I press and bench with no modifications. I got rid of the box for squats the end of July. I was cleared from physical therapy on May 16, 2019, about three months after my surgery, and after only six PT sessions. I have no issues taking the stairs, just a little knee discomfort here and there. I also started boxing sessions once a week with one of my coaches as I am not allowed to start back to BJJ until September. Most importantly, I have not missed a single coaching or training session since my surgery. Wrap Up As of August 20, 2019, it will be six months post-op. I plan to squat 135 pounds for three sets of five on this day and am scheduled to deadlift 200 pounds on August 23. And unless you have been following my Instagram page and know about my rehab, you would never even know that I had knee surgery. I have been walking and training normally for the past four and a half months. What made my recovery so fast? Strength. If I had not spent the last several years of my life squatting, benching, pressing and deadlifting, I would not have had the strength to continue to be as active as I was after my surgery, and I most certainly would not have known how to rehab my knee on my own. I would have relied strictly on physical therapy. I definitely know that I would not have been able to do all that I can do now, if I had not gone into the surgery strong. Strength is one of the most important aspects of our lives. Being stronger is always better than being weak. Life happens and our bodies will sometimes let us down. But if we are stronger, we are harder to break, and we most certainly recover faster and better. Discuss in Forums