Laurie’s assistant put a heat-pack on my knee, the envelope with the scans on a chair and left the room. I waited for about ten minutes, feeling tired and wondering the point of the heat-pack. It felt good but wasn’t going to help.
When Laurie bustled in he said my knee was fine. ‘There’s no meniscus tear,’ he said.
The diagnosis
That didn’t make sense. ‘Okay, so what is it then?’
He frowned and asked about the pain.
‘It doesn’t hurt because I haven’t been running,’ I said. ‘But I still can’t touch my ass with my heel.’
‘Hang on,’ he said and fled the room, coming back moments later and searching the envelope, looking for the report.
‘There is no report in there,’ I said.
He straightened. ‘That’s fine,’ Laurie said. ‘They emailed it to me. I just can’t find it. Back in a second.’
His assistant, a man about the same age as Laurie, came in and searched the envelope.
‘There’s no report but there’s a disc in there,’ I said.
The assistant took it.
Laurie came back. ‘You’ve got a meniscus tear,’ he said. ‘Sorry about before.’ He smiled. ‘I was emailed a report on another knee patient today and his knee is fine. Yours isn’t.’
I sighed. ‘What do I do?’
Laurie shook his head. ‘Meniscus tears don’t heal by themselves.’
‘So I need surgery.’
He thought for a moment. ‘If it was my knee I’d have it done. I had surgery to repair a meniscus tear and I can’t remember what knee it was. I’d suggest you have it done and you’ll be running two weeks later.’
‘What if I don’t have the surgery?’
He shrugged. ‘You can change your life to suit the injury and be careful with the knee, but you like running, right?’
I nodded. ‘And I’ve got a 14-month old boy.’
Laurie nodded. ‘The problem with meniscus tears is one day you’ll go to pick something up under the bed and you’ll tear it fully. Then you’ll have to have surgery anyway.’
He gave me the name of a doctor to see, for a referral to an orthopaedic surgeon. After giving me a printout of the report, Laurie waved me through reception. No charge again. When I got home I read the report with Kristine.
MRI SCAN LEFT KNEE
Indication: Medial knee pain.
Findings: A moderate effusion is seen.
There is a horizontal oblique tear of the posterior horn of the medial meniscus with some tiny parameniscal cysts under the surface cleft. The lateral meniscus is normal.
Hyaline cartilage over the condyles is well preserved.
Cruciate and collateral ligaments look normal.
Patellofemoral articulation shows some mild degenerative change with some midline patella low grade chondromalacia.
Minimal effusion is seen with Baker’s cyst. No tendinopathy is identified.
Impression: Horizontal oblique tear of the posterior horn of medial meniscus and low grade chondromalacia of the central patella. Moderate effusion of Baker’s cyst. No loose body.
The diagnosis reads much worse than the injury is. I walk without a limp, only because I’m not running. When the knee gets sore, it’s in the afternoon. The swelling was gone. I was careful with the knee.
Dr Mark Gregg works out of a small clinic in Nundah. I had to drop Laurie’s name in order to get an appointment. Like Laurie, Gregg is also an AFL fan, loosely following Brisbane but more interested in the QAFL. After viewing the scan, he breathed a sigh of relief.
‘Your ACL is fine,’ Gregg said. ‘But I can see the tear in the meniscus.’ He turned from the scan and made a small smile, looked at the scan and frowned. ‘Every week I see torn ACLs and tell men a lot younger than you they need a reconstruction. You’re lucky.’
I didn’t feel lucky as he applied the McMurray Test, just to be sure the knee really was injured. He asked if I had private health insurance. We talked footy as he wrote a referral to the Prince Charles Hospital. Gregg was hardly interested in the discussion so I kept it short.
‘You might get an intern at Prince Charles who wants to do this surgery,’ he said. ‘If not you might have to wait a while. You can pay to have it done privately or you can go on an intermediate list, which is cheaper.’
‘Intermediate is fine.’
Gregg suggested I see Dr Dale Rimmington, an orthopaedic surgeon working out of St Andrews Hospital.
He smiled as I got up to leave. ‘You’ll be running two weeks after the surgery,’ he said. His smile was tired when I thanked him.
The receptionist waved me through. ‘No charge today,’ she said.
The final examination
Doctor Dale Rimmington follows AFL too and has a fondness for umpires. We talked footy. Like Gregg, Rimmington has only a passing interest. He was more intent on the scans, showing me the tear. It looked as simple as a pencil line drawn through a grey, oblong shape.
‘This is an impact injury,’ he said. ‘It’s not a wear and tear injury.’
He gave me the same look Laurie and Gregg did, when I said I couldn’t remember the impact that tore my meniscus.
Rimmington shook his head. ‘These injuries commonly occur during a collision, when the knee joint is jarred backwards or sideways. You should’ve felt it immediately.’
‘I don’t know how it happened,’ I said. ‘I can’t remember any impact. The first pain I felt was at the back of my knee in February.’
Rimmington smiled doubtfully. He demonstrated a meniscus tear on a flexible knee joint. ‘There has to be an impact to the leg for the meniscus to tear. You can run for decades without tearing it.’
I shrugged. Like Laurie and Gregg, Rimmington’s curiosity was palpable. He had to know how it happened, offering suggestions like mistiming the gutter when running or falling down a few steps or off a ladder. He gave up when I kept shaking my head.
He explained the surgery and the risks, blood clots or infections. ‘About one in 500 experience side effects.’ Then Rimmington explained the costs, about ten grand if I paid to have it done privately, less if I went on an intermediate list and free if I waited for surgery through the public system.
If I went onto the intermediate list, all I had to pay for was Rimmington’s work. I asked for a quote. It should be about two grand.
Last year I assured Andy I’d be running the Gold Coast marathon with him. Injury has killed that ambition, not for the first time. Back in 2009 a calf muscle injury put me out of the Gold Coast half marathon. That injury took eighteen months to fully recover from.
A knee reconstruction also ruled Andy out of the 2009 Gold Coast half marathon, but he’s been running half marathons and marathons since 2010.
Medical opinion suggests I’ll be running two weeks after surgery. By the time my surgery is done on September 6, the Brisbane running festival will be over. I won’t be fit enough to compete in Melbourne in October either.
Given I’m not a professional athlete, and given I’m hardly an athlete, I don’t need to spend ten hours in the gym so I can run in two weeks. My recovery will be slow and careful.
As Dr Gregg said, I am lucky. The injury is relatively minor, as far as knee injuries go. It’s not a reconstruction or calf tear.
But I’ve had enough of injury. Last year, a quad tear ruined the last half marathon of the year. I haven’t been able to run at any events this year.
Most afternoons I am drawn to the clock, finding the time I would usually be out running. I feel idle, sedentary, and angry that injury has cruelled what I love, which is running long distances.
In June, with the knee feeling reasonable, I wondered out loud if I should go for a run around the block.
‘Three kilometres can’t hurt,’ I said. ‘I won’t do anymore damage.’
‘Don’t be silly,’ Kristine said.
I longed to run but was forced to live vicariously through Andy, who is in his final preparations for the Gold Coast Marathon. A week ago I drove him to Shorncliffe, along the foreshore and over the bridge to Redcliffe. The course would take about three hours to run.
After dropping Andy off I drove home in a rueful mood.
People have told me not to run after the surgery. Age has been mentioned, as though it is the reason the injury occurred, that being 42 automatically results in meniscus tears.
The retort is obvious. Age has nothing to do with the injury. Lack of preparation or foolish training has nothing to do with it either. Most athletes, at some stage of their career, will suffer a knee injury. A lot of amateurs do, too.
I just got injured, again.
As the medical professionals said, meniscus tears are caused by impact. This Ramble would’ve been much better if I could remember how it happened…
