Training begins

A bit later than I would like, but I finally got back on a trainer this week. It's always a great feeling to get back on the bike after a long break (I had a short ride over Christmas break, but before then was Bucket 100 back in October). However, I was a bit apprehensive. In February 2011, I tore my medial meniscus while on a trainer.

That fall I decided to take a Health and Kinesiology course in injury prevention and assessment. I learned meniscus injuries are difficult to diagnose. The most common mechanism of injury is a rotary force with the knee flexed or extended while weight bearing.  I didn't point to the trainer incident right away when talking to doctors. After all, I was still able to race that season without too much issue and participate in my first tour, Cover Indiana. It really bothered me after a long drive in the car. 13.5 hours and 2 stops. Not my best idea. I remember having cruise control engaged and resting my leg in such a way that the heel of my foot was on the floorboard causing a rotation in my knee. That non-neutral position really aggravated it. For a couple of weeks it even hurt to walk. Walking down stairs was a pain for the first time in my life. I had to focus and be aware of my knee position while sitting for hours at work. This was getting old. I wanted to be able to continue my participation on the Big Bass Drum Crew in the fall and begin my preparations for its physical fitness requirements. I found a doctor while at my internship in the D.C. area.  He was excellent. He eventually gave me a prescription for an anti-inflammatory, physical therapy, and an MRI, but he wanted me to try a knee brace first. With some rest and the brace I was able to run with 4 weeks left in the summer. I did fine in the physical fitness tests, but I aggravated it again a few weeks later while pushing the drum.  Enough already! I had the MRI in September and filled the anti-inflammatory prescription. Then my knee started to do really good. I completed my first century ride later that month. After my doctor confirmed the tear, I thought about it some more, and I realized it must have been that trainer ride. It was extremely painful. I got off the bike and sat on the floor for quite a while with some ice, which I am so glad I did. The first hours after an injury are very important. It ended up being that my saddle was too low. Having a proper fit is critical. There are lots of resources on this.

If you have a meniscus injury:

Signs:
-Effusion developing over 48-72 hour period
-Joint line pain and loss of motion
-Intermittent locking and giving way
-Pain with squatting

Care:
-Immediate care = PRICE - Protect, Rest, Ice, Compression, Elevation
-If the knee is not locked, but indications of a tear are present, further diagnostic testing may be required
-If locking occurs, anesthesia may be necessary to unlock the joint with possible arthroscopic surgery follow-up
-With surgery all efforts are made to preserve the meniscus with full healing depending on location
-Torn meniscus may be repaired using sutures