Returning to Running After a Meniscus Injury

by Janis
(N.S. Canada)

I have developed a meniscus injury which requires surgery. I run 1/2 and full marathons and haven't been able to run for the past 3 months as I wait for the surgery.

How long after surgery should I wait before I start running again? Also, what are the best post-op exercises I can do to prepare for running again? Thanks.

Janis, Running Addict!

Answer by Dominique:
Hi Janis,
Thanks for your questions.

I have had two keyhole surgeries, on both knees. I can cover:

1. What my recovery was like
2. Post-op exercise
3. Use the opportunity

What was my recovery like

Both times I had surgery on my meniscus, the surgeon considered it "a bit of a clean-up". After surgery, I had to keep my leg as straight as possible for 2-4 weeks.

Keeping the leg bent for longer periods of time was painful, even after the first two weeks. E.g. driving for a longer distance and my long train commute caused a bit of discomfort.

Both times I started running little bits after about six weeks. It was very limited though. And you will feel it if you are starting too soon. The knee will simply hurt too much.

You can only really return to any weight-bearing / impact exercise like running when your knee is back to full range of motion and you no longer have bruising or swelling.

Post-Op Exercise

Replacing my running with the exercise-bike was not a great option. The exercise bike is lower impact, but there is still enough force needed from the knee as you are pedalling that it caused discomfort.

Walking is your best option to get back into exercise earlier and a bit of movement is actually great for the healing process as it stimulates blood flow. Keep it sensible, don't go too fanatical. Do it as a way to keep some sanity, rather than trying at all might to keep a level of fitness. Alternatively, swimming or the elliptical can be reasonable alternatives.

However, in short, my advice is to respect the recovery process. Don't go back to running too quickly and follow the guidance from your surgeon. The surgeon is likely to tell you that you'll need to stay away from running, weights and exercises that test your range of motion like deep squats for six weeks at least. Follow their advice!

That may not be what you want to hear... So, let's focus on the opportunity you have.

Use the Opportunity

After both surgeries I really used the rehabilitation period to focus on building a solid base. I ran much slower than usual and was just focusing on keeping my heart rate very low, about 10 beats per minute slower than what was my normal easy running heart rate.

Why?

Slower pace really reduced the impact on my knees. Which meant that I was able to build up my time spent running quite quickly.

I used a treadmill both times, at 0% incline, just to keep the running as smooth as possible.

Both times I kept to this slow and easy running for about eight weeks. I really used it as a pure base building phase. Which, let's face it, so many of us don't do enough. We like the quality stuff, we like the variety of the workouts.

But the ultra-slow running really paid off...

... For one, being able to run for longer times kept me sane...

But also, before too long I was easily able to run every day and I was able to build up my mileage well without pushing the knee beyond what it was capable of.

If you use that post-op period wisely, you will find that you can rebuild a lot of your fitness during those eight weeks. Use the opportunity and make it a jumping-off point for renewed levels of fitness!

When returning to strength training, really take it easy on those knees. Don't go heavy squatting immediately. Again, as with your running, start off super easy and build up from there.

You'll work out when bodyweight squats are possible again and when you can start loading up weights. But once, again, respect the healing process!

A meniscus surgery is not the end of the world. Generally, you can pick up your running relatively quickly again. All depends on the exact procedure and the healing process. At all times, follow your medical professional's recommendations to avoid re-injury and complications.

All the best.
Kind regards,
Dominique