“There isn’t much I can do,” the orthopaedic surgeon said. “I could cut away your meniscus, but you’ll develop arthritis in 10 years. I don’t want to do that.
“The best you can do is alter your lifestyle. If it hurts after an hour of cycling, maybe just stop cycling after an hour.”
I walked out of that consulting room deflated. For several months, I’d suffered a mysterious pain in my left knee. I’d barely ridden, giving it every chance to recover. Whenever I hopped on a bike, the pain returned within 30 minutes.
And so, it seemed, I’d just have to live with it.
No more racing. No more long rides. No keeping up with clubmates. Forever confined to slow, painful shuffles to and from the shops. Life in a cycling straitjacket.
On one level, it was a relief to identify the problem. The meniscus is a piece of cartilage that sits between the femur (thigh bone) and tibia (shin bone). It acts as a cushion where two bones would otherwise be rubbing and rattling against each other.
My meniscus was torn towards the outside of the knee, known as a lateral tear. As a related problem, I also had fluid-filled cysts in my knee, which showed up as white patches on the MRI. Knowing what was causing the pain gave me some closure.
More confusing was how I injured it. Torn menisci are usually associated with the twisting forces of sports like basketball, oztag and hockey. The linear up-and-down motion of pedalling doesn’t strain the knee in that way. In fact, physiotherapists usually recommend cycling to patients recovering from knee injuries. I’m only 27 years old—surely too young to have knee problems?
When I put this to the surgeon, he answered: “This tearing is degenerative. You have a defective meniscus.” In other words, hard luck—you were born with a weak knee and you’ll die with one.
So, what now? Nothing could be done medically. Could I ever ride again at the same level?
You know, cyclists can be stupidly single-minded. Hence these stubborn exchanges with my wife, who is a doctor:
Wife: You’ll just have to accept you won’t be able to ride competitively anymore.
Me: Why?
Wife: You need to look after your meniscus so you don’t get arthritis in 15 years.
Me: I’d rather ride for 15 years and get arthritis than spend the rest of my life not riding at all.
Me: What’s the point of having a meniscus if I can’t use it for cycling?
Wife: So you can use it for other things, like walking.
Me: I don’t need to walk, I’ll just cycle everywhere.
Wife: I think you’ll find you walk more often than you cycle.
Me: Walking is just a means of getting to and from the bike.
Now that I knew surgery wasn’t an option, I thought about adjusting my riding to manage the pain.
Three things came to mind:
- Get a professional bike fit. I’d make sure I was pedalling the bike correctly and not twisting my knee, which could exacerbate the pain.
- See a physio. They could help me with leg strength to stabilise my knee and reduce pressure on the joint.
- Gradually build back into cycling. I’d take it easy at first, then increase duration and intensity over time to see how far my knee can go without hurting.
That was three months ago. I’ve had my bike fit and started seeing a physio. I’m happy to report that so far, things look good. I haven’t raced yet—that will come with time—but I’ve been commuting several days a week and tried a few harder group rides, all pain-free.
It’s too early to know how far I can go, whether I can still reach my cycling goals. Perhaps the pain will return. But I won’t let my enjoyment of cycling die in that consulting room.
Don’t usually comment on these things but hoping my situation can help others. I had a severe meniscus tear 9 years ago causing my leg to lock in a bent position. I was completely immobile. I had no choice but to go ahead with surgery and they removed a load of it. I have been having early signs of arthritis the past few years, so it really does creep up with you quickly. I have re-torn the meniscus again! But this time I am mobile and the pain isn’t so bad. The surgeon recommended to remove but I have said no. Please bear in mind that, it’s a really easy quick procedure for surgeons who get paid a lot of money for each time they perform one. Some times (only some times) you need to ask the question are they actually thinking of your health, quality of life and longevity or are they wanting a quick easy pay out for themselves. I’m not in pain with my new tear, just discomfort from time to time. I’m going to adapt and do plenty of quad, hamstring excercises accompanied with bike ridding to strengthen the muscles. My point is, first of all each persons tear is completely different so people shouldn’t compare to others circumstance, however if you can bare the discomfort and most of the time have a normal life, then surgery should be the last option. We’re all going to get arthritis which ever choice we make, but why speed the process up if you don’t have to. That’s my thought anyway.
Lisa, you wrote on Mar 8 about whether to have surgery or not, but the reply button is not working, so hopefully you see this message. I had a bucket handle meniscus tear and had it stitched at the age of 31. That was after months of PT and living in daily discomfort when bending/straightening knee. After surgery, I spent 6 weeks in a brace, then some months doing gradually increasing PT/exercise. It took me probably a year to feel confident fully playing sports again, but it is a fully functioning knee now. In deep bend, I feel slight discomfort, but this is scar tissue rather than the meniscus – and it is not pain. I’m happy to squat on it. Hope that helps – but it depends on the severity of the tear. The surgeon said I had a grade 3 bucket handle tear – and surgery was only option. I know people who had done physio for 6 months to fix small tears.
My doctor told me I can do spinning but don’t get up from the seat and do the resistance to the minimun
Hiya I’m 47 too , and have had a large meniscus tear for five years now.
I just put up with it , but sometimes it hurts a lot more than other times.
I’m avoiding surgery , as one- I couldn’t be without driving all that time , and two – how do we know that it will def be better after surgery , snd there’s also risk of infection , arthritis etc .
Has anyone had surgery and can say it’s def better , and can it be torn again once we’ve had surgery ?
Questions questions !!?
I’m so undecided to have surgery as something about it doesn’t feel quite right
Thank you for that information. Cyclist, former runner/tri-athlete, medial torn meniscus. Just recently dx’d,
Thanks Ryan, you give me hope. I’ve just had that ‘you might as well stop exercise forever’ conversation after an MRI and I’m about to start on that round of visits to surgeons and sports doctors. I’m ready to ride more and run less- that should be fun, if more time consuming. I hope you’re totally back to normal now
Leteral meniscus tear, no idea how. Lots of good info but nobody talks about how hard they spin/cycle, whether they remain in t he seat. Physio told me to remain seated but no idea how hard I can ride to get my heart rate up.
At 65 yrs old, an MRI confirmed a partial lateral tear of my meniscus. The pain had been with me for over 6 months. It could keep me up at night on occasion, and I had enough of a limp to make walking unpleasant. Interestingly, the only thing that gave me relief was the bike. The second I got off the bike, the pain came back instantly.
The surgeon did not recommend surgery at my age, he said to try and suck it up and give physio a try. I asked what was the best physio. He replied that my 5000 kms per year was the best physio, and he also recommend leg presses. Not leg extensions, or leg curls, those would not help. Leg presses are the ones where you are sitting on a reclined bench, and push weight by pushing your feet out.
Cycling was a natural for me, as I am religious about my mileage. But I did join a gym and did the leg presses with heavy weight. Interestingly, like the bike, the leg presses gave me an almost instant relief. After my workouts, I left the gym feeling like I was floating on air. The pain was slowly going away.
After about 5 months of 3X a week gym sessions, plus my usual cycling, the knee pain was about 80% gone. Today, another 6 months later, my knee feels 99.9% pain free. I am convinced the tear is fully healed or close to it.
Bottom line…..give physio a chance, and yes, a torn meniscus can heal itself at 66 years of age. Good luck to all in a similar situation !
Had arthroscopic surgery for a meniscus tear on my right knee from jogging about 3 years ago. I started riding my bike when COVID started in 2020 and for the last month or so have suddenly discovered my knee is functioning almost like new. I am 80 years old so bear with me on the fact that I do 10 miles daily at about 11 miles/hour. The interesting thing is that pedaling has always been painless but walking had been somewhat painful until about three months ago when I suddenly noticed that I was beginning to walk for long periods of time without any discomfort. I have a suspicion that it has simply taken that long for my leg muscles and ligaments to adjust to the repaired meniscus. My point here is if an 80 year old can improve there has to be hope.
Hello I’m 71 and have a torn myniskus. I also have arthritis and have been told by Dr the the torn myniskus will cause more arthritis along the way. Tried using the vertical bike but as everyone is saying I start getting pain again. I’m facing a knee replacement trying to avoid that. Are there any old timers that have experienced similar situations
Hello Ryan,
I’ve got a torn meniscus now in my left knee. I’ve been riding for sixty years and never been off the bike this long.
Could I trouble you to describe which PT exercises you are doing?
I’ve been trying a lot of different ones for two months but I can’t tell if they are working or are the right ones.
Thanks very much
Dave
I know it sounds a bit drastic, but about 10 years ago I injured my meniscus terribly and was able to get a (human) meniscal transplant and have had no problems since. Not sure if your doctor mentioned this but if your pain comes back you may want to look into the option – it’s not an easy procedure but from what I understand it is a long term solution. I had my surgery done at the Hospital for Special Surgery in NYC, a leader in sports injury surgeries.
Hi Ryan,
I’m in a similar situation at the moment. I’m 26 with an MRI showing a torn meniscus. We have been out on the road together at parra park. Who did you see for your bike fit and how’s the knee? It’s been 3 months for me, definitely some improvement. The indoor trainer gives me no pain, but outdoor raining is still a constraint and something I worry about.
Hi Mathew, I ended up seeing Aaron Dunford of Fusion Peak (you can read my blog post about it). That was 18 months ago, and I haven’t had any issues with the knee since. For me, I have to watch out for sudden increases in training volume (e.g. riding lots during the Christmas break), but I haven’t experienced any pain for quite a while now.
68 years old, meniscus tears so bad I walked with 2 canes for 2 years.
I got a rebounder (mini trampoline) just for general cardio. I did 30-45 minutes a day of gentle movements: stepping back and forth, side to side, etc. Unexpectedly, I was able to walk without canes after 3 months. Been going strong for 6 months now.
I did physio-type exercises previously, the theory being that stronger leg/hip muscles will take the strain off the knees. The problem is, those exercises are boring and you only do them for a few minutes at a time, which isn’t enough. (Or you give up out of frustration.) Whereas the mini trampoline is fun, and you’re more likely to do it for longer periods.
Thank you for the post. I’m looking into getting a bicycle now.
Thanks for sharing your story. Great to hear you’ve been exceeding expectations!
Cycling isn’t a natural human movement, walking is.
I had to ditch my single speed because of knee pain.
The un-natural strain on my neck from looking up is
causing me to have painful rides. I had to raise the bar
and not ride in such an aggressive pose. Not to mention
numb hands and balls. I’ve cycled for decades but still
understand it’s not native to the body.
I torn my medial meniscus after a long 3 hours walk 🙁 it does not mean the cycling is worse then walking. my meniscus is completely torn and I can feel the piece that dislocated through my skin. 🙁 hopefully will be able to bike again
Hi. I’m probably going to be told just to go talk to my doctor again but, in short, I have a meniscal tear in my right knee (suspected in my left knee now as well though, but haven’t confirmed by imaging). I was advised by my family doctor to get a bike throughout COVID and winter months to keep up exercise and mobility as excessive weight gain can make the pressure worse on these injuries. In short, when I am on the bike pedaling, I have never experienced any pain or discomfort in my knee. However, when I am off the bike and walking around later in the day, I am now beginning to notice worsening pain in the knee which is distressing. This is literally the only form of exercise I’ve got left, as walking has been agonizing even with a brace. Really don’t want to stop the bike but, is it really making things worse? Why would it not hurt while I’m actually pedaling on the bike? Wondering if anyone else has had this experience. Just dropped several hundred for the new bike as well, about a month and a half ago so… yeah. It would be a shame if I had to stop. Just not sure what to do and hope to find others in my situation.
Hey! This is very interesting. I have the same unfortunately. However I’m not a cyclist but I play football 3 nights a week! I’m here because I thought cycling might aid recovery with it strengthing the legs whilst reducing impact and twisting…
Hey Ryan, your post is eerie as it’s the exact profile of what I’m dealing with, 27, torn meniscus with cysts from overuse on the bike and a genetic disposition to it. How’s the recovery going? Would be keen to keep updated as I start in on the bike fit/physio journey too
Sorry to hear about your injury! I’ve been riding fine and pain-free since I wrote this post. You may have read my post about my bike fit. My physio sessions concentrated on flexibility, with a little bit of strength. I’ve been riding as normal (well, mostly indoors thanks to COVID) without pain. Occasionally I’ll feel a niggle in the knee, so I’ll just back off for a few seconds before getting back into it. Let us know how your treatment goes.
Hi. I have the same problem. Im 32 with a miniscus tear. And i cant do gymming any more
Hello, I had experienced the lateral meniscus tear for my left knee 4 months ago. I got treatment of taking medication while being in rest, wearing knee brace for 2 months, doing exercises for strengthening my knee. But still I face a pain if I stand for more than 15 min. Can u help me with a advise? Can cycling help my meniscus tear pain?
Hi Bennett, sorry to hear about your injury. I’m not a medical professional, so I’m afraid I don’t have the answers for you. In general, cycling has a relatively light impact on the knees, so it can be good for strengthening the leg muscles without injuring your knee. You’d best consult a doctor and/or physiotherapist about your particular case. I hope your knee recovers soon!
Hi I’ve been told that I’ve got meniscus tear in my left leg I’m having pains and cannot walk properly waiting to see the bone people any suggestions as I love to get back on my bike please
Hi I’ve been told that I’ve got meniscus tear in my left leg I’m having pains and cannot walk properly waiting to see the bone people any suggestions as I love to get back on my bike please
Hey, Ryan, what has happened with your injury? Seems like I might be in the same boat as you. I’m 47 yrs old and I’m starting to realize that I’ve had this come and go over the past couple of years. I have pulled out of it, but seemed to have gone backwards. I had a good MRI only 2 years ago. I believe I tore the meniscus at some point along the way treading PFPS while doing physio exercises and pretty much can pinpoint the day I did re-injured it trying to stretch my quads. Let me know how you have made out.
Hi Chad, so far so good! I got a bike fit to make sure I wasn’t straining it unnaturally, and saw a physio who got me to work on flexibility and core strength.
It hasn’t hurt too much since. Sometimes, it feels a bit uncomfortable and I just ease up on the pedals for a few minutes. It clicks every now and then, but that doesn’t bother me too much.