Cycling with a torn meniscus

Torn meniscus of the left knee in an MRI

“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:

  1. 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.
  2. See a physio. They could help me with leg strength to stabilise my knee and reduce pressure on the joint.
  3. 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.

18 Replies to “Cycling with a torn meniscus

  1. 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.

  2. 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.

    1. 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.

  3. 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.

  4. 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.

    1. 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

  5. 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.

  6. 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…

  7. 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

    1. 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.

  8. 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?

    1. 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!

    2. 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

    3. 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

  9. 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.

    1. 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.

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