(From Matt: I’m pleased to welcome Naushad Godrej (AKA “Naush”) to the Upright Health family. Naush has recently made a big transition into the world of health and fitness and has a strong passion to help others get their lives back. This is his first post to Upright Health, and it’s a good one for anyone who’s had or is considering knee surgery.)[hr]
During the winter of my junior year in high school, we were finishing up conditioning drills on a cold evening at my soccer practice, and I noticed something was off. My left knee was clicking, and it really hurt this time. At that point my life revolved around soccer, and I played year-round in hopes of getting recruited onto a D-I college squad. The clicking in my knee was a sign that those chances had just lowered dramatically.
After sitting through the blissful experience of getting an MRI (I’ve had several, and they are not actually enjoyable) and a few visits to the doctor’s office, I was scheduled to get arthroscopic surgery to repair what I soon found out was a torn meniscus in my knee. I would be off the playing field for a good three months with a long road of rehab ahead.
More so than the physical setback of going through knee surgery and the physical therapy regimen, the emotional setback of not being able to play at such a pivotal time in my soccer career hurt me the most. To me, being injured felt like I was locked inside a room, unable to join in on the fun while my peers inched closer toward their goals. It was a sad time.
Because I still had my eyes set on college soccer, I faced rehab determined to play as soon as possible. I was committed to my therapy schedule, and in about three months I was back on the field. Sounds simple, right? What I didn’t foresee at the time was that I would have to continue to fight through a lot of pain in my left knee. I had worked hard to strengthen all the muscles surrounding the knee joint to make it more stable and ready for the pounding, but I wasn’t ready to accept that full recovery would take more time and work. So, at the recommendation of my doctors, I was on a diet of Advil and ice to stop the inflammation and pain. I probably averaged three Advil a day for a year after that surgery. In hindsight, that was a bad idea. The Advil helped to mask pain signals from my body telling me that it needed fixing, and I continued to tax my body day in and day out.
I continued through the next season playing with a nagging left knee, but in my mind it was worth the cost of admission to college soccer. The problem was that I was still at about 80% of peak fitness level, and my knee was sending me signals that it wasn’t feeling right. Nearly a year after my first surgery, I was under anesthesia to get my knee scoped again. The orthopedic surgeon I saw this time was more well-known in the Bay Area sports scene, and according to this doctor, the first surgery wasn’t done correctly. He needed to remove more meniscus for the knee to function properly. So, my trusting self agreed to get it done and go through the whole rehab process again.
This time, I was more diligent and careful during the recovery process. I wanted to get it right, and I wasn’t rushing back to the field. But this meant I’d likely have to tryout as a walk-on if I ever wanted to play at the D-I level. I had missed too many club games, and my injury history prevented me from playing at the level necessary to be a top recruit. There was still hope for me to improve, but I knew I had to realistically adjust what the peak of my future soccer career could be.
In the end, after a long series of other injuries, I ended up playing D-I soccer for Santa Clara University, even though it wasn’t until my junior year that I saw action in an official game. My knee was in “working condition,” but playing in college required me to fight through a lot pain that was not beneficial to my long-term health. It’s crazy how much you can push yourself when you seriously work towards something you’re passionate about.
The truth is, I wish I had known more about functional training and corrective exercise 10 years ago. I probably would not have had surgery and would have been more holistic in my approach to rehab, which would have saved me inordinate amount of time, money, and chronic pain. Yes, there was an issue inside my knee joint that caused clicking, but there was a host of other problems going on with my postural alignment and muscle function. To start, I had serious foot pronation (flat feet) and ankle instability. My glutes were not firing evenly, and my hips were misaligned due to all the kicking, twisting, and pounding my body had to endure. This resulted in problems with my back and nerve stinging down my legs. I soon started to see how everything in the body was connected.
My experience also got me to think about the necessity of knee surgery for a torn meniscus on a larger scale. After all, it is a procedure performed around 700,000 times a year, with a total price tag of $4 billion to our healthcare system. In most cases where someone has torn cartilage in the knee, arthroscopic surgery is performed to remove meniscus that is out of place or interfering with joint movement.
A recent study in the New England Journal of Medicine concluded with a strong confidence level that knee meniscectomy surgery was no better than a sham knee surgery. Another study showed that doing physical therapy alone was just as effective as getting knee arthroscopy followed by postoperative therapy. Sound shocking? It should. This information should force us to think differently about the current treatment for meniscus tears, especially if alternatives are cheaper and just as effective. I’m not saying that surgery is always a bad thing, but I think we should be more holistic in our approach to meniscus tears.
My perspective on training and rehab has changed significantly over the years. Knowing what I do now, it’s very unlikely I would have rushed to get surgery to fix my problem. I’ve learned that looking at the body more holistically for function and alignment is much more effective than treating the location of the pain. Focusing on the cause of the problem rather than the symptom is a better approach for the long term. In my situation, I had a lack of proper function in my hips, which caused pain in the knees. If I had known how to activate the muscles that were not firing properly and stretch the muscles that were too tight and overworked, I would not have relied on Advil as much as I did. In a way, the surgeries and Advil regimen delayed the inevitable for me – learning how to improve function and balance from my feet up.
If you’re thinking about knee surgery, make sure to ask yourself what other musculoskeletal problems could be causing your pain. Commit to working on those problems first and seek out the help of fitness and health professionals who are willing and able to identify your underlying problems. While undergoing surgery may be presented to you as the primary or only solution, it’s worth considering the long-term costs in terms of time, money, and physical health.