A reader who works an intense physical job and has an adrenaline hobby that is also physically demanding is experiencing pain in his right knee. An MRI showed damage to both menisci, as well as thinning of the joint cartilage with damage in multiple areas of the knee. He’s asking if the proposed arthroscopic surgery to repair the meniscal damage will allow him to continue all his activities as before. He is 48 years old.

The MRI findings point to degenerative changes in the knee, indicating the onset of osteoarthritis. This means that the knee’s cushioning mechanisms (cartilage and menisci) can no longer handle the total stress they are subjected to, accumulating microdamage that the body cannot repair, which leads to changes in the physical properties of these tissues, as seen on the MRI, and even more clearly during arthroscopy.

The surgery may help with the pain if the meniscal damage is causing it (which cannot be confirmed without an examination). However, the procedure will not change the knee in a way that allows it to handle the same loads that caused the damage. In short, your physical activity must be modified. Otherwise, it is highly likely that the degenerative processes will accelerate.

Modifying physical activity starts with keeping a detailed training log. Then an examination and specific tests are conducted. Next, goals are set for the physical performance the body needs to meet, and an optimal training process is established to achieve that goal. This includes “cleaning up” the training by reducing unnecessary stress, incorporating preventive and prophylactic measures like low-intensity aerobic training, stretching, proprioception, and muscle balance training. A daily, weekly, and monthly rest plan is also established. Dietary habits may be addressed as well. All of this aims to help the body and the knee maintain or improve physical performance while reducing stress on the injured tissues.