On Seeking a Second Opinion (Guest Post)

By Alison Conway

A year ago, I wrote here about an injury and dispiriting MRI results: complex and degenerative tears in both menisci. The specialist sat me down for the bad news: surgeons in my town were not going to be interested in having a look, believing that meniscus surgery puts knees at risk for joint replacement down the road. I had some questions about my injury—it didn’t fit the meniscus tear stories I had read, which included sudden pulls or twists or pops. Nor was I experiencing the usual symptoms related to meniscal injury: knee locking, clicking, giving way. But the images seemed to speak for themselves. The specialist was sorry. There you go.

As he delivered the bad news, I should have remembered that visual data is always context specific and always read through an interpretive lens. I couldn’t find my way to questioning conclusions that the MRI results seemed to underscore, but I was alert to the significance of a remark made along the way, something along the lines of, “You know, you can burn more calories riding a bike than you do running.”  “Hold up,” I thought, “who said anything about calorie burning?” I didn’t run to manage my weight, nor do I talk about exercise in this way. I suddenly saw myself as, I’m guessing, the specialist saw me–a middle-aged woman who jogs to keep her weight down. I became suspicious of his quick assessments and conclusions. My family doctor also had some questions. To his mind, there was no reason not to put me in front of a surgeon rather than discounting the possibility of an intervention out of hand. He agreed that a second opinion was in order.

Fast forward past the usual long wait time and I’m in front of a specialist in another city. The conclusions he draws, looking at the MRI images, are radically different. The degenerative meniscal tears, he says, are pretty run of the mill. I have probably been running with them for years. There is no need for surgery because they aren’t the cause of the injury.  He puts me through a range of tests relating to meniscal function, closely examines my gait and alignment, and then announces, “Patellar tendinopathy.”  My gait, he points out, is slightly knock-kneed, and in the absence of strength training to support proper alignment, the tendon is aggravated by being dragged over the joint the wrong way. I had been sitting on my butt for months at the start of Covid, leaving the house only for easy runs and not much else—certainly not strength training at the gym. The knee trouble began when I ramped up to longer distances the fall of 2020.

These days I’m running again, shorter distances until I have time to undertake strength training with diligence and attention. Will I run a marathon again? I don’t know. But I do know that I was able reclaim running by advocating for myself. I thank the doctors who respected what running means to me.

I recently finished a sprint triathlon, my first in four years.  The run felt like freedom.

Alison Conway trains and works on the traditional and unceded territory of the Syilx Okanagan People.