I am a 61-year old fit and active sportsman and I have played a number of sports at a high level, so I am familiar with the usual run of injuries that come on a cricket or rugby pitch, or on a squash court. Over the last few years, golf has been my principle exercise, as a County Senior Team golfer, along with semi-regular gym sessions, and apart from the small niggles that come from over-practicing, my sport has been lucky enough to be unaffected by injury.
That all came to an end in July this year, when in the most innocuous of accidents, I jumped over a puddle, slipped on a white line, and found myself hobbling in agony across a busy road having hyperextended my knee. In classic sportsman’s fashion, I thought I’d be fine… that perhaps I’d just twisted my knee, and that ‘something’ would click back into place, and I could defend my County Senior title a week later. However, I developed increasing difficulty weight-bearing, and over the next few days, in spite of the usual ice and anti-inflammatory approach, the knee became increasingly painful and stiff, and the joint became moderately swollen, and I found myself limping badly. I could not extend my knee whilst standing, and could only squat about one-third of the way down as I was so limited by pain in my right knee. Sleep was impossible, and my mobility was significantly impaired.
I had a great physio in Johnny Lawton at North London Physio, who I’d been seeing on and off for a couple of years to manage the ‘usual’ tweaks and twinges, so I was hopeful he’d work his magic over a few ‘hands-on’ sessions, give me some stretching and rehab exercises, and I’d be back on the golf course quickly. However, his assessment produced frowns and shakes of his head, and an honest and informed view that there was more damage than a course of physio treatments could resolve. I am grateful for his honesty and clinical skill in referring me to Mr McDermott at London Bridge for an orthopaedic examination.
Mr McDermott is a calm, communicative, expert and reassuring clinician. He took a detailed history, and understood quickly that I am a committed sportsman with a desire to continue competing at the highest level I can, and his examination was thorough and informative. His provisional diagnosis of a meniscal tear in my knee needed to be confirmed by an MRI scan, which he arranged in short order. Mr McDermott reviewed the results of that scan with me, and he showed me the extent of the damage I had done to the meniscus. This confirmation of his initial diagnosis was both reassuring, but also hugely disappointing, as it signalled that there was significant damage to the joint. Mr McDermott explained the different treatment options to me, and it was clear from the scan that with this injury there would be no possibility of a physiotherapy-based recovery, or one that could have been achieved through cortisone injections, and I agreed to proceed with surgery.
I had to be out of the country for two weeks, and in the five weeks between sustaining the injury and surgery it was clear that in spite of my continued efforts at managing the pain and swelling as I had always successfully done with other injuries, things were getting worse. The joint pain continued, my limp became worse and I began to experience other muscular aches and pains in response to my poor posture and walking.
Seeing Mr McDermott again pre-surgery was helpful in again excluding any possibility of a rest and recovery, or physiotherapy-based course of treatment. In for the surgery then, at London bridge Hospital, where the facilities, pre-op assessments and the care were superb. My immediate conscious awareness and first thought as I came out of the anaesthetic was: “wow, the pain has gone”. I couldn’t believe it, as I was expecting the pain to be much worse after surgery for some days, and then to recover steadily. But I had no pain in the knee. The relief after 5 weeks of suffering was immense.
I was in hospital for a day, and was able to leave on crutches some 8 hours after coming out of theatre. I was surprised to find I did not need any medication pain relief that day or in the days after, and although stiff and uncomfortable, I quickly felt that I would recover, and that I could dump the fear that I would not be able to play golf again.
I was back at work within 3 days, and while stairs were a challenge in rush-hour traffic, on flat ground I was soon walking well, with some stiffness. I dutifully worked through the daily rehab exercises London Bridge had demonstrated to me, and saw Mr. McDermott for a follow-up where, he showed me the ‘video’ of the damage to my meniscus and the work he had done in surgery. Those images made it abundantly clear why physiotherapy alone would not have been a viable treatment option, and why the surgery had immediately left me pain-free. Within 3 weeks, I went back to Johnny Lawton on Mr McDermott’s advice to establish a sustained rehab programme. Mr McDermott had shared the report of my surgery with Johnny, which meant he tailored the exercises to the specific surgery that I had had.
Johnny was somewhat surprised and pleased with my status when I saw him for the first time post-op, and our subsequent rehab sessions have built on the work I have been doing at home. Most importantly, I was back on the driving range 8 weeks post-surgery, and won my first competitive ‘comeback’ tournament exactly 12 weeks after surgery.
I cannot express my gratitude strongly enough to Mr McDermott – for his calm reassurance, his obvious expertise and knowledge, his evaluation of the pros and cons of different treatment options, and his surgical skills, which he had applied so carefully to tidying up my shredded meniscus whilst saving as much the meniscus as he could. It was just abundantly clear that physiotherapy could not have resolved this issue – and the longer I might have delayed surgery, the more damage I was doing to the joint, and elsewhere.
I continue the exercise rehabilitation, and am looking forward to the next golf season, and being able to walk and exercise more as I regain full mobility. My best advice for anyone in a similar situation – find a great surgeon (like Mr McDermott), get a good scan to carefully evaluate and be certain of what the damage is, and then make your treatment decisions based on the evidence. Yes – do question and establish what the least intrusive treatment is that is going to work… which might be physio if the damage is minor. But if the evidence says the damage goes beyond a rest and recovery / physiotherapy option, be aware that delays in treatment or the use of inappropriate treatments (like cortisone injections, which may help in the short-term, but which may also mean that you are delaying the essential surgery) may do you more harm than good.
Thank you to Johnny for knowing he needed to refer me for a surgical consultation; thank you to Mr McDermott for his skills and advice, and the effort he put into saving as much of the meniscus as possible, and thank you to the staff at London Bridge for their superb care. I am grateful to you all.
Mr Scott Galloway
5th December 2020