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Megan Rath

Philadelphia, PA
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Hello. My name is Megan Rath and I am amateur athlete sharing the story of my comeback and ongoing management of the cartilage defects in my knees. I have historically been a believer of working hard in silence and grinding in the dark away from the crowds, so this is tough for me to share, but important.

I have been dealing with bilateral patellofemoral pain for the last 16 years. I separated the cartilage from my left patella after coming in from a run and stretching my piriformis when I was 27. I went from doctor to doctor for years, and no one could find anything “wrong” with my patella. My right patella cartilage degeneration was from wear and tear and faulty mechanics among other things like muscle imbalance and weakness.

Through it all I was able to perform at a high level. I played ten years of squash and ten years of mid-distance triathlon (Olympic and 70.3 distances). In 2016, I hiked into Everest Base Camp and was instantly inspired by one of the women I met who was climbing the seven summits and was training for Everest. In 2018, I climbed Mt. Kilimanjaro and then Mt. Elbrus in 2019. COVID hit in 2020 which put a pause on the climbing, but I continued to train hard.

I had my first knee surgery in October 2020 to clean up the cartilage defects. I came back three months later and climbed Cotopaxi and Cayambe in Ecuador. I was in peak form and the only thing I couldn’t do post-surgery was run. In March 2021, I turned 41 and literally the wheels came off. I had a medial plica on my left knee that became symptomatic, and I had a ganglion cyst under my IT band on the right. I had committed to the Escape from Alcatraz triathlon, and I was determined to see it through recognizing that it could be my last race. I got the cyst drained that last week of May and by first week of June I was back running. However, one month into running again I had major sharp pains in both knees that any normal person would have pumped the breaks and reassessed the situation.

I pushed on through and continued to train because in my mind nothing was going to stop me from heading out to San Francisco and ‘toe the line” with the Olympians who just came back from Tokyo. I finished although it wasn’t pretty. I ended up with bilateral bone marrow edema in my patellae and my fat pad in the right knee had hypertrophied so much so that I couldn’t walk right.

In any case, along my triathlon journey I met Dr. Karen Sutton, a sports medicine surgeon at HSS who suggested that I see Dr. Andreas Gomoll. Ironically, I had spent a majority of my career in orthopedics selling trauma and hip and knee replacements but cartilage transplants and joint preservation were foreign to me. I thought to myself, if I couldn’t figure this out, what about everyone else?

It got to a point where I couldn’t really walk or go down the stairs. Therefore, I decided to proceed with my left knee first and had the separated cartilage removed from the patella and an intraosseous injection of BMAC. Six weeks later we did the right knee which was more complicated: cleanup of new flaps, Intraosseous injection of BMAC to the patella, medial plica removed and the ganglion cyst decompressed. However, 6 weeks out from this surgery we went back into both knees to remove the infrapatellar plica among other things and cut out the ganglion cyst under the IT band.

From there, it was a long road back and I’m still not where I want to be. I had 80 something PT sessions, 20 rounds of laser and 10 rounds of shockwave (the kind they use on racehorses). I recovered well enough to go to Girona in November 2022 for a ride camp to help me build fitness on the bike in preparation for Mt. Vinson in Antarctica in December. I wasn’t sure if I would be able to pull it off, but I had to try. I have walked the razor’s edge for many years, but this was going to be a real test to see if I could continue with my seven summits quest.

I summited Mt. Vinson on the 24th of December. The struggle was real, literally every step of the way and mostly due to the fact that I was just six weeks out from the last shockwave treatment. The experience in Antarctica was nothing short of sensational and I was not going to leave without touching the top. Broken but still in it. However, in the front of my mind I was thinking about my knees the entire time and knowing that I am putting myself at risk and steps closer to the cartilage transplants. I will 100% need future knee surgeries but today is not that day. I have thought about giving up more times than I can count but if I quit, it would surely be over. At this point, I focus on getting 1% better every day because there is still so much room for improvement.

A relationship with HSS and Dr. Gomoll was not the long-term relationship I had been looking for. But, if there was a team to go the distance with, this would be the one. I am heading to Denali in six short weeks and the journey continues. Stay tuned.