Tear in the minsucus

[Antz]

Hi coach,

Hope you can help me on this since it concerns my brother and I really want him to alleviate this pain in his knee.

10 years ago he was skiing and felt on the snow, his leg got stuck in the snow and his body continued leaning forward which caused his leg to break on the knee level.

His problem is known as " a small tear in the minsucus ". Still until now he can walk properly and normally but can't do any kind of activity that puts pressure on the knee like playing soccer or sprinting or what I was aiming for " Squatting ".

He is the kind of bodybuilders that work only his upper body with isolation exercises. I have been trying to get him to start SS to change his perspective on weight training and stop him from wasting his time and of course the most important of all reason is to let him get rid of this knee pain that doesn't allow him to do any kind of activity.

He tried squatting without a bar but his knee hurt him badly.

The doctors recommended him to do a surgery for his knees. We are trying to avoid this since it is dangerous. For this reason, can you please recommend what type of program he must follow in order to rehab his knee?

Thanks for your precious time & BR Coach,
Antz

[veryhrm]

where do you live? all surgeries have risk, but arthroscopic knee surgery isn't particularly dangerous as surgeries go.

My comment/suggestion would be that he find a surgeon that's more about sewing things up rather than cutting things out. In my experience (as a lay person and ocassional patient) US surgeons want to do as much removal, replacement or remodelling of your parts as you're willing to let them get away with :-)

oh, also unless he's had an MRI or explorative surgery(unlikely) don't put TOO much stock in the specifics of the diagnosis. Even w/ an MRI it's not always clear what the state of the cartilage is until the doc actually looks at it during surgery.

[Antz]

where do you live? all surgeries have risk, but arthroscopic knee surgery isn't particularly dangerous as surgeries go.

My comment/suggestion would be that he find a surgeon that's more about sewing things up rather than cutting things out. In my experience (as a lay person and ocassional patient) US surgeons want to do as much removal, replacement or remodelling of your parts as you're willing to let them get away with :-)

oh, also unless he's had an MRI or explorative surgery(unlikely) don't put TOO much stock in the specifics of the diagnosis. Even w/ an MRI it's not always clear what the state of the cartilage is until the doc actually looks at it during surgery.

Hey,

Thanks for the reply.

I live in Lebanon but he lives in the states so they are US doctors that suggested the surgery for him.
From what I recall, he told me they want to cut instead of sewing. I was reading this thread http://startingstrength.com/resources/forum/showthread.php?t=10950&highlight=knee+rehab which is almost similar and Rip suggested to squat eventhough it hurts but to squat with the correct technique. I made him yesterday buy the book and learn how to squat properly so that next time he tries maybe it won't hurt him as much and he can at least start progressing. Do you think him squatting correctly and increasing weight in a small incremental fashion is a better solution then the surgery ?

Thanks,
Antz

[HONEYBADGER]

I second the response to have a second opinion, and make SURE you go to a physician who deals with athletes, and explain to him that he wants to lift, train, etc. In many cases a minor tear does not need to be operated on, and there are tons of rehabilitative measures that can help the knee issues if the damage is not too far along.

For one, do LOTS of hamstring work at the knee end. Leg curls with the toes out, toes in, ghr's etc, but find the weak points along the lower hamstrings and make them solid and strong.

Next, make sure the vmo is firing properly. TKE's are great for this. You can palpate the vmo when he squats and see if the vmo is turning on properly, if its not, hit the tke's with a passion and fix that issue, as improper tracking is going to magnify his injury issue.

Last, make sure the glutes are firing properly and are activated. Plenty of glute activation exercises making sure the glutes are leading hip extension will prove invaluable for some with knee issues, as they are overcompensating with the lower extremeties in many cases.