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Thread: Squatting with a plica?

  1. #1
    Join Date
    Jan 2013
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    18

    Exclamation Squatting with a plica?

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    Hey guys, I have a medial plica in my right knee that makes an odd POP during the eccentric phase of squats right before I hit parallel.

    It is fine on the up part of the lift. It does not hurt when lifting but it sure is disconcerting. That part of the knee feels a bit irritated most of the time but no worse lifting.

    I am seeing a PT who also lifts and he suggested avoiding loaded exercises that make the plica snap over the femoral condyle...

    Any thoughts on this programming wise? Should I leave out squats and just do deads, squat partial depth, or go ahead and squat with the popping?

    My form has been checked here and is fine.

    Thoughts welcome, especially those who have had a plica or coached someone who has.

    Thanks!

  2. #2
    Join Date
    Feb 2011
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    I'm afraid I have very little experience with this, and no experience in a coaching context. Knee plica falls under the rubric of what an emergency physician would consider an "internal derangement of the knee," with referral to sports med or ortho.

    That said: squatting partial depth is not the answer. Your PT is just talking out his ass. Ask him about the large longitudinal studies of long-term outcome in patients with knee plica who squat heavy below parallel. That's right: there aren't any. It might make your knee worse. It might not. Popping is not the problem. If your knee wants to pop, let it pop. Inflammation and pain from the plica rubbing on your femur, on the other hand, are problems, and there is a potential for things to get worse.

    Your options are:

    Option 1. Don't squat. Wouldn't be my first choice, but does give you time to explore Option 3 (below).

    Option 2. Continue squatting to depth, ignore the pop, and See What Happens. Three scenarios obtain:

    Scenario 2a. Knee starts to hurt. (Stop squatting, see option 3.)
    Scenario 2b. Knee doesn't hurt. (Keep squatting.)
    Scenario 2c. Knee explodes, mid-squat, into an ultra-high-energy fireball of quarks and gluons, creating a black hole that swallows this wicked, wicked world. Probably at the worst possible time, when you have the most to live for.

    Option 3. Just go to an orthopod, tell him Squatting Is Your Life, ask him to break out his propofol and his arthroscope to fix the fucking thing, and get it over with. This is an excellent option.

    Please observe that Option 3 can be exercised either BEFORE or AFTER the knee starts to hurt, but cannot be exercised once scenario 2c has materialized. Once your knee destroys the universe it will be too late. Even if you have Blue Cross.

    Wish I could be more help. In all seriousness, let us know what you end up doing and how it turns out. This is a new one on me, and I'd like to know for future reference.

    Maybe somebody else with relevant experiences will have something more helpful.


    This post is for educational, illustrative and entertainment purposes only, and does not represent medical advice for any particular patient, medical condition or elementary particle. No particular exercise program is advocated herein. Sullydog doesn't know from plicas. He's really kinda full of shit, he's not your doctor, and he is absolutely not to be trusted. He once stole ten dollars and a pack of cigarettes from his Mama. No doctor-patient relationship is established by this post. Individuals with medical questions or problems should seek proper medical attention. Quark-gluon plasmas are extremely hazardous and should not be handled without specialized training and permission from the gummint.

  3. #3
    Join Date
    Jan 2013
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    Well, I went to one ortho six months ago for this who essentially brushed me off.

    Went to another one two weeks ago who referred me to this PT.

    The knee feels irritated around the plica (whole medial knee area really) pretty much all the time but does not feel WORSE when doing squats, deadlifts, or cycling. Basically bothers me all the time and not much makes it better OR worse.

    It is annoying as shit and wish someone would just scope it and be done with it. I am only 27 and "just don't squat" for the rest of my life seems to be an unacceptable solution.

    Jonathon, thank you much. ANyone one else with experience please jump in also...

    I will continue squatting full depth for the time being and ask my current ortho about a scope when I go back in two weeks. Will update here.

  4. #4
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    Quote Originally Posted by jkarrasch View Post
    Well, I went to one ortho six months ago for this who essentially brushed me off.
    Too busy with $30,000 total hips to worry about your pesky little synovial tag. Sorry about that. I'm familiar with the phenomenon.

    It is annoying as shit and wish someone would just scope it and be done with it. I am only 27 and "just don't squat" for the rest of my life seems to be an unacceptable solution.
    It would be unacceptable to me, too.

    Jonathon, thank you much.
    For what? I wasn't much help, I'm afraid.

    I will continue squatting full depth for the time being and ask my current ortho about a scope when I go back in two weeks. Will update here.
    Please do.

  5. #5
    Join Date
    Apr 2010
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    Unfortunately I do not have any relevant coaching experience to offer here. But Sully's small-print disclaimers are, like fine wine, getting better with age.

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