A Scrawny Lifter's Redemption Song

[Gary Gibson]

05/15/2009

BP 45x5, 95x5, 135x3, 165x3, 185x4x8

BP was finally challenging and was all I had the energy for today. Got really hard after the fifth set.

Got under an empty bar and did a few sets of perfect paused squats while resting between bench sets. Knee was pretty happy with it, but I pinched the medial thingee on one forceful extension.

Nearly a week of GOMAD for ~4000 kcal/day. 165-166 lbs.

Injury Progress: Drained 15 cc three nights ago, 12 and 12 yesterday afternoon and evening. 12 again tonight. Minimal rice bodies (?). I was worried that there was refill today after that very light bit of bar squatting (just to practice form), but after the 12 draw tonight my knee is the most normal I can remember seeing it and it feels the best it has since I started keeping this journal. Even the usual distolateral bulge is finally shrinking. I think this constant draining is finally taking hold.

Able to do my supine leg extensions with 10 lbs and no stalling at the sticking point. Much improvement over last week. Extension and flexion feel smooth and fluid through entire ROM. This may not be the case tomorrow, but for right now it seems that the draining and rehab is making progress despite the occasional overreach and refill.

[Gary Gibson]

05/16/2009

BP 45x6, 95x5, 135x3, 175x2, 195x3x10
SQ 45x10
Chin Up x5, +50x5x2

BP was hard pretty much throughout. Last rep of chins was a bit of a cheat; had to draw my knees up to finish it.

Injury Report: Spent all of the day running around to pick up 10 45's and attempted to move a piano onto a van. Knee refilled and that night I drew an easy 17 cc and there's more in there as I type this.

Edit: Right after I made this entry I went in and got another 17 ml of synovial fluid. Slightly bloody.

It's possible that I have some sort of synovitis, but this fluid does NOT spontaneously fill in; it seems to be directly related to the amount of stress I place on the knee. The three distinct cases of refilling followed obvious increases in the intensity or volume of activity:

1) Deep knee bends performed right after the last aspiration of the long-standing effusion

2) A three-mile walk

3) Moving several 45-lb plates and attempting to load a very heavy piano into a truck.

[Gary Gibson]

05/18/2009

BP 45x10, 95x5, 135x5, 170x6x6
Chin Up x4, +55x5x2

Nothing special about bench. Rushed a bit (lunch break) and was a little looser than I would have liked, but nothing terribly unusual to report. Chin was surprisingly strong. Drew knees up on last rep of second set, but first set with 55x5 was extremely strong.

Injury Report: Very exciting development. I don't want to speak too soon, but it seems as if my knee injury has finally turned the corner! Pain is virtually gone and refilling is at an absolute crawl after my last (very easy) 7 ml draw. The refill might have stopped entirely. What's exciting about this is that this is in spite of considerable use of the knee, the sort that usually induces effusion. As of this afternoon, I'm able to do normal activities with only the slightest hint that there was a problem. The effusion remains minimal and my range of motion remains at 95%. There is ZERO catching in the medial area upon forceful extension...though I'm sure that could come back if I'm not careful and the effusion starts to return.

I know I'm not ready for truly intense activity like running, jumping and heavy squatting, but it really feels like the touch-and-go period is coming to a close.

Update...
Another 12 cc this evening, slightly bloody...
Next day, early morning: another 7 cc, very bloody...

Still nearly full ROM. Biggest and most persistent distolateral lump seems to be shrinking, but effusion is still clearly present.

[Gary Gibson]

05/20/2009

BP 45x10. 95x5, 135x5, 180x5x7
Pull Up +25x5x2

Nothing special to report. Sets got easier with number four, hard with number six. Pull ups were strong.

Injury Report: Okay. Drained another 10-15 (I forget) last night. Knee felt so incredibly good, as if a boatload of healing had cemented. Did 3 sets of 10 with supine knee extensions (femur perpendicular to floor) with 10 lbs, 16 lbs and 20 lbs. Amazingly easy considering I could barely do these with no added weight a couple of weeks ago. Did sets of 5 deep, paused front squats with the 70lb kettlebell, too.

Today I ran around with only the barest hint of discomfort. Ran up and down stairs. Walked hard and fast to the gym. Felt like jumping. Last night I walked a couple of miles in Hampden to view the some Craig's List items. Even sprinted across the street to catch the light rail back to Mount Vernon. Felt great yesterday and today.

Tonight, however, I drew an easy 28 cc!!!!! The knee was looking a tad bit puffy...very obvious on the lateral side. No pain with insertion and the synovial fluid just poured into the container. No rice bodies, fairly transparent with maybe just a hint of bloodiness. No discomfort, however; the knee feels healed, yet clearly my casual use of it has resulted in effusion.

No catching/pinching in the joint with extension. None of the usual pain. Just refill with strenuous, continuous use. No mystery there; I walked plenty last night and scampered about like a healthy man today. I want to believe this is almost over, but so much fluid worries me...

Muscles of right leg clearly smaller and weaker. Able to do step up with right leg, but it's much harder compared to the left. Pistols are impossible. If the knee continues to effuse, the muscles will be inhibited and atrophy/lack of symmetrical growth will continue. I hope, of course, that the cavity will eventually stop overproducing the fluid.

[Gary Gibson]

05/22/2009

BP 45x6, 95x5, 135x5, 190x4x8
Chin Up +0x5, +60x5

Bench getting hard, but only one more day to go. Got smoother on fourth set, but last rep of last two sets was pretty hard. A little extra rest before last set to make sure I would get the reps.

Chins were hard. Decided against a second set because I knew I wouldn't get five reps again. I think that completely fresh I could get five reps with 75 lbs.

I've been having some luck pressing the 70lb KB lately, but tonight was special. Got the 70 up with my left arm and using minimal leg push. Got it strict with the right arm. Both of these were after a clean of course.

Injury Report: Lots of developments.

I've been using the knee like crazy lately. Yesterday I picked up that old York rack and an armchair and moved them into my apartment. Walked the couple of miles on Falls Rd from Hampden back to Mount Vernon. I've graduated from rehab with supine leg extensions to practice with KB front squats as of yesterday. Tonight I did step ups on my new bench (I made it a point to try a couple with my other leg completely straight to provide no assistance--very hard to do this way with the right leg and I had too much lateral motion when I quickly tired; felt my medial ligament wobble). Also practiced lots of low-bar squats with broom.

Overall the leg feels incredibly solid. I still get that worrying ligament wobbling when the muscles fail and there is lateral motion. There is the infrequent pinching feeling if I lock out extension too hard and fast, but it's not quite the same as it was before. It's farther back and it feels more like an overworking or strain than an actual pinching. I do believe the actual pinching was due to something getting caught once the effusion was drained a bit and there was room for things to move around. This current sensation is much more rare and feels like the ghost of the initial injury from two years ago.

I did all of tonight's squat practice and step ups with knee sleeves on.

About three days ago I drained 30 cc of fluid from my knee. Last night I drained 15 and then later only a bit of bloody fluid. Tonight was more bloody fluid and only about 7 cc of it. This is after lots of knee use yesterday. This is a vast improvement; hardly any refill lately despite in the face of increased strength, decreased pain and much more use.

There seems to be a permanent osseous change to the bony prominence in the anteriomedial condyle (?) of my tibia. That's right where the inflamed medial plica (?) was sliding around for over a year. I'm no doctor and I may be misapplying these terms. I'm trying to say that whatever was swollen, palpable, pinching, clicking and snapping was sliding over the top, inner part of my big lower leg bone. Now there seems to be an extra bit of bone there that I'm sure wasn't there before.

Oh well. If my knee remains relatively free of new effusion over this long weekend, I will be one very happy trainee. If it swells back up with 30 cc, then I will be worried about needing surgery to correct this problem.

[Gary Gibson]

05/23/2009

BP 45x5, 95x5, 135x5, 185x3, 200x3x10
Chin Up +70x5*

Set up with hands a little too far right on set seven; rep was awful; reset. Sets 8 and 9 were the best. Glad this is over. Rest a week and test next Saturday.

Felt froggy afterward and tried a max set of five with 70 on chins. Last rep I had to draw my feet up which I consider a bit of a cheat.

Injury Report: Knee did not refill overnight. ROM and strength still there today. Still some pain in tendon above kneecap in bottommost position of flexion. Still some sliding and soreness around that bony prominence where I've been going in and draining from. Was able to do a very easy pistol with left leg, but couldn't get into bottom position with right leg. Step ups with right leg getting much more solid and stronger. (Left leg held straight)

Later...knee looking a tad soft and full and feeling a bit funny. Drained 18 cc. Pretty depressing that it refilled, but I have to take into account the amount of refill against the amount of use. That ratio keeps improving and maybe eventually the refill will stop or be negligible.

[Gary Gibson]

05/26/2009

Resting for the big bench press new max test on Saturday. Resting in general. I attempt a clean and press with the 70lb KB a couple times per day, but I never really strain. Usually get the right arm. Left still requires a little push assist from the lower body.

Injury Report: More developments

10 cc last night and an easy 20 tonight, but ROM remains at 100% active and almost 100% passive (still can't quite pull heel to glute). Swelling in infrapatellar region continues to diminish. It's hard to tell if the stuff I'm pulling out now is refill or the last of it.

I am using the knee very hard. Step ups to various heights with the right leg. Standing up from seated positions with the right leg alone. It hurts a bit, but it's getting easier. The muscles around the knee are clearly deflated compared to the left. I think it's time for actual squats to help fill in that missing mass. Unilateral work is waking the nerves up, but the mass won't come till I squat.

Weird new sensation. Rubbing the swelling over the medial lump produces tightness on the other side of the patella in the infrapatellar region. It's as if something has been deflated and is sliding around. This only happens when there is pressure on a specific point on the medial side. Otherwise the knee is working as smoothly as can be hoped. Just noticeably weak.

Couple hours later...another 15 cc. Maybe it is refilling. Contours of knee nearly totally normal again. Haven't seen refill like that first time where knee got as puffy and painful as it had been.

[Gary Gibson]

05/28/2009

God, this city sucks.

The apartment is getting pretty comfy, but no amount of domestic charm can make forget that I live in one of the worst urban failures on the east coast. Training--particularly squat training--used to help me forget that. It's hard not to notice I live in Baltimore when I can't block out the blight by focusing on upping my squat.

Knee looking almost exactly like other knee. All contours are back as the effusion is almost entirely drained. I got another 11 cc tonight, but I had to push deep and milk; pushed the very much reduced infrapatellar lateral bulge so that the fluid went toward the medial entry point. That strange bowing can still be felt when I flip the band of tissue over the medial bony prominence, but it doesn't happen with normal knee motion.

There appears to be no refill and all the stuff I'm getting out now seems to be the remnant. In fact, I'm starting to worry that I will be tapping fluid that's supposed to be there and bringing pressure below normal!

Have been doing plenty of practice squats with a broom handle in my new old York rack. (It's actually a lovely piece of furniture, too.) Wearing a little neoprene seems to keep the knee warm and happy. The slightest bit of pain sometimes on very forceful extensions to lockout, but nothing like I used to have. Next week I start squatting with the bar for 20 reps. Add 10 lbs/ per day every day. I may have to break up the 20 reps into two sets of 10 as I approach 135.

Tomorrow I do my warm up test for a new bench max. Saturday I go for a true max. Then two weeks of PTP-style daily practice while rehabbing and reintroducing the barbell squat to my life.

[Gary Gibson]

05/29/2009

It's the little victories...

BP 45x5, 95x3, 135x3, 185x1, 205x1, 225x1, 235x1/2, 230x1, 225x1
SQ 45x10
Chin Up +0x3, +45x1, +90x1, +115x1/4, +105x1/2

New personal best on BP! First time in my life I benched two wheels and more! I really think I could have gotten 235 if I'd rested a bit more, but I was so nervous and I didn't want to keep the PT I'd grabbed to spot waiting too long. 230 went up so easily. Today was just an easy test day and tomorrow I'll try to push a little harder and a little more carefully.

Ten squats with just the bar. No pinching or catching, but I'm still a little nervous and feel that even the slightest wiggle in form will result in a small disaster. I think further draining is the only thing that will reduce this likelihood.

[Gary Gibson]

05/30/2009

BP 45x5, 95x5, 135x3, 185, 225, 235, 245, (250)
SQ 45x20

Got up to 245 tonight! That's a total of 25 lbs on my best touch-and-go bench. Three weeks of training, one week of rest and two days of ramp up.

Almost can't believe I got 245. It actually didn't feel that hard and I was a little shocked that I missed 250 so utterly and quickly. I chalk it up to the fact that I'd just done two new personal bests. It had to end somewhere. I might have gotten it if I'd gone straight from 235 to 250, but that wasn't the case. Still, 25 lbs of improvement in a month is nothing to regret.

Now it's three weeks of 5x5x5: One set of five reps with five movements, five days per week. This should help me refine my strength on the bench a bit more and I may come out of this with at least 250 and possibly as much as 260. How exciting would that be?

Injury Report: Still a hint of catching/pinching on the medial side of the knee at the top of faster lockouts. Knee is looking about as normal as I suppose it can and all the other troubles I've had (quadriceps inhibition, popliteal cyst, hip snapping, even the catching) have diminished as I've continually drained the effusion. As of right now, even that lateral infrapatellar bulge is almost entirely gone; it had been the most persistent evidence of effusion since this concentrated effort on aspiration began. As I type this my right leg's passive range of flexion is significantly greater than my left's; first time I can remember this happening. Interesting to see if this holds for several days.

Came home and drained another 7 cc, but it was very hard to get and took a lot of doing. I really don't think there is much if any refilling going on. This is great news! I do believe, however, that too much trauma would reactivate what looks to be synovitis.

That strange guitar string sensation (ligamentum mucosum/infrapatellar plica?) is still happening when I rub the swollen nub over the medial bony prominence. I'd obviously rather it wasn't there, but it only happens when the tissue is flicked over the prominence and not during any other activity.

Only other problem is general weakness. The muscles on my right are clearly smaller than those on the left. Experience says that only squat training will address the mass difference. Unilateral work (box pistols, step ups) teaches the muscles to fire again, but they don't increase mass.