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Thread: Torn meniscus, lingering knee pain and confidence in the squat

  1. #1
    Join Date
    Feb 2019
    Posts
    107

    Default Torn meniscus, lingering knee pain and confidence in the squat

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    Many moons ago, I tore the lateral meniscus in my right knee during a front squat. Not knowing what I was doing, I allowed my knees to buckle in dramatically during the rep which probably caused the tear. Initially the knee was so unstable that I found it difficult to stand up out of a chair, and had to walk and cycle very carefully to avoid a great deal of pain. If I was not careful with how I loaded my knee, it would collapse under me and I would fall down with acute pain along the outside of the knee, laterally to the kneecap. My GP referred me to a physiotherapist who was, predictably, of no help whatsoever.

    Over the next few weeks I successfully rehabilitated the injury myself by performing repeated sets of 20 very slow back squats with extremely strict form, starting with bodyweight squats in my kitchen and eventually moving to the empty bar and slowly going up from there. I found that even a slight deviation in my knee angle - i.e. if my right knee did not track perfectly over my toes - caused instant instability and pain, and during the rehabilitation process I suspect I tore the meniscus again, at least slightly, on a couple of occasions when I allowed this to happen. Eventually I worked back up to my previous weight on the squat for sets of five, and I haven't done a front squat since.

    This injury occurred over two years ago, but my knee still occasionally bothers me suggesting that the rehabilitation process remains incomplete, although I'm not sure if there's still a problem there which no amount of rehabilitation will solve, and I'm unclear as to what effect last year's long, government-enforced layoff from training might have had. I now occasionally experience a milder pain deep in the back of my knee, as opposed to on the outside edge of my knee, when cycling and squatting. Fortunately, when training this pain usually disappears during the warm-up sets, but sometimes it persists through the work sets, and when it does it typically lingers between sets whilst I'm standing or walking around the gym. As before, the pain increases if I do not keep my knee in line with my foot, but it does not feel weak or unstable like it did when I was first rehabilitating it.

    Although this injury has forced me to think much harder about maintaining good form in the squat, I think it continues to limit me because I struggle to bring myself to be aggressive during a heavy set. During the rehabilitation I got into the habit of descending very slowly into the bottom and not bouncing aggressively to begin the drive, in order to help me keep my knee in position. I think I have embedded some subconscious fear of blowing out my knee again which means my squats lack any use of the stretch reflex, and I cannot bring myself to move at the speeds required to take advantage of a bounce. So far I'm not having any problems with 5lb increases every workout, but I know my caution is preventing me from lifting as much as I could and making progress as quickly as I could. I don't want to get stuck on the squat or end up moving to intermediate programming prematurely because I'm not mentally prepared to push hard enough during the last phase of linear progression, but equally the last thing I want to do is set myself back by weeks or months by re-injuring myself.

    I would greatly appreciate any advice as to how best to proceed. I wonder if it would be advisable to sleeve or wrap my knees, and if it's likely there will always be an increased risk of re-tearing the meniscus or if I am simply being a coward.

  2. #2
    Join Date
    Aug 2010
    Location
    Wichita Falls, Texas
    Posts
    2,414

    Default

    Quote Originally Posted by MWM View Post
    Many moons ago, I tore the lateral meniscus in my right knee during a front squat. Not knowing what I was doing, I allowed my knees to buckle in dramatically during the rep which probably caused the tear. Initially the knee was so unstable that I found it difficult to stand up out of a chair, and had to walk and cycle very carefully to avoid a great deal of pain. If I was not careful with how I loaded my knee, it would collapse under me and I would fall down with acute pain along the outside of the knee, laterally to the kneecap. My GP referred me to a physiotherapist who was, predictably, of no help whatsoever.

    Over the next few weeks I successfully rehabilitated the injury myself by performing repeated sets of 20 very slow back squats with extremely strict form, starting with bodyweight squats in my kitchen and eventually moving to the empty bar and slowly going up from there. I found that even a slight deviation in my knee angle - i.e. if my right knee did not track perfectly over my toes - caused instant instability and pain, and during the rehabilitation process I suspect I tore the meniscus again, at least slightly, on a couple of occasions when I allowed this to happen. Eventually I worked back up to my previous weight on the squat for sets of five, and I haven't done a front squat since.

    This injury occurred over two years ago, but my knee still occasionally bothers me suggesting that the rehabilitation process remains incomplete, although I'm not sure if there's still a problem there which no amount of rehabilitation will solve, and I'm unclear as to what effect last year's long, government-enforced layoff from training might have had. I now occasionally experience a milder pain deep in the back of my knee, as opposed to on the outside edge of my knee, when cycling and squatting. Fortunately, when training this pain usually disappears during the warm-up sets, but sometimes it persists through the work sets, and when it does it typically lingers between sets whilst I'm standing or walking around the gym. As before, the pain increases if I do not keep my knee in line with my foot, but it does not feel weak or unstable like it did when I was first rehabilitating it.

    Although this injury has forced me to think much harder about maintaining good form in the squat, I think it continues to limit me because I struggle to bring myself to be aggressive during a heavy set. During the rehabilitation I got into the habit of descending very slowly into the bottom and not bouncing aggressively to begin the drive, in order to help me keep my knee in position. I think I have embedded some subconscious fear of blowing out my knee again which means my squats lack any use of the stretch reflex, and I cannot bring myself to move at the speeds required to take advantage of a bounce. So far I'm not having any problems with 5lb increases every workout, but I know my caution is preventing me from lifting as much as I could and making progress as quickly as I could. I don't want to get stuck on the squat or end up moving to intermediate programming prematurely because I'm not mentally prepared to push hard enough during the last phase of linear progression, but equally the last thing I want to do is set myself back by weeks or months by re-injuring myself.

    I would greatly appreciate any advice as to how best to proceed. I wonder if it would be advisable to sleeve or wrap my knees, and if it's likely there will always be an increased risk of re-tearing the meniscus or if I am simply being a coward.
    You got yourself into a pickle, for sure. If you'd be interested, shoot me an email at William.morris217@gmail.com and we can start working on this. This is far too complicated for a message board. This is definitely a situation where you would want a professional looking after this case.

  3. #3
    Join Date
    Feb 2019
    Posts
    107

    Default

    Thank-you Will. I've sent you an e-mail.

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