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Thread: Knee issue...unrelated to training..but still some after effects

  1. #1
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    Jul 2016
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    Default Knee issue...unrelated to training..but still some after effects

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    November 2020....had emergency knee surgery to drain my knee after an inflammatory response to an Orthovisc injection. Spent a week in the hospital hooked up to antibiotics while they waited to see if anything they drained grew in culture; luckily nothing did. I couldn't really put pressure on my left leg until 5 days after the operation. Surgeon said the knee was structurally fine with minimal arthritis, although he did clean up the patella minimally since" he was in there". It took 2 months or so to be able to climb the stairs without noticing discomfort.

    I was given a very basic knee conditioning program to do at home designed to strengthen glutes, calfs hamstrings, abductors, and adductors. REALLY basic. After 8-12 weeks my knee still felt "heavy". Particularly noticeable when swinging my left leg out of the driver's seat of the car. I spent all spring, summer and fall walking and hiking trying to build up my leg strength again. Those activities didnt bother bother me, but I can't tell you the # of times, I had to help lift my leg out of the car by pulling on my pants leg. Then I would feel real pain using that leg to push off-of in order to stand up. Getting out of the car was the most difficult and painful thing I faced daily. I didn't have a lot of confidence to try to resume strength training. This continued for 11 months; but the good news is that this has improved significantly since I restarted the NLP a month ago. I have my squat up to 200lbs, I'm taking it slow and so far so good.

    However, I still notice pain and discomfort in 2 distinct scenarios: 1) Squat warmups with an empty bar or just warmup weights on the bar the knee feels tense/tight and weak squatting down. With work set weights either the pain isn't there under there under the load or I'm not noticing it since I too preoccupied managing the weight to notice any discomfort. 2) Anytime I raise my knee to near chest height; whether from a seated position or while standing. I'm feeling weakness / and low-moderate anterior pain in the knee. The knee cracks and pops when I raise it.

    The good news is that barbell squatting now is doing more than those PT exercises did or miles upon miles of hiking I did in the past year. I'm 12 months out from this event and still have these issues; although they have moderated. If this is just a lack of general strength in the area, what else can I or should I do other than the NLP to strengthen these muscles?

  2. #2
    Join Date
    Jan 2016
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    Knee surgeries can take time to recover from. In my experience, the best thing to do was getting squat and deadlift strong again, and controlling any inflammation with ice. Other physio stuff "felt" like it was helping, but more real progress was made with the bar. I included Romanian deadlifts rather than cleans.

  3. #3
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    Nov 2014
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    I recommend staying with the NLP and continuing to increase your strength to stabilize the knee. I ruptured both patellar tendons simultaneously, had emergency surgery, and then had two additional surgeries (one each knee) to remove/repair 3-4 meniscus. Just as you described, I had knee pain, cracking, general discomfort. It may never get to a "100%," but I am confident it is better than without strength training.

  4. #4
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    What's confusing to me is what exactly is going on in there. I wouldn't expect "weakness" to persist for a year.

  5. #5
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    Given the fact that you didn't train for a year after major surgery, what exactly would you expect the weakness to do? Just spontaneously go away?

  6. #6
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    Quote Originally Posted by Mark Rippetoe View Post
    Given the fact that you didn't train for a year after major surgery, what exactly would you expect the weakness to do? Just spontaneously go away?
    Hi Rip!

    I'm confused as to what I'm feeling. "It" feels like a combination of sensations: tightness, tugging, pain, and weakness.

    I wouldn't be surprised with weakness during training, and training is definitely helping. I am surprised that I still notice it doing things of a more domestic variety, like climbing stairs, or lifting the leg to get out the car after spending much of the last year walking & hiking multiple miles 2-3x per week.

    From a training perspective after restarting the NLP, squats with warm-up weights usually feel bad until maybe my last warmup set and then usually work weight sets feel better. The initial discomfort has been messing with my confidence and nerves.

    I've tried to do a number of things to warmup prior to warming up with the barbell (stretching, 5-min on the bike, lunges, etc) none of them really helped. Tonight I did a couple of sets of body-weight Bulgarian split squats for my warmup. I had the usual tightness in the knee during those warmups, but during my barbell squats I felt no discomfort or tightness at all. I did my work sets at 210lbs and felt like i could have easily handled more. I'm not sure what it is about that initial loading that is so uncomfortable, but once it was out of the way tonight I was able to be pain free.

  7. #7
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    Your knee will not feel normal for quite a while -- in fact, it won't feel normal until you forget what it felt like before. A lot of shit has happened to it, and it's no longer original equipment. But you'll be fine, eventually.

  8. #8
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    Jul 2016
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    Shit did happen, yes. I've also been down this road before where any surgical intervention, minor or major, has always taken about a year to resolve to a decent level of normalcy. Trigger fingers to full on shoulder labrum repairs. It's maddening to me.

    I know you've also had a rough time with your leg from listening to the podcast. I hope your situation is making a turn for the better as well.

  9. #9
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    It hasn't yet.

  10. #10
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    Jan 2019
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    starting strength coach development program
    Quote Originally Posted by Mark Rippetoe View Post
    in fact, it won't feel normal until you forget what it felt like before.
    One of life's most bitter pills.

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