Squating with leg atrophy

[Guigui]

Hi all,

Would love to hear about someone having gone through the same experience as me as well to recommendation on how to deal with what i'm going through without ending more injured than I am already...

I had stopped barbell training 3/4 years ago because I developed problem in my right knee that suddenly started to swell A LOT. It is mostly painless, but swelling has been so bad at some times that my leg even became unstable (knee sometimes suddenly “let go”) and the swelling has been limiting range of motion. When it first happened it lasted ~ a year. I stopped all physical activity at that time, while I was trying to figure what was happening. Over that period, I suffered a significant atrophy of the right thigh leaving me clearly non asymmetrical below the waist.

Symptom have been diminishing after that initial flare, but sometime come back when my knee get irritated. Cycling was very well tolerated, so I did that a lots in past 3 years, but it never re-grew my right quads.

I must say I didn’t really got a clear medical explanation about what is happening. I did all types of imaging modern science offer, but nothing obvious could be found. Meniscus look good, and cartilage show no more damages than is be expected to be seen in person my age. Not trace of infection. And not really responding to corticoids. Seems I have to leave with some kind of inflammatory problem.

Lately I decided fuck it with cycling, I want to be strong again, so been doing NLP, starting with empty bar. I’ve been avoiding power cleans, because it tends not to be tolerated well by my knee. Current situation is training is clearly irrating my knee, but it has been manageable so far. My lifts are squat 300, DL 330, press 135, bench 175 and body weight 222 . I must say I cannot really feel my leg imbalance while squatting and in video, form seem OK. However, while my left quad became more muscular recently, imbalance with right leg seem even more obvious as the right legs remains much smaller.

I'm really not concerned about aesthetics, but as bars are moving up in weight, I’m being more and more afraid that by squatting heavy with such imbalance in legs, I will end up developing problems somewhere else. For example, I have developed tendonitis in right quad, could it be related ? Also wondering if there's anything i could do to force that f@#!g leg to grow !

Thanks

[Mark Rippetoe]

Age? And you really need to make these fucking Frenchman doctors give you an actual diagnosis, so we can decide what to do.

[Guigui]

Hi Mark, I'm 43.

Regarding getting an actual diagnostic, all I could get is that mechanically my knee looks "normal" as far as can be seen from MRI, X-RAys, and arthrography (sc.
So it must be inflammatory arthritis, maybe related to psoriasis. I've been offered to try medications coming with significant risk of fucking up my liver (methotrexate), so passed on that.

Cheers

[Mark Rippetoe]

What do NSAIDs do to the knee?

[Will Morris]

Do you have laboratory findings suggestive of psoriatic arthritis? You have an erosive, inflammatory arthritis but normal radiographs of the knee? Or, is this just a scientific wild ass guess because you also have some psoriasis?

[Guigui]

What do NSAIDs do to the knee?

As pills, it has been useless. Got some relief from injection directly inside the joint, but not fully sure if it came from the drug or the fact that doctor was also pumping fluids out in these occasions.

Do you have laboratory findings suggestive of psoriatic arthritis? You have an erosive, inflammatory arthritis but normal radiographs of the knee? Or, is this just a scientific wild ass guess because you also have some psoriasis?

Knee juice analysis showed no sign of infection, but high level of inflammation markers. I've also been tested for genetic predisposition to polymyalgia rheumatica that came back negative. Imaging shows no more wear of cartilage than expected in someone my age. I don't think they can test specifically for psoriasis arthritis, but it is what's left after everything else is ruled out.

[Will Morris]

As pills, it has been useless. Got some relief from injection directly inside the joint, but not fully sure if it came from the drug or the fact that doctor was also pumping fluids out in these occasions.



Knee juice analysis showed no sign of infection, but high level of inflammation markers. I've also been tested for genetic predisposition to polymyalgia rheumatica that came back negative. Imaging shows no more wear of cartilage than expected in someone my age. I don't think they can test specifically for psoriasis arthritis, but it is what's left after everything else is ruled out.

When your knee was swollen, was it red and warm to the touch? Do you have any other joints that are involved? Any radiographic evidence of bony erosion or fusion in any small joints? Do you have swollen fingers, joints of the fingers, radiographic changes to your hands?

[Guigui]

When your knee was swollen, was it red and warm to the touch? Do you have any other joints that are involved? Any radiographic evidence of bony erosion or fusion in any small joints? Do you have swollen fingers, joints of the fingers, radiographic changes to your hands?

Hi Will,
This sounds a lot like questions set my doctors has been asking Swelling knee can be hot sometime, but not red. My hand are fine (not twisted hooked finger as can be seen in people suffering from arthritis). No other joints seem to be involved. Besides that big knee and small thigh, I'm in great shape. And again, imaging of the knee did not show erosion. Some signs of wear can be seen, but apparently typically what is expected to be found in a 40+ fat guy.
Honestly, I've given up on the idea that I will get a clear medical explanation to what is happening. I'm pretty sure than few year from now it will become more clear as it worsen

My question is more about how to train safely with one legs being (visually) stronger than the other and at the same time limiting as much as possible irritating the knee.

[mark031111]

It might be Gout, like what I have. You should consider consulting a rheumatologist.

[Mark Rippetoe]

It might be Gout, like what I have. You should consider consulting a rheumatologist.

You have gout only in a knee?