OCD - osteochondritis dissecans

[konkoba98]

My girlfriend (32) has OCD of the knee after having a torn ACL misdiagnosed /undiagnosed for a long time by some worthless docs. She had the ACL repaired but now has an area of no cartilage and dying subchondral bone. She was told she needed many surgeries just to delay the inevitable knee replacement when she is old enough. One proposed surgery is to break the bone, remove a wedge of it so that the knee becomes bowlegged and reduces the pressure on the OCD area.

She has trouble walking around for a long time but she has been doing RDL's, press/bench, and chins for the 1.5 years since the surgery and has no pain or problem with the RDL's.

Two days ago we said, 'fuck it, lets squat'. She did fine with no pain. Her knee was noisy though but she has more pain and inflammation from walking long distances and certainly from stairs. She has had zero pain or postworkout inflammation after two sessions of squatting.

My question, finally, is if this person came into your gym with this back story, what would you do with her? I was going to let her continue with the RDL's as the main lift along with pressing and chins, but add the squats to a midweek interval session as the first movement in a complex. I was going to progress it very slowly if at all.

Mon
rdl
bench
chin

Wed
intervals/complexes starting with sets of 10 squat

Fri
rdl
press
chin

Any advice? Also, her ACL may be loose, according to another doc.

[Mark Rippetoe]

I'd say that if she was going to have a problem with squats later, the best way to flare the knee up would be to squat higher reps. I think I'd have her do 3 x 3 across after a low-rep warmup, instead of 10s.

[konkoba98]

In that case would you progress the load and program it as you would in the normal SS template, assuming she tolerates it.

[Mark Rippetoe]

Just like normal, as she tolerates it.

[konkoba98]

Thanks!

[Kent Berry]

I have a very similar story. I was given the generic osteochrondritis dissecans diagnosis, probably as a result of an unidentified injury, as a young teenager. When I was 19 y/o, I broke about a dime-sized piece of cartilage off the medial joint surface of my left femur. The treatment consisted of cutting the knee open from stem to stern (my orthopod: "I don't do surgery through keyholes"), removing the errant chunk of gristle, immobilizing the knee while scar tissue formed in the hole, and applying leeches. This was a long time ago.

Like your girlfriend, my knee hurts and sometimes hurts like hell, especially when I walk a lot. Mine probably hurts more, since I doubt your girlfriend is 6'7" 290 lbs. Also like your girlfriend, mine doesn't bother me when I squat, although mine does get sore for a day or so afterwards because I'm old and creaky. I'd recommend you get her some knee sleeves. I recently started using them, and keeping nice and warm all the stuff which doesn't quite work the way it should really seems to help.