Osgood-Schlatter and lifting

[Codisseus]

I'd like to start by stating that I am new to the starting strength program but I really like everything I've heard on the podcast and am really looking forward to getting into it.

I am asking this question for my brother. He is 6'3", 22 and 185 pounds. When he was around 10 or so he was diagnosed with osgood-schlatter disease and told that he would eventually grow out of it. Now 12 years and multiple high school sports later he still has pain with it anytime he even starts to squat. Even without weight it bothers him and he has therefore never pushed himself to squat and has very little leg strength. The knee in question protrudes noticeably more than his other knee as well.

My advice to him is to work past the pain and build up from no weight to the bar to weight but he is hesitant to try and I am entirely uneducated as to whether this disease is something that should be worked through or if he should look into surgery for it.

Please let me know if you are familiar with this injury and how he might approach his situation.

Thank you

[Mark Rippetoe]

How does he know squats will hurt if he hasn't tried them?

[Codisseus]

How does he know squats will hurt if he hasn't tried them?

Anytime I've worked him through the movement he claims it produces pain and if he gets himself through an actual set, soreness sets in the next day in the bone. I feel like this is natural if it is underused. My main concern is the possibility of making it worse. I feel like your pin-firing method from askrip 9 would certainly be worth trying and should be explored for more than just one set, but again I don't want to see him legitimately physically debilitated to the state that he has let himself become limited in the squat psychologically.

Bottom line, I don't know enough about osgood-schlatter to know if it can be worsened by intentional overuse.

[Mark Rippetoe]

And I'd like to make sure he is squatting with proper form. Post a video.

[Codisseus]

[shib]

I thought I would weigh in on this as I've got a bit of experience in this area.

I'm ~4 years older than your brother, and during my novice LP there was a training session where I felt a pop in my left knee, followed by some pain. Stopped the training and thought I had fucked up my knee by squatting because I noticed a bump that was there that I hadn't noticed before. After a bit of research I suspected I had OSD and that the bump was there for some time and I just hadn't noticed it. Went to a doctor and had an X-Ray and was confirmed that I had OSD in my left knee. Now I know experiences vary, but I wanted to share a few observations I had that might carry over to your brother:

1) I had no knee pain whatsoever going through my novice LP other than the above incident, which resolved itself before I finished walking back from the gym. I didn't deload or change the reps/weights. I just did the same weights again, without pain, and continued through the rest of the LP with no knee pain.

2) Doing squats with the empty bar hurts my knees, hell any kind of squat warmup kind of feels shitty on my knees. As the weight goes up for the warm ups my knee pain goes away quickly. I don't entirely know why this is the case but I would suspect it's a combination of the differences in the mechanics between squatting the empty bar and squatting a loaded bar; and possibly some kind of self-affirming psychological thing. Not sure.

3) I've noticed during layoffs my knees tend to hurt more, typically I'm fine with a break from the gym but the only real connection I'm seeing to knee pain is absence from training.

4) Past the novice phase I've noticed for me that lowering the frequency of squatting has been hugely beneficial in resolving my knee pain. I've been struggling with dealing with knee pain for a while and a combination of fixing my form (thanks to Nick Delgadillo for this one, fixed me in like 5 seconds) and (plug incoming) following Andy Baker's programming on the Baker Barbell Club has cleared up any pain I'd had (pain free since early June).

I think your brother will be worse off if he doesn't train and should just push through the pain. Either he's going to actually be able to squat which will help the OSD. Or he's going to get stubborn enough that the pain really doesn't seem like a big deal to him.

Looks like a win-win to me.

[Mark Rippetoe]

Brye is a skinny mess with a horrible squat. His coach needs to learn some things about squat mechanics, Brye needs to gain about 50 pounds, and when he does his knee pain will be a distant memory.

[Codisseus]

Appreciate it, glad to hear that once proper lifting form is attained and gaining the right amount of weight this should be less of a problem. Thanks

[Will Morris]

OSD is a disease of childhood and is completely asymptomatic once someone reaches skeletal maturity. He may have some patellar tendinitis on the same knee that he previously had OSD, but for the most part, you can safely tell him to stop using OSD as a reason to not train.

[David Mitchell]

I had OSD as a child. I can't kneel without some pain due to the bony protrusions and, as Will said, there may be some tendinitis, but OSD does not otherwise effect lifting at all.