Meniscus, pattela and my fuck up little city

[macetini]

Hi coach,

5 years ago ( I'm 25 now ) had medial meniscus surgery. Had a bucket handle type of tear and the surgeon had to take out around 20%, the rims are whole. Never had any meniscus issues or knee pain after that and I did a lot of sports; running, lifting (never did squats but leg presses or knee extensions, didn't know any better).

6 months ago I read SS and started squatting. I was very inflexible in my hips and quads and that combined with bad squat form I hurt my quad ( went down to fast with too much weight and my VM and VL got swollen ). After swelling went down I returned to squatting ( and stretching this time ). After few months, when I approached 250 on my squat, my patella started to make sounds ( crunching ones ) but no pain. I ignored it the since it didn't hurt but the symptoms worsened, the crunching become much more louder until the point I started to freak out, but still no pain. I went to couple a doctors (orthos and sport med. experts), did and ultra sound and all told me my knee is stable (but my patella is a little tilted laterally, tightens I guess) and there is no chondromalacia. I stooped squatting for a month and crunching has subdued a lot. I purchased "Bulletproof knees" from Mike Robertson and started program of stretching, foam rolling everything and fixing (medial-lateral) muscle imbalances (my left leg, the dominant, crunchy and operated one, is half an inch bigger.)

My question is after all this crap, and being constantly told by all the people in the gym, my family, my girlfriend, and every doctor that squatting low is bad for knees ( I swear by God everybody are against me ) did you trained anybody with meniscus surgery that was able to squat, and not just light weight, but heavy like 400 plus as I would like to one day, I realize you had some meniscus tears yourself, and if not what could be long term dangers (like osteoarthritis)?

Thanks

[Mark Rippetoe]

I have trained so many people with so many injuries that a common one such as this doesn't stand out in my memory. I'm sure I have a few small tears in my right lateral, and it causes me no problems. But the folks reading this will have some input.

[Bleve]

This is just an anecdote.

I've had this done :

Ruptured right ACL, bucket handle tear of right lateral
meniscus, full thickness chondral defect of lateral femoral
condyte
Right arthroscopic hamstring ACL reconstruction, partial
lateral menisectomy, chondroplasty of lateral femoral condyle
This was done on my right knee after a ski-ing wreck in 1996 when I was ~110kg and playing rugby union. I wish Rip would go back in time and write SS:BBT back then, it would have made a huge difference to my rugby career! We did everything so, so wrong in the gym ... such a waste of time and effort, but we knew no better ...

On Monday I squatted 205kg (~450lb) and deadlifted 185kg (~405lb) at a BW of ~111kg (~240lb) It clicks a bit, but otherwise, no problems with weight training. If I run on it, it blows up like a balloon, but I always hated running anyway.

[nisora33]

Macetini:

Are you worried that the cracking and popping sound is the meniscus? A meniscus usually makes a deep hollow clunking noise when it gets caught and snaps back into place (know this from experience), and since you've had the problematic area excised already, I don't think that this is what you're experiencing.

A problem with the meniscus that is constantly being aggravated will also leave you with a feeling of "fullness" deep inside the joint, which is a sign of effusion. If you're not experiencing this and there is no visible swelling, I don't see the problem.

Yes, the patellar problem could be tightness and nothing more.

No one here is going to be able to guarantee you 100% that you will never have any problems out of that knee ever while squatting heavy. I will tell you that it is very unlikely based on my personal experience and the experience I've had with training people in situations similar to yours.

Bottom line, if you're waiting for guarantees, you're wasting time. Stop worrying and get squatting, is my advice.

-Stacey

[Anthony D]

I have inquired with Ripp a few times on my knee which I highly suspect to be a meniscus issue. The short answer is no. I squatted a semi-respectable (for me) 405 back when I was healthy but ever since the injury I haven't squatted a respectable amount (over 300, really) without any kind of nagging pain.

Right now I have tried numerous ways to combat this, most of which are something Ripp would encourage but i'll post them anyway. Right now, for some reason, front squats feel better than back squats. For me there's less to worry about in respect to the knee joint when doing them. Also, I feel I can put a lot of the stress on the glutes when I front squat so that helps. Secondly, I've played around with single leg squats and I have found that loading the glute immensely on this exercise is perhaps the most pain free squatting simply because I find it easier for the knee to track the toe.

Lastly, what I am doing now, is working with baby weights on my back squat and really hammering form. What caused my knee problem in the first place was my squat stance and spreading my knees too far apart, ironically enough.

Either way, I'd work on with submaximal weights and gradually accumulate volume. Don't grind any lifts, make every rep perfect and just build over a long time frame. I'll let you know if I ever get back to where I was.

Ripp: any reason why you think front squats feel better than back squats on the knees for me?

[bjvinson]

I've had two medial meniscus surgeries on my left knee. The first one 27 years ago when I was 21 and the 2nd when I was 23. Both caused by rather spectacular dismounts from a Suzuki RM 400.

My knee actually feels better now than it did when I was sitting on my ass :-)

I'm not a doctor but I don't think the meniscus will cause a problem. As far as the pops and clicks, I dunno when you get to be my age everything pops and clicks...

[Mark Rippetoe]

Ripp: any reason why you think front squats feel better than back squats on the knees for me?

None that I can think of. The only way I've ever hurt my knees squatting (other than tendinitis) was front squatting. Felt a pop doing them heavy once.