Swiss cheese bones

[Dillman]

Rip,
I searched the threads on this and found some useful information but thought I'd present my situation as it is unique. I suffered a pilon fracture to my right ankle 8 years ago that left me with 3 plates, 18 screws, and constant soreness. I have not been able to match the range of motion of my right foot to my left foot despite stretching (dorsi and plantar flexion) constantly.

I just got a consult and a surgery date to remove the hardware and some bone spurs. The doctors think it is the bone spurs that are limiting the dorsi flexion (while my foot is planted on the ground I can push my right knee to just past my toes, maybe 0.5 inch, before the heel rises without feeling tightness in my calf but my left knee can reach 5-7 inches past the toes and the heel rise comes after calf tightness). Also a rapid recovery is expected. I should be walking the same day as surgery or certainly within 2-3 days.

The question is, once I have the hardware removed how do I deal with a tibia and fibula that look like Swiss cheese? I don't think that I'll lose much muscle mass since I should be walking soon after the procedure but with holes in my bones I think I should take it easy on squats and deadlifts for a while. Obviously the holes will fill so it isn't a permanent problem. Please share any knowledge you or your clients have had with a situation like this.
Thanks

Stats are below.
Age: 29
Height:5'9"
Weight: 206 #

Current work set weights.
Squat: 260 #(should be 280-285 just before surgery)
Deadlift: 285 #(should be 305 just before surgery)
Press: 145 #
Bench Press: 215 #

[Mark Rippetoe]

I don't think you have to deal with it at all. The holes will be filled within 6 weeks with an intermediate type of new bone, and the holes themselves will not represent a significant structural defect in the non-dynamic loading capacity of the bone. The holes are there now, filled with metal but still holes. Loaded statically, there should not be a problem. You'll be sore from the osteophyte removal, so you can't start back at heavy weights anyway. Just work the lifts back up with no dynamic loading over about 6 weeks, and you'll be fine.

[Dillman]

I wasn't sure if empty holes would be much different than metal filled ones. Also I have not learned and therefore not incorporated the power clean into my training yet. I assume the "no dynamic loading" advice means to forget about the power cleans until 6 weeks after the surgery. Thanks for your thoughts/analysis.

[Mark Rippetoe]

No jumping of any kind. Static loads should be okay if titrated up gradually.

[FatButWeak]

I don't think you have to deal with it at all. The holes will be filled within 6 weeks with an intermediate type of new bone, and the holes themselves will not represent a significant structural defect in the non-dynamic loading capacity of the bone. The holes are there now, filled with metal but still holes. Loaded statically, there should not be a problem. You'll be sore from the osteophyte removal, so you can't start back at heavy weights anyway. Just work the lifts back up with no dynamic loading over about 6 weeks, and you'll be fine.

Would this be an opportunity for this lifter to maintain intensity by using reduced weight (as required by the holy bones) but for higher reps (10 reps, eg) so that in 6 weeks when he is ready to return to heavy sets of five he might have a little hypertrophy that improves his leverages?

[Mark Rippetoe]

Intensity and higher reps are opposing concepts.

[stronger]

I'd love to see DEXA scans of women who were tested for low bone density before and after they started barbell training. Something tells me 135lbs on a woman's back does more/is less expensive that supplementation

[Dillman]

Would this be an opportunity for this lifter to maintain intensity by using reduced weight (as required by the holy bones) but for higher reps (10 reps, eg) so that in 6 weeks when he is ready to return to heavy sets of five he might have a little hypertrophy that improves his leverages?

I think you mean volume. I may do this. I also think the higher reps will help get more practice and therefore reinforce proper form, assuming proper form is practiced. An opportunity to grease the groove I guess.

[FatButWeak]

Intensity and higher reps are opposing concepts.

I dont have my/your books with me but I thought there was a formula in one of them for calculating intensity (there may be another word) along a sliding scale: 3 sets of 5 at your five rep max is intensity level X; 3 sets of 10 at your ten rep max (which is by necessity a lower weight than that of your 5 rep max) is also of intensity level x. Perhaps you used a differnt word than intensity for this concept?

[Mark Rippetoe]

Two different concepts. The closer the 1RM, the higher the intensity.