Bad knee, bad knee

[goskers]

Hello Coach,

First off, like many, I thank you for the efforts. The books and dvd have been tremendous helps in following your prescribed program.

I started the program roughly 5-6 months ago. After the first month or so I developed a pain in my right knee. I chalked it up to nothing as the knee still felt structurally stable. I immediately began icing as I had swelling and lifted when I didn't have extreme pain. The only lifts that this really messed up was squatting.

I tried everything from rest to ice/compression and ibu with no significant luck. After weeks and weeks of this I ended up going to see the doctor. My GP did all of the normal tests with no x-ray (as I didn't have an accident) and told me that I was fine. I continued on when I could and about a month later I was so sick of no progress that I decided to see an orthopaedic surgeon. We started with x-rays and then moved onto an MRI. At the end of it all he said nothing was wrong. Something may not be wrong but I promise you that it's not right either. I refuse to live with this for the rest of my life as it affects everyday things and especially squats. Typed below are the results of the MRI tech. Could you please give me what you think might be a resonable next step?

MRI Conclusions:
1. The dominant findings are promenent patellofemoral chondromalacia, osteochondral erosions, and surrounding fibrovascular stress reaction. Related large joint effusion present.
2. Mild jumper knee
3. Evidence of contusion and mild mucoid change in the posterior horn of the medial meniscus, without evidence of communicating macrotear.

Thanks for any suggestions.

[Mark Rippetoe]

Your surgeon probably said that you don't need surgery, not that there was nothing wrong. You have inflamed the damn thing, probably with a quad-dominant above-parallel squat technique. All the radiology comments indicate reversible stuff. I'd need to see a video from several angles, if that's possible, but I'll bet you $10 that if you sit back at the bottom and shove your knees as you come down that it will go away.

[goskers]

I would be glad to lose that $10 if this could fix the problem.

I will take some video tonight during the session and get it posted. I'll definitely be looking for your feedback as I pray you are correct.

The surgeon specifically said that there was nothing wrong. This is the same thing that my GP said. Luckily, neither said that I should change anything regarding lifting.

[Albert987]

I started my roommate on SS. He had a knee pain that sounds similar. He kept going and kept improving his form. After a while the pain magically disappeared. His squats went from 95lbs to 200 in a month.

[goskers]

Attached below are three angles of my last lifting session.

Albert, my knee pain did not exist when I started the program. At some point it became a consistent problem which I have been battling for months. Nothing would make me happier in life right now than to fix this issue. I was squatting 255 months ago when this started acting up. Since things have been getting progressively worse with my knee I backed the weights off. This really pisses me off as my training partner has now surpassed me in squats. I don't like to lose.

Side: http://www.youtube.com/watch?v=v8Ev_QBQXv4


Front: http://www.youtube.com/watch?v=3pyFawZJi0o


Angle: http://www.youtube.com/watch?v=CFOO07RcGgw

Sorry for the side view and male pattern baldness.

[Mark Rippetoe]

Knees are too far forward. See how your heels de-load at the bottom of each rep? A guy with aggravated knees needs to learn to stay out of his knees better than this. You will need to try to squat with you shins almost vertical. Think about what this takes to stay in balance, and when you get it done you'll be placing about 50% less stress on your knees than you are now.

[goskers]

Thanks for the tips. I will start working on this fix right away!

[Ian Kovtunovich]

I took a stab at squatting before getting SS:BBT, and put the tweakin's on my right knee. Took some time off, ibu, etc., but it didn't seem to change. Pain, catching, popping sounds...I was certain, with the help of the internet, that I had a meniscus tear and would need surgery. Finally, after a few stupid months, I went to a knee specialist, who basically said that even if there was a tear, it was so minor he would not want to operate. Bottom line, he gave me some stretches to do, told me to slowly ramp up the exercising, and essentially not to worry about the occasional pops, etc. Turned out that all the limping around and favoring the knee was really aggravating it, and that stretching my hamstrings regularly did a ton to alleviate the problem. Maybe you will be as lucky.

[goskers]

Coach,

I went back and re-read the squat chapter for specific things which might help keep my knees back.

During my last two squat sessions I have really tried to sit back. This doesn't seem to be working at all when I have a load on my back. I do feel that my hip drive has probably become a little lazy since I started. I am trying to fix this by staying controlled and tight during the decent with specific focus on driving from the heels and hips on ascent.

Are there any tips/tricks that you could give for keeping your knees as far back as possible? I noticed that if keep a wider stance that your knees will be further back. Would this be recommended in my scenario?

Again, any tips would be very much appreciated.

Thanks.

[Mark Rippetoe]

Some things have to be coached in person. Where are you?