Squatting with "almost bone one bone" knees

[asubtlearis]

I recently signed a new client and she is 65, a bit overweight (seems to be mostly visceral rather than subcutaneous) and she wants to get strong. She has osteoarthritis in both her knees and her doctor said its "almost bone on bone", she says it hurts to walk so she doesn't do any additional (treadmill) walking but that the recumbent bike does not hurt her knees. In her initial assessment we did squats onto an above-parallel box and her knee pain was gone once we got her to shove her knees out and use some hip drahve. I'd like to progress her to a below-parallel box and eventually load her squat but I want to make sure its safe to do so.

My thoughts are its good to get her squatting as long as she is not bone-on-bone, which she is not. Am I correct in this thinking?

On a side note, I seem to remember Baraki saying even bone-on-bone knees can be trained with the squat, or am I remembering wrong?

[Cheesepuff]

I'm 63. I was using two canes, before SS.

All of my cartridge was removed from my right knee in 1974. Since then, I have been "bone on bone".

Before finding Starting Strength, I tried a number of things to "rehab". I became very volume sensitive, weak and over weight.

I like your plan, it is what I would recommend.

In my case, dead lifts did a lot for my progress and I was able to far outrun my squat. I'd consider deadlifts twice a week until a significant weight (30% to 50% of BW) squat can be done for 3 sets. (aka until the weight of the squat sets no longer allows sufficient recovery from multiple single heavy deadlifts per week)

The deadlift will most likely allow much greater overall (and squat) progress.

While my lifts are by no means great, BW deadlift and 89% BW squat both for reps. I have not used my canes in a long time.

Work the range of motion you have, and you'll get more.

Good work!

[beefeater]

I have a good deal of arthritis in both knees and an MCL tear in my left knee. I couldn't squat to depth when I started the program, in fact I had trouble with deadlifts too at that time.

I began by doing Dumbell Goblet Squats, and gradually was able to increase the depth. I now am able to low bar squat to a legit depth.

[Bestafter60]

I've got a related question to ask you guys that have suffered arthritis: my 59 year old wife suffers from painful arthritis of the thumbs. It's painful for her to grasp any object. Do you think any weightlifting exercise wiuld help reduce her pain?

[Cheesepuff]

In a word, YES. Heavy compound exercises release growth factors. That is nearly a universal cure, it will make things better. Due to my own injury mechanics, I had more early relative success with the dead lift than the squat. YMMV. Do what you can and you'll be able to do more. Good luck!

[Gene61]

I've got a related question to ask you guys that have suffered arthritis: my 59 year old wife suffers from painful arthritis of the thumbs. It's painful for her to grasp any object. Do you think any weightlifting exercise wiuld help reduce her pain?

If this is rheumatoid arthritis she might try a an "anti-autoimmune" diet along with lifting. Its basically a strict paleo diet without eggs, dairy or nightshades (tomatos, peppers, potatoes). Friends of mine have had some success with this.

[Gene61]

Also, I have pretty advanced arthritis (not rheumatoid) in my right knee. Not quite bone on bone, but close. I had lots of pain before I started lifing 5 years ago. The pain has never gone away completely but is has become much much reduced over the lifting years. Get her squatting and deadlifting.

I have a theory that the meniscus heals slowly due to lack of blood flow in the area, which gets worse as we age. The pressure - release cycle that a heavy set of squats or DLs put the knee though may be pushing out old blood allowing new blood to come in during recovery, aiding regrowth. Might be true!

[misterponytail]

Hi everybody, first post here. I'm 58 now (at least for a couple more months!) and I had both knees replaced around my 56th birthday, one just before, one just after.

Before that, I had osteoarthritis, was bone on bone in a large part of my motion, and my knee joints had deteriorated to where I was bow-legged. I had regular synvisc injections and was on diclofenac every day just so I could walk.

Getting my knees replaced was amazing! I am now pain-free, I can walk, and I can sit down and stand up without a cane or hand rails. Best of all for me, I can train legs without joint pain! I can squat with 315, I've gotten reps with 405 using a Hatfield bar and handles on the rack, and I got 12 reps with 540 on the 45 degree leg press day before yesterday. Considering I almost couldn't walk at all three years ago, this is fantastic!

Now, to be completely honest, recovery was hard. The first couple weeks there was a fair amount of pain (swelling, muscular pain and incision pain, not joint pain). I did PT three days a week. After an hour and a half of work, I would go home and sleep for four hours. I also did a lot of work on my own outside of the PT office. The more work you put in on PT, the better you'll be. But it was all worth it! I now have over 140 degrees of flexion in both knees and I can squat below parallel! I attached a pic of me doing hacks; I can bottom out the machine, even with three plates a side!

Bottom line, if someone is bone on bone and lives with pain every day, total knee replacements are life changing.

low hack.jpg

[SteveL]

Hi everybody, first post here. I'm 58 now (at least for a couple more months!) and I had both knees replaced around my 56th birthday, one just before, one just after.

Before that, I had osteoarthritis, was bone on bone in a large part of my motion, and my knee joints had deteriorated to where I was bow-legged. I had regular synvisc injections and was on diclofenac every day just so I could walk.

Getting my knees replaced was amazing! I am now pain-free, I can walk, and I can sit down and stand up without a cane or hand rails. Best of all for me, I can train legs without joint pain! I can squat with 315, I've gotten reps with 405 using a Hatfield bar and handles on the rack, and I got 12 reps with 540 on the 45 degree leg press day before yesterday. Considering I almost couldn't walk at all three years ago, this is fantastic!

Now, to be completely honest, recovery was hard. The first couple weeks there was a fair amount of pain (swelling, muscular pain and incision pain, not joint pain). I did PT three days a week. After an hour and a half of work, I would go home and sleep for four hours. I also did a lot of work on my own outside of the PT office. The more work you put in on PT, the better you'll be. But it was all worth it! I now have over 140 degrees of flexion in both knees and I can squat below parallel! I attached a pic of me doing hacks; I can bottom out the machine, even with three plates a side!

Bottom line, if someone is bone on bone and lives with pain every day, total knee replacements are life changing.

low hack.jpg

While my knees are fine every friend I have that has gotten a knee or both replaced wished they had done it a year earlier than they did. They all did mention that PT was painful but it had to be done.