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  • Persistent Knee Swelling

    Hi Doctors,

    I have a question regarding squatting and deadlifting. I've had knee issues for around 8 years after having a lateral meniscus removal. Still, I squatted, benched, and deadlifted without much of a problem, save for a swollen knee and some intermittent discomfort (not pain).

    After a recent visit to the doctor, I was told not to squat or deadlift for fear that it would accelerate the osteoarthritis in my meniscus-less knee. He conducted an MRI of my knee and suggested signs of developing arthritis/wear and tear on the joint. I'm 23. I love powerlifting but I also want to be able to walk in 20 years. I don't know if I'm prepared to give up powerlifting, but I will if it can help me further down the line.

    With that being said, my questions are four-fold:

    1) I've read that strength training reduces the acceleration of osteoarthritis by strengthening the muscles around the joint. Does this logic hold when someone is missing something like a meniscus?
    2) Should I be concerned with swelling in my knee, even if there is no pain minus the occasional stiffness caused by said swelling? I wear SBD knee sleeves when I squat, and they always seem to help bring the swelling down.
    3) I want to continue squatting, benching, and deadlifting. But, should someone with knee issues alter their approach/technique? For example, should I still be squatting so that the hip crease is below the knee?
    4) Even if I can squat/bench/deadlift, should I consider avoiding heavier weights and stick to lighter weight for higher reps?

    I'd appreciate any advice you have to offer. I can provide more information if need be.

  • #2
    Originally posted by nowm View Post
    Hi Doctors,

    I have a question regarding squatting and deadlifting. I've had knee issues for around 8 years after having a lateral meniscus removal. Still, I squatted, benched, and deadlifted without much of a problem, save for a swollen knee and some intermittent discomfort (not pain).

    After a recent visit to the doctor, I was told not to squat or deadlift for fear that it would accelerate the osteoarthritis in my meniscus-less knee. He conducted an MRI of my knee and suggested signs of developing arthritis/wear and tear on the joint. I'm 23. I love powerlifting but I also want to be able to walk in 20 years. I don't know if I'm prepared to give up powerlifting, but I will if it can help me further down the line.

    With that being said, my questions are four-fold:

    1) I've read that strength training reduces the acceleration of osteoarthritis by strengthening the muscles around the joint. Does this logic hold when someone is missing something like a meniscus?
    2) Should I be concerned with swelling in my knee, even if there is no pain minus the occasional stiffness caused by said swelling? I wear SBD knee sleeves when I squat, and they always seem to help bring the swelling down.
    3) I want to continue squatting, benching, and deadlifting. But, should someone with knee issues alter their approach/technique? For example, should I still be squatting so that the hip crease is below the knee?
    4) Even if I can squat/bench/deadlift, should I consider avoiding heavier weights and stick to lighter weight for higher reps?

    I'd appreciate any advice you have to offer. I can provide more information if need be.
    Hey nowm!

    Sorry to hear that you were told not to squat or deadlift anymore by someone you trust to get medical information from! That is far from an appropriate recommendation but unfortunately the norm.

    1) One of the best things that you can do in regards to osteoarthritis is to do resistance training. Not only is it safe, but it also aids in doing what you said as far as keeping the musculature around the joint strong, although the argument that strength is a cause of decreased pain is a little bit hazy in itself. The thing I think best to point out here would be that just because you have osteoarthritis does not mean that you should or will have symptoms such as pain. Even at 23 years old we know that arthritis is a normal part of aging and not pathology and should not be viewed as such. We know that there is a very large population of people with degenerative changes just like osteoarthritis with no symptoms at all! If you can like you said squat and deadlift without much od a problem, I would recommend that you simply continue to train because if it is not making things worse then why not train? Specifics as far as programming or training specifics could definitely be run by Michael and Derek to get their professional input as if it is best for your current situation.

    2) The swelling is a little bit of an "I dont know" detail for me personally as Im unsure what would be causing it, but again if it is not getting worse with training then why not? Maybe you can get a better answer than that from those two!

    3) Squatting below parallel is not dangerous and, I feel like a broken record here, but if it is not giving you symptoms and you are able to train in a full range of motion under resistance than why would you stop?

    4) Heavier weights, if you are progressing into them appropriately and intelligently, should not be an issue at all. The body will adapt to the stress that you put through it, given that you give it time to adapt to a stimulus. Heavy is relative to the user and consulting with Michael and Derek on programming and their knee template to ensure intelligent progression would not hurt!

    Hopefully this helps and hopefully Michael and Derek agree with me on this stuff but I would love to see what they have to say about it all

    Good luck!

    Comment


    • #3
      Hey Joe!

      Thanks so much for the response--you're definitely confirming a lot of what I was thinking after reading through some of the material here and elsewhere. I think shifting my mindset about osteoarthritis from pathology to a normal part of the aging process (and not one that necessarily causes pain) is an important piece to all of this. You're right: I don't have any pain that's outside the normal aches of training heavy and often. As long as I keep feeling that way, I'm going to take your advice and keep at it. I suppose the knee issue is a bit of a blessing and a curse: it sucks to have, but it made me learn to squat correctly and ultimately get into resistance training/powerlifting.

      I'll also take a look into the pain & rehab consultation. It seems like a great next step.

      Again, thanks so much for your response, and best of luck!!

      Comment


      • #4
        Originally posted by nowm View Post
        Hi Doctors,

        I have a question regarding squatting and deadlifting. I've had knee issues for around 8 years after having a lateral meniscus removal. Still, I squatted, benched, and deadlifted without much of a problem, save for a swollen knee and some intermittent discomfort (not pain).

        After a recent visit to the doctor, I was told not to squat or deadlift for fear that it would accelerate the osteoarthritis in my meniscus-less knee. He conducted an MRI of my knee and suggested signs of developing arthritis/wear and tear on the joint. I'm 23. I love powerlifting but I also want to be able to walk in 20 years. I don't know if I'm prepared to give up powerlifting, but I will if it can help me further down the line.

        With that being said, my questions are four-fold:

        1) I've read that strength training reduces the acceleration of osteoarthritis by strengthening the muscles around the joint. Does this logic hold when someone is missing something like a meniscus?
        2) Should I be concerned with swelling in my knee, even if there is no pain minus the occasional stiffness caused by said swelling? I wear SBD knee sleeves when I squat, and they always seem to help bring the swelling down.
        3) I want to continue squatting, benching, and deadlifting. But, should someone with knee issues alter their approach/technique? For example, should I still be squatting so that the hip crease is below the knee?
        4) Even if I can squat/bench/deadlift, should I consider avoiding heavier weights and stick to lighter weight for higher reps?

        I'd appreciate any advice you have to offer. I can provide more information if need be.
        Hey Nowm,

        Sorry to hear about the knee issue. Joe_ has supplied some good input. Just to follow-up.

        Overall, this situation is unfortanate given the misinformation the physician supplied you.

        Can you provide background details - What prompted the meniscectomy? What prompted the recent visit to the physician?

        Regarding your questions:

        1) Overall - I wouldn't concern myself with the advancement of osteoarthritis given this happens with aging and prevalence increases throughout life (even in asymptomatic individuals).

        See: Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis

        What is important are the thoughts and beliefs patients have once they've been informed about the osteoarthritis.

        See: Living with osteoarthritis is a balancing act: an exploration of patients’ beliefs about knee pain. If we become worried and concerned about the "integrity" of our knee and we begin self-selecting activity for fear of the outcome of pain or worsening of the OA - then this is not good and in essence the clinician has elicited a nocebo response with their words. This is something we fight regularly at Barbell Medicine.

        2) I do not typically concern myself with swelling as you are describing. If the swelling worsens and impedes range of motion and function - then modifications likely need to be made.

        3) No alterations need to be made that would be different from our usual recommendations - mainly, manage loading and fatigue appropriately with RPE. There is nothing wrong with squatting full range of motion.

        4) No.

        I'm happy to discuss any of this and again, I hate to hear when a clinician has unnecessarily instilled fear in a patient.




        Last edited by Michael Ray; 01-16-2019, 02:59 PM.

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