Hello doctors! I hope that you could help me figure it out.
I’m an Italian pharmacist 29yo 6feet 85kg been training on and off for the last 5 years. PR squat 150kg deadlift 170kg bench press 100kg.
I’ve been having a knee issue (only at my right one) for the last 2 months but nevertheless I finished the endurance template, and made some steady progress and new PRs.
Now before I start a new one I would like to have your opinion.
I hear a pop every time I squat around parallel, and I see that my knee get swollen on the outside part every time I bend my leg. If I try to sit on my heels I feel a big discomfort/pain and I need to straighten my leg.
I’ve been using dicoflenac gel 2% everyday but now I don’t know if I’m doing it wrong since the pain is always there.
I did a MRI and it only says that my knee isn’t perfectly straight up with my leg and there are signs of hyper compression plus a bit of a torn ACL. I saw an orthopedic like a month ago. He dismissed me quickly saying that there is nothing to do. He barely touched my knee and looked at my MRI. Should I seek for other doctors or just accept that I should not squat (I don’t compete and I just would like to be strong and fit).
Would you advice me to not squat for a couple of weeks or just pretend it’s nothing? In the former case what should I do?
P.s. other squat variants or unilateral movements hurt too.
Thank you Austin for answering me so quickly! I’ll try tomorrow and write how it goes. in the mean time I would like to ask:
is a 303 tempo squat less stressful on the knee since it’s a lighter and more controlled movement?
2)not squatting at all (I’m not interested in competing, but just to be healthy and strong) would be detrimental to my overall strength? And if I choose to not do squat, what would you advice me to do instead?
We simply want to find a tolerable dose of stimulus to use as a starting point. I would not try to frame this in terms of “stress” on the knee.
There is no such thing as “overall strength”. If you want to get strong at squatting, you should squat. If you do not care about squatting / squat strength, you can get quite strong at whatever other movements you desire. With that said, having some pain when squatting currently is not itself a reason to abandon squatting altogether.
Hi Austin! I did try bodyweight 303 squat. I still feel the single creepy noise and feel pain/fatigue at the right knee. If I try to stretch like sitting on my heel or evening kneeling while doing jiu jitsu exercises, I feel pain and a bit of swelling on the outside of the knee.
I have no issue doing conventional deadlift, a bit doing sumo.
Probably all your templates have some squat or variations, should I just avoid squatting for like a month or two? In that case which template should I do? Could I just substitute squatting with more pulling?
You are free to do whatever you’d like, but we do not recommend total avoidance of a movement or similar movements. It sounds like you have a tolerable place to start.
Have you watched the youtube video in which Austin outlines the 4 Steps for Managing Pain in the Gym? The approach he outlines is what I believe you should implement, especially since there doesn’t seem to be any red flags. That said if your not particularly attached to the idea of having a strong squat it is not particularly important that you squat. Strength is a skill as well as a physical attribute, I don’t believe there is anything magical about squats that you are missing out on, if you don’t care about how much you squat.
@Austin_Baraki I worry that I could make it worse by pretending it’s nothing to care about it, you say that avoidance is not the answer, but would focusing more on other movements a wise idea? I still don’t know what to do. @4l3x I’ve seen that video some months ago, and I found it very useful! I have discomfort/pain mostly when I sit on my knee, or bend the leg and sit on my heel, the flexion of the right leg give me much more discomfort and pain than doing heavy squat. I hope that I explain myself clearly, my worries are if doing squat would aggravate/wouldn’t allow healing of my right knee.
Maybe I could do partial squat? if I don’t break parallel I don’t hear the “noise” and it seems better, but I never did partial squat in my life lol Rip taught us how evil partial squats are…
I’m not so sure that it makes much sense to worry about letting you knee heal, my thinking is that it is more about being able to tolerate use of your knee (squatting). Therefore, you should do exercises specific to the goal of squatting with the caveat that everything you do should be at a tolerable level of pain, making you more comfortable with squats. It sounds like you have found a decently specific exercise that you can tolerate. I think that you should start with partial squats and as you gain confidence you will likely find that even more specific exercises are tolerable and you can work your way back to full squats.
Also, I suspect your pain might not have much to do with the mild “deformities” seen on the MRI. This does not mean that your pain isn’t real, or “nothing to care about” I think it just means that you should focus your rehab approach on how you feel and perform rather than, say, continuously getting more imaging done to wait and see if your knee is ready for you to squat.
Hi, they also have a good article on “joint noises” (Crepitus: Expectations vs. Reality | Barbell Medicine). Some people with noise have pain and many do not. The existence of the noise isn’t an indication of injury.
Your knee isn’t a broken metal gear. If you continued to use a machine with one broken gear, the broken gear would grind against the other gear and break-down more until the machine stopped working. For your knee, “motion is lotion”. It is a living organism that will heal better if you use it at the highest effort that is comfortable. Think stress, recovery, adaptation. Movement does not slow healing. 100% rest just results in you adapting to being weaker.
And, actually, a partial squat variation is recommended for improving jumping (think basketball players).