Knee Osteoarthritis has returned

Medical Q&A [Moderated]
1

Stats: 40 year old male, 174 pounds. About 6 years ago, had micro-fracture surgery on my right knee to deal with an absence of cartilage under my knee cap. Since the recovery, I’ve been pain free and had no bouts of swelling or any other symptoms.

Until yesterday. Yesterday marked the completion of week 7 working through the Starting Strength NLP. It was a pretty heavy day for me with the weight I added on the program. Completed first two sets on the back squat, but failed after 2 reps on the third set. Deadlift was similarly difficult, completing only 4 reps but couldn’t wrap up rep 5.

Not long after the training session, I could tell something wasn’t quite right with the knee. And sure enough, swelling began to occur in and around my knee. It wasn’t tremendous swelling like I used to get prior to my surgery, but a sign that things aren’t right. I iced the knee that evening, but I’m a bit freaked out about what this means for me and my strength training.

  1. How do I find a knowledgeable doctor who is familiar with strength training (like Austin and Jordan) as well as help me continue to move forward with my strength training rather than tell me to go do aquatic exercises or something?

  2. What do you recommend based on what I’ve described here? Should I just power through and continue to follow the program? Or should I make some intelligent modifications? I’m currently in the gaining weight phase, but now I wonder if putting on additional weight isn’t the smartest thing to do on a weight bearing joint.

2

MrBeanz,

Thanks for the post here and on the nutrition forum. I’m getting to know more about you, which is helpful for discussing what you should do.

  1. I wouldn’t see a doctor about this likely, however since I am not your doctor I cannot advise you to do the same. Rather, any sports med doctor should be able to competently rule out (or in) anything serious that requires active management.

  2. I would continue to squat after taking 10% off the bar from the previous LP session (this is your reset). I don’t know if you need to continue to gain weight because it sounds like you have gained a decent amount of weight thus far- like 15lbs in 7 weeks- and I’d be looking to see what your waist has done in the same period of time. In any event, the weight increase on the bar (10lbs per session) is probably too much at this point so I would recommend taking 10% off the bar and doing 5lb jumps until LP stops working. Then I’d stop LP entirely and move to a different program.

3

Hi Jordan,

I really appreciate your responses.

I continued to have swelling yesterday, and this morning I also woke up with a dull consistent pain in my right knee which is continuing right now. I iced the knee two days ago on the day of my workout, and I iced once again yesterday on my first recovery day.

I’ll absolutely follow your advice. I’ll take 10% off the bar and start moving forward with 5lb jumps. I’ll also hold off on the doctor visit for now, I just hope this is a one time flare up.

What led me to eventually take the more drastic approach of surgery a number of years ago was because the pain got to the point where even doing low impact exercise on an elliptical would cause random sharp pains during the movements.

Thanks again for your help, and thanks also for putting out all the content via your website and YouTube. You are definitely providing a much needed perspective based on medicine and science which helps us normal people weed out all the broscience that plagues the internet.