Hi all,
I know this general topic is one that is discussed over and over again within the BBM echo chamber, but even though I’ve considered myself part of this community for years now, I still struggle with really understanding when/how to differentiate between when pain is a legitimate concern vs a psychological barrier to training. Maybe this forum isn’t the best platform for this discussion, but I would personally benefit from a deeper understanding - regardless of the fact that I’ve read a lot on the subject, listened to the podcasts, etc. There is a difference between understanding (or thinking you understand) the theory, and putting it into practice.
My case:
40 years old, 175lbs. I tore the meniscus in my left knee about three years ago. Diagnosed with imaging. Worked with a sports med doc and PT. No surgery. At the time of injury I was squatting mid-300’s for sets of five. Post injury, pain would start to develop when the weight would reach roughly 200lbs. I wasn’t overly concerned. Did my PT, varied my exercises over the next year to allow myself to continue training. Deadlifts were generally ok, as were pin squats (1/2 squat), and also hack squats. Long story short, life went on.
Fast forward three years and after a break from lifting (thanks to Covid closing down the gyms for 5 months), I’ve been training regularly for about 7 weeks. My lifts are all moving nicely, considering the extended break, and this week I squatted 320 @ RPE 8. I’m generally happy, and looking forward to completing this strength block sometime near Christmas.
However, my knee pain still presents itself from time to time. Specifically when there is pressure on the inside of the knee when bent, and when intensity reaches that RPE 8 level. Examples would be sumo deadlift or a wide stance squat. Obviously, I can avoid sumo and can squat with my feet closer together (I happen to be doing sumo this block just because I’ve never really focused on it, and decided to give it a try for comparison). The pain hasn’t been debilitating, and it doesn’t linger after sets. It comes on almost as a “warning” and I keep telling myself not to overthink it. I’ve been worried about the knee injury for so long, that I’m not surprised I am overly conscious of any feeling from that general area. Basically, doing my best not to fall into the nocebo routine.
But, yesterday I was standing on a short three legged stool (1ft off the ground) to grab something out of reach. The stool flipped and I slipped/fell off. I landed on my left foot, putting pressure on the inside of the left knee. There was instant sharp pain in the injury area (I realize the injury isn’t necessarily in “that” area, but same pain location as with the tear). It was gone as soon as it happened, and I feel fine. But, it did make me think more about whether or not that pain was legitimate (i.e., is there a residual mechanical issue that is unresolved with my knee). When lifting weights, I have time to get myself psychologically nocebo’d up before the pain develops (if that makes sense), but this was unexpected. I guess, I’m trying to determine whether or not I should actually be more concerned about the pain when lifting (i.e., go back to conventional DL’s, etc). I don’t want to nocebo myself, but I also don’t want to cause damage if there really is an unresolved/unhealed knee issue.
Like I said, life goes on. I’m more interested from an academic perspective than anything else. Obviously, I don’t want to make things worse but I’m also interested in further understanding the subject matter.