Torn ACL, untrained female, how best to start NLP?

Medical Q&A [Moderated]
1

Hello BBM crew!

I’d like to ask some advice about a theoretical person. This person is a 200-lb, 5 foot 2 inch, untrained 42-year old female. Let’s also say that she has a fully-torn ACL from a sports injury plus localized ‘bone bruising’, as confirmed by MRI. She can walk fine, but sudden direction changes require discipline and caution. We need to get her stronger to return quality of life, so a Starting Strength NLP is on the menu along with weight loss. Her doctor has given a green light for squats.

  • What, if anything, would you do differently in the early stages of LP? I presume reduced range of motion for the squat early on via raised pins and/or box squats to a little above the point of pain. Then gradually increase depth over time.

  • Should she wear the knee brace that the sports medicine clinic prescribed for her while squatting/deadlifting? I fear that it will reduce the stress on the stabilizing muscles, slowing the gainzZz. But I don’t want to cause other problems!

If it matters; she had done the StrongLifts program for about 2 months a little over a year ago, but other life events took priority.

Thanks!

2

How long ago was this injury?

  1. I would see what she can do on day 1. Her history does not necessarily guarantee that she’ll need significant exercise modification. We assume people can do the movements until proven otherwise.

  2. It will not have a significant impact on stabilizing muscles, and will not “slow the gains” – especially if the alternative is not being able to train consistently or productively. Ideally, in the long run, she won’t need the brace, but there may be some fear that she needs to overcome at the start, and it may help.

3

The recent incident that prompted medical attention was about 1 month ago. She’s had previous discrete knee pain incidents multiple times, but this one was different. Maybe it was partially torn some time ago and finally let go.

  1. I like that approach. We’ll assume no issues and monitor the progress.

  2. Right, the mental aspect is always the most complex part. I’ll feel out the confidence level and adjust on the fly.

Thank you very much for your input, Austin!