Squats and the meniscus

GiddyupTim
GiddyupTim Posts: 2,819 Member
This question came up in one of the other groups, a Crossfit group. But it did not get a good answer.
The OP has a torn meniscus, and his doctor told him he could do a leg press machine, but should not do squats anymore.
I have a torn meniscus too (trimmed) so I am curious about this question too.
Does anyone know why a leg press would put a different stress on the knee than a squat?
Does anyone know why squatting might not be a good idea if someone has a torn meniscus?
I have googled this question all over the internet, and cannot find a knowledgeable, credible answer.
Lots of guys on forums say: 'I have a torn meniscus and I squat with no problems.' But, guys do what guys do.
The meniscus does thin as you get older, and probably gets weaker too. Moreover, putting huge pressure on the knee with a heavy squat could possibly cause a tear to rip further. But, i also know that docs still say "Don't squat. It is too hard on the knee." When, most of the research shows that proper squats do not hurt the knee, do not stress the ACL and probably do not put that much pressure on the knee relative to sprinting and some other movements.
Please. HELP ! Anyone?

Replies

  • Sarauk2sf
    Sarauk2sf Posts: 28,072 Member
    Sorry - missed this.

    This is not something I am familiar enough with to give a decent response, but am posting so it shows up on my feed. Hopefully someone will have a decent answer for you.
  • markink81
    markink81 Posts: 73 Member
    OP I have a torn medial tear of my meniscus due to years of sports and running.
    I haven't had mine surgically repaired however it was recommended by my doctor not to do heavy squats as well as this causes excessive compression of the meniscus.

    I inlisted the services of a certified strength and conditioning coach to help me with proper form and help me regain range of motion. I no longer go past parallel when doing this exercise but after 6 months of proper lifitng technique I'm happy to report that I can lift 325LBS 10 times without issue (far cry from what I used to lift but I will take it) So to answer your question, yes you can perform squats with proper mechinics. I highly suggest working with someone to help you through your situtiation. Feel free to direct message me if you have specific questions.
  • GiddyupTim
    GiddyupTim Posts: 2,819 Member
    Thanks much, Markin, Sara.
    Your experience is kinda what I read when I googled around the internet, and it is reassuring. Lots of people say they have a torn meniscus and they squat with no trouble.
    But what I am curious about is: What about over time? I mean, you might be able to squat 100 times -- even 2,000 times with no problem -- but what happens five years down the road? And are you at risk of aggravating that tear, and causing it to rip further? I mean, it might only take one lift.
    Did your doctor approve of this plan, of working with the coach and resuming squatting? And, if so, did he have any basis for his permission -- other than just his limited experience in the medical office seeing a few patients?
    And lastly, why it is important not to go past parallel? Do you know that the pressure on the meniscus increases a lot when you are past parallel? Or, is it just that you are afraid you won't be able to get up? (I ask because I know that there is not more stress on the ACL when you go past parallel because the muscle recruitment changes when you get low, and your hamstrings fire more.)
    I worry about this. But, it hasn't stopped me from squatting. On the other hand, though, I do not go very heavy. I do not squat over 250 pounds; if I went heavier it would worry me more.
    The other guy that I mentioned, the guy whose doctor told him not to squat, is a super strong guy. I could see that his case might be much different from mine. I am a little curious, though, that the doctor would say that the leg press is okay.
  • sunman00
    sunman00 Posts: 872 Member
    not directly relevant as I've never done loaded squats, but in my day I was leg pressing 240kg.
    I played a good level of competitive squash, and golf, and as a result of a combination of getting a bit overweight & both full flexing and rotating my knee joint I ended up with a meniscus tear and general degradation and eventually had to have an arthroscopy to clear all the debris from the joint.
    The surgeon discouraged me from leg presses on the basis of the full flexing of the joint, which I guess is what you're hearing about flexing beyond 90 dgs in a squat, as it invites the possibility of more tear, and will exacerbate any existing meniscus degradation which leads to irreversible osteoarthritis.
    Osteoarthritis, for those who don't know is where joint bones rub together when flexed because there is little or no cartilage between the bones to protect them from each other, and the bones grind each other down.
    After my surgery and 3 months careful recuperation as prescribed I resumed normal life but pretty soon after my joint pain (through a degree of osteoarthritis) returned.
    I consulted the surgeon again & he advised absolutely no full flexing (over 90dg) of the joint and no 'trauma' which included running, golf was still a bit painful too so I drastically cut that down too.
    He also advised weight loss, simply to put less burden on the joint, which was a major factor in starting my journey on here, and I have to say that since losing some weight the joint does feel generally much happier.

    Once meniscus damage, and the resultant osteoarthritis becomes too bad it's a one way street to full knee replacement; no technology exists to repair or replace cartilage. There are a few injections which are promoted which have mixed reviews at best but in reality the damage is irreversible. I researched that a lot, it's fully effective in more than 50% of cases and much greater in terms of people who are much happier.
    And, a prosthetist advised me to have a full replacement sooner rather than later as compensating for the pain in one knee causes trauma in the other knee and you'll end up needing both replaced.

    So, I quit the gym, quit golf, and lost weight. I walk at least 4 miles every day and do some basic body resistance workout routines at home, including 90 dg squats, 4x25 3 times a week and can report that my joint is 'happy'.

    hope this all helps, good luck.
  • GiddyupTim
    GiddyupTim Posts: 2,819 Member
    Thanks all
  • elly1979
    elly1979 Posts: 79 Member
    Thanks for this post, and the responses. I tore mine when I was 16, and don't know if the tear was repaired or removed. I am 34 now.

    Deadlifts (classical) killed my knee after a certain weight. Basically now I try to remain aware of weight, and reps, with squats, deads, lunges, etc.

    What I wonder is for those of us who watch both reps (not too much volume to overly tax the knee) and weight load, is there any chance of linear progression?

    I've shifted focus to progression on upper body but wonder if lack of progression on my lower body impedes progress for weight loss, muscular sustainment as I age, etc.
  • markink81
    markink81 Posts: 73 Member
    Thanks much, Markin, Sara.
    Your experience is kinda what I read when I googled around the internet, and it is reassuring. Lots of people say they have a torn meniscus and they squat with no trouble.
    But what I am curious about is: What about over time? I mean, you might be able to squat 100 times -- even 2,000 times with no problem -- but what happens five years down the road? And are you at risk of aggravating that tear, and causing it to rip further? I mean, it might only take one lift.
    Did your doctor approve of this plan, of working with the coach and resuming squatting? And, if so, did he have any basis for his permission -- other than just his limited experience in the medical office seeing a few patients?
    And lastly, why it is important not to go past parallel? Do you know that the pressure on the meniscus increases a lot when you are past parallel? Or, is it just that you are afraid you won't be able to get up? (I ask because I know that there is not more stress on the ACL when you go past parallel because the muscle recruitment changes when you get low, and your hamstrings fire more.)
    I worry about this. But, it hasn't stopped me from squatting. On the other hand, though, I do not go very heavy. I do not squat over 250 pounds; if I went heavier it would worry me more.
    The other guy that I mentioned, the guy whose doctor told him not to squat, is a super strong guy. I could see that his case might be much different from mine. I am a little curious, though, that the doctor would say that the leg press is okay.

    Depending on the type of tear you have it can worsen overtime. My doctor told me stories of guys coming into his office not being able to straighten their knees because they had locked and were unable to straighten them. At that point your looking at surgery which isn't a huge deal and many people resume regular activity once they rehab.

    Mine flairs up ever so often but is only an ancillary issue for me. The main culprit for me is grade 4 arthritis(bone to bone) in both my knees meaning it's just a matter of time before i get brand new Titanium...Not looking forward to this. The arthritis is actually more painful for me than the tear..

    My family doctor is a general practitioner who specializes in sports medicine so he has seen his share of bad knees. Since there is a shelf life on knee replacements he and I are working to get me another 10 years on my natural set by strengthening the muscles around the knee which in turn helps them stabilize.

    The doctor and trainer both said if you didn't have knee issues that going past parallel is better because it recruits the glutes and hamstrings as you had mentioned. The problem with going deep with squats and having a tear is the compression of the meniscus the more compression the more stretching of the cartridge. So as a safety precaution my strength coach and doctor both advise against it and having the arthritis makes it tough anyway...so I listen to them.

    As far as the weight on the bar goes that's relative to the one doing the lifting. I try hard to not let my competitiveness get in the way of my progress so I don't push a lot of weight anymore I do more time under tension so that I'm exhausting the muscle fibers with very little time resting between sets.

    Another thing worth mentioning is getting yourself some proper lifting shoes if it wasn't for mine I would have a lot harder time. The nice thing about lifting shoes is that there heels are as hard as a rock and will not give when you push up through your exercise. They have been made a huge difference and have been my life saver.