Q&A

Mike-

I got to your site a bit circuitously via stronglifts.com. Your “Bulletproof Knees” intrigues me greatly as I own a reconstructed ACL in my left knee and I am a sponge for good info.

I have two questions (if I may):

1) I started the stronglifts 5x5 program about four weeks ago and have been progressing slowly as I am “new” to free weights. I added Bulgarian split squats to my routine as a means of developing the posterior chain. I have no issues going past parallel with either a front of low back squat. I have no pain. I think my technique is solid (feedback from a PT on site where I work out).

My problem/issue is that I have developed a bit of swelling above the knee to the outside of each knee, with the “good” knee carrying a bit more fluid than the left oddly enough. Nothing excessive but noticeable when I fire the quads, you can see a bit of a bulge. Does this sound like an overuse issue due to the additional BSS routine or something I should go see my orthopod about? Empty bar on the BSS and I am currently squatting 140lbs front and back….like I said, just getting started.

2) Plantar Faciitis in left heel…barefoot or shoes? Is there a connection between the aftermath of the ACL issues and the plantar facilities issues? There is a good deal of size difference between the left and right leg, top to bottom. (Many years wearing a brace before the re-construction and poor maintenance during that time…I’m getting religion late in life.).

Oh, I’m 53, 175lbs and an avid squash player who can’t get off the court even when his body tells him to until it breaks down (very stubborn).

Thanks for reading and if the short answer is to “buy the book” or “go see your Doc” that’s cool. Just wanted to get a gauge as to the type of info I can expect with the book.

#1 - It's hard to say exactly why your knee is swelling without watching you perform the exercises at hand. If you haven't been training all that heavy, it could just me an instance of doing too much, too soon. If the knees aren't ready for it, a natural response is swelling until your body acclimates to the loading.

Now, one suggest I would make is that BSS's aren't an optimal choice if you're looking for posterior chain development. I would prefer a PC dominant movement like RDL's, deadlifts, etc. If you want a unilateral PC dominant exercise, single-leg RDL's would be a good option as well.

#2 - With regards to the plantar fascitis, it could be a result of the surrounding tissues "stiffening" to protect the knee joint. I would get some aggressive soft-tissue work done (ART, deep tissue massage, foam rolling) on the gastroc/soleus, Achilles tendon and plantar fascia. You may even be tight up into your hamstrings, so you'll have to explore a little. Some old fashioned static stretching may help as well. If your quads aren't firing as expected, loosening up the posterior knee musculature should help.

And when in doubt, buy the book ;)

Stay strong
MR