Episode #329: Severe Bilateral Knee Pain After Squatting 600 pounds
Jan 3, 2025
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Derek Miles, Head of the Pain and Rehab Division and a doctor of physical therapy, joins the discussion to dissect a unique case of a powerlifter suffering severe knee pain after a heavy squat attempt. They explore the causes of knee injuries, including bilateral quadriceps tendon ruptures and ACL injuries. The conversation touches on the effects of anabolic steroids on tendon health and the importance of gradual training progression. Rehabilitation strategies are emphasized, along with the critical role of psychological factors in recovery.
The podcast investigates a case of severe bilateral knee pain in a patient following a heavy squat, examining potential quadriceps tendon injuries and diagnostic approaches.
A critical discussion on the importance of addressing both physical and psychological aspects in rehabilitation highlights how fear of re-injury can impact recovery outcomes.
The nuanced relationship between anabolic steroid use and tendon injuries is explored, emphasizing the significance of training behaviors and loads over substance use alone.
Deep dives
Introduction of New Training Programs
Two new training programs have been launched, with the first being the second generation of the Strength One program. This program is designed to enhance strength in fundamental lifts such as the squat, bench press, deadlift, and overhead press. It offers four 12-week programs allowing users to select their own exercises and choose between flexible workout schedules. The programming has been improved based on user feedback to optimize results, accommodating various preferences and equipment availability.
Time Crunch Program for Busy Individuals
The second new program, titled the Time Crunch program, caters specifically to busy individuals, including parents and professionals who still wish to achieve fitness goals without extensive gym time. This program consists of six 12-week options that range from less frequent, longer workouts to shorter daily sessions. The emphasis is on delivering effective training solutions, regardless of the user's schedule. Both training programs can be performed with basic gym equipment, providing options for varied fitness levels and available tools.
Understanding a Mystery Medical Case
The podcast features a medical case involving a patient who experienced severe leg pain while squatting during a powerlifting meet. Upon examination, the physician suspects possible quadriceps tendon injuries based on the reported mechanism of injury and physical examination findings. Various diagnostic assessments, including potential imaging and physical tests, are discussed to pinpoint the exact nature of the injury. The analysis emphasizes the significance of a thorough evaluation and highlights the distinction between different types of knee injuries.
Risk Factors and Return to Sport After ACL Injuries
The discussion transitions to the implications of ACL injuries and emphasizes understanding the associated risk factors and return-to-sport strategies. It is noted that patients tend to return to their sport more effectively when their rehabilitation programs address both physical and psychological aspects. Fear of re-injury can impact recovery and performance, highlighting the need for strategies to build confidence and strength. Successful rehabilitation is not only determined by surgical intervention but also by a well-structured program that accounts for individual readiness.
Impact of Anabolic Steroids on Tendon Injuries
An exploration of the role of anabolic steroids in the context of tendon injuries reveals a nuanced understanding of their relationship. While past beliefs suggested a direct correlation between steroid use and increased injury risk, recent discussions express a more cautious view, focusing on training behaviors and intensity rather than merely substance use. Evidence suggests that training loads and recovery practices significantly influence injury occurrences among athletes. The conversation stresses the importance of balanced training alongside any substances used to minimize the risk of injury.
In this podcast, Drs. Miles and Feigenbaum review a mystery case where thee patient presented with severe bilateral leg pain after attempting a 620 lb squat. We discuss anabolic steroid use, knee pathology, rehab strategies, and more.
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