Squatting with chondromalacia

[coreJack]

Rip has said that squatting has helped some folks with chondro that he's trained. Would love to hear from guys here with chondro, or coaches/trainers who've worked with such clients.

Has squatting, particularly, the low bar back squat, helped? Do you find that you have to modify the form from the 'standard' form - Rip's mentioned that guys with chondro may have to do a more shins-vertical squat.

I've been dealing with this shit for a few years, and the thing that's helped the most is the box squat (unweighted) and now that I can finally hit parallel on that, I'm about to give the back squat another try (first time around it was just making my knees worse), so any advice is appreciated.

Will try to get a video up with just the bar (or enough weight to push me below parallel) - my gym doesn't allow recording (), so I'll try to get to a friend's gym this weekend.

[Dastardly]

It seems you havent had many replies so I thought I may as well write something.

Orthopedic consultant said I have shallow throchlear grooves, thin cartilage & chrondomalacia.

But He said that any and all exercise is still good as long as i do not apply rotational stress to my knees.

I have been fervently squatting, and pushed myself hard when switching to SS and fixing my squat form. I had been having problems with knees but continued due to the consensus/belief that a good squat was the best most balanced way to strengthen leg muscles. And strengthening muscles is the advice always given by doctors and therapists to help knee problems like this.

however I must admit, that as I have continued to squat my chronomalacia has gotten worse and worse. My knees also feel less stable & secure.

Squatting heavier weights is supposed to strengthen & tighten ligaments for MORE stable joints. But it feels that my knees are getting looser and less stable.

This is all the opposite of what I had hoped and expected, but I still have faith that this is merely a dip in the through. This may be partially a blind faith, but it is good to keep goals simple. I want to get strong, and getting strong does not happen by not squatting.

Knees having been getting rougher and more painful, but I am indeed hoping they will eventually condition to the new stresses, ROM and alignment caused by extra muscle, forces and motion of squatting. And that huge amounts of muscle will in itself stabilise knees greatly.

[Dastardly]

I also should add, that is impossible to do a shins vertical squat with good depth unless you have really weird body proportions.

If you have extreme sit-back, your knees will slide forwards when at the bottom of the squat. This will cause more problems.

[tnumrych]

Ok, I'll bite on this one.

Jack, back in grad school I was a part of a weightlifting team was mostly comprised of Exercise Science, Athletic Training, and Kinesiology students (we were coached by one of the professors, a Masters Oly champ at her age/weight class).

During a particularly hard training phase that included lots of heavy squatting (and of course cleaning and snatching) I developed a pain under my knee cap. Two of the ATs that competed with us also served as team ATs. Both examined me and performed the Clark's Sign Test, which is used to diagnose chondromalacia. I came up positive several times but both warned me that test and diagnosis is going by the way of the Dodo (supported by Wikipedia article). They cited false positives and many other causes since found to be the cause of pain in that area. Anyways, since my next meet was relatively close, with heavy icing and Vitamin I, I continued squatting. Within several weeks the pain dissipated and never really came back. That was over a year ago, I have since switched to low bar squatting, and haven't had any pain in that area that wasn't caused by getting out of position, and even then the pain is only transient and subsides by the next training session.

It's also important to add that back then all of my squatting was done in a high bar Olympic style which is much less forgiving on the knees than the low bar advocated on this board.

[Malcontent]

Don't have much to contribute, but I was recently diagnosed with chondromalacia. I've had it for years, but it was never a big enough issue to have it looked into. I only had it diagnosed because a friendly physiotherapist offered to do some tests.

My experience is the exact opposite from most. I can do ass to grass front squats as often as I want to (3x a week) without aggravating my knees, but low bar squats cause tendonitis and aggravate the effects of the chondro (crepitus, poor patellar tracking, etc). In fact, the front squats make my knees feel great and if I don't do them I notice it more.

Purely anecdotally, without a shred of evidence to back up this claim, I believe descending to parallel, or slightly below, is more stressful on the knees than going as deep as you're physiologically capable of going. I feel like getting maximum hamstring bounce out of the bottom significantly reduces the pressure on the knees.

From my experience sumo deadlifts seem to be quite beneficial as well.

[coreJack]

I also should add, that is impossible to do a shins vertical squat with good depth unless you have really weird body proportions.

Of course. I just meant more vertical shins than the typical low bar back squat form.

If you have extreme sit-back, your knees will slide forwards when at the bottom of the squat. This will cause more problems.

Thanks, I'll keep an eye out for that.

It's also important to add that back then all of my squatting was done in a high bar Olympic style which is much less forgiving on the knees than the low bar advocated on this board.

Yeah, it seems that in terms of stress on knees, front squat > high bar back squat > low bar back squat > box squat.

Anyway, I'll hopefully be able to get some video of my form with an empty bar taken tomorrow. If I can't find a way to make back squats work for my knees, I'll start doing weighted box squats, though this has a finite limit in that my gym doesn't have proper plyo boxes.

My experience is the exact opposite from most. I can do ass to grass front squats as often as I want to (3x a week) without aggravating my knees, but low bar squats cause tendonitis and aggravate the effects of the chondro (crepitus, poor patellar tracking, etc). In fact, the front squats make my knees feel great and if I don't do them I notice it more.

I think this goes to tnumrych's point that chondromalacia is a catch-all diagnosis, and different cases have different causes and aggravating factors. But it's great that you found a way to squat and keep the chondro at bay.

Purely anecdotally, without a shred of evidence to back up this claim, I believe descending to parallel, or slightly below, is more stressful on the knees than going as deep as you're physiologically capable of going. I feel like getting maximum hamstring bounce out of the bottom significantly reduces the pressure on the knees.

My hips and hammies are too tight to go much below parallel, but it makes sense to me to use the full range of motion (without buttwink of course).

[Jenny]

I was diagnosed with patellofemoral syndrome about 10 years ago when I was in college. X-rays showed that my patellas were pulling toward the outsides of my knees. At the time I was doing quarter squats and trying to learn to English style horse-back riding which involved my sister yelling at me to point my toes forward while sitting on a horse (torque on the knee).

The PT had me doing some stretches, leg extensions, and leg curls along with ice and lots of vitamin I. That helped somewhat, but I would still have occasional flare-ups.

But since starting to low-bar back squat a few years ago, my knees have been feeling much better. For me the more regularly I low-bar squat, the better my knees feel. I suspect that this has something to do with the low-bar squats strengthening my adductors to counteract the tendency of my knee caps to track to the outside.