Avoiding Knee Injuries in Olympic Weightlifting
Make no mistake about it, Olympic Weightlifting is a brutal sport. Although the incidence of severe injury is low compared to field sports like American Football or Rugby, Olympic Weightlifters do encounter their fair share of injuries. One key area that is injured often is the knee.
Makes sense, right? This is a the key joint involved in lifting the weight off the ground and overhead. As much as it is useful for us to know what area is most commonly injured, it would also be prudent to know how to avoid them.
Due to the frequency of squatting and deadlifting in Olympic Weightlifting, knee injuries are by far the most common, and annoying. Most knee injuries in Olympic Weightlifting occur due to their repetitive nature. Unlike field sports that have traumatic occurrences (and hence, unpredictable), traumatic injuries are rare. Therefore, knee injuries are easier to predict, as they primarily occur due to overuse.
How do we determine overuse? This is a great question and there is never going to be a clear answer, because it would be difficult to classify something as ‘overused’ until it is hurt. However, there has been research that suggests if total volume within a week exceeds the previous by 20%, you could be in for some trouble. There is also the acute on chronic work ratio that postulates an increase of more than 20% based off the average of the last 4 weeks of volume, would be an indicator of potential overuse.
But what about range? The most common injuries I come across for the knees occur at inner range or outer range, very rarely in mid range. In practical applications, this might look like the dip in the jerk (inner range), or the bottom of the front squat or clean (outer range). I will never be able to pinpoint exactly why this is the case, but my guess is that these two ranges are often stressed with the stretch-shorten cycle more so than mid range. This would be an example of a magnified overuse model – that the specific range of use can lead to overuse injury.
So the next question is – having this paradigm as our predominant hypothesis is how do we avoid knee injury? First and foremost, the global rule of avoiding more than 20% increase week to week (and even less if you’re elite level) would be wise. Not only from an injury mitigation perspective, but even from a progressive overload standpoint.
Secondly, specific ranges that have proven track records of danger (end range and inner range knee flexion) should be programmed sparingly. Pause front squats, back squats, jerk dips are all movements that can flare up knee tendons very quickly. In fact, it might be wise to have partial variations of these movements to avoid excessive use of that range.
Personally, I will program box squats so my lifters still obtain the trunk benefits of heavy load, but protect their knees end range. I haven’t found a good way around jerk dips yet, so if I do program them, it’ll only ever be for once per week.
Lastly, as the stretch shorten cycle seems to be one risk factor for developing knee issues, it would be wise to limit the use of this quality during off-season or when the lifter begins to experience early symptoms. I have in the past resorted to a whole week of power cleans and power snatches to avoid deep knee flexion, to great results. Another example would be to incorporate tempo squats to prevent use of the bounce.
Minimising knee injury is all about knowing the qualities of the injury you’re avoiding and planning accordingly.