patella tendon pain stopping me squatting

[danlightbulb]

Hi coaches.

For the past few months I had been working up my squat. I had reached about 115kg and started getting a bit of pain in my patella tendons. First in my right knee, then it moved across to my left. It was only slight, and so I pressed on to 117.5kg and then squatted 120kg shortly after.

Since then I have had pain in both patella tendons. I cannot squat. I've had 16 days off from squatting and the pain has not gone away really. I squatted 60kg on Thursday and its back as bad as it was before. I cannot squat down unloaded without it hurting now.

I bought some rogue rubber bands to use as compression and have been doing that but its not helped at all.

My right patella had started growing some kind of bony lump on the patella tendon join area at the base of the patella. This is slowly disappearing.

I'm really needing some help. I had been trying really hard on my squats recently and was doing really well, and now this. Even unloaded bending of the knee is now painful. I cannot run either, as the impact causes pain in both patella tendons. Feels a bit like shin splints.

It is only the patella tendon and its joint with the patella, no other area of the knee hurts at all.

Here is my last squat which was the main onset of the issues, as in the days after this the pain came: https://www.youtube.com/watch?v=N7pqZpLKm8o

I have asked for advice in the technique section (squat check please + knees advice , and one of the SS coaches, Jeremy, has commented that my toes are out-turned a little too much. He also thinks my knees may be caving in. I really don't think they are though, I have worked hard on form and I feel my knees are rock solid in that video. My feet are at about a 40 degree angle which is how I've been squatting for ages and felt comfortable until all this happened.

Really don't know where to go from here.

Thanks for reading.

Dan

[Tom Campitelli]

Firstly, Jeremy gave you all kinds of good input on that thread. Fuck, he is one patient dude. Jeremy, if you read this, job well done. I would read his comments a few times and make sure you are implementing his advice.

Patellar tendinopathy is the bane of several trainees existences. Once it starts, it can be very difficult to resolve. However, yours is not a typical presentation. Patellar ligament (more correctly) pain normally comes on slowly and can often be present for months before it really starts getting in the way. Further, if squatting is bothering it, it is unusual that a 16 day cessation did not make it feel any better.

The first thing to do is to relax. While the patellar ligament hurts and is annoying, it is not indicative that your knee is going to fall apart, or that anything terrible is afoot. You can even squat with decent form and sometimes develop patellar ligament pain. It does not happen to most trainees, but I know a few, including myself who suffer from it.

Try this:

• Do five days of ibuprofen, as described here. See if that knocks things down a little. You are early into this, so it may be all you need to do.
• Decrease your squatting frequency to once a week. Deload as needed. See if the pain subsides.
• Consider doing box squats. These encourage a more vertical shin and can keep you out of your knees a little.
• Stretch your quads, hammies, and calves three to five times a day for at least 60 seconds at a time. Might work. Might not. Try it for two weeks.
• Foam roll, or roll on a lacrosse ball two or three times a day focusing on the quads near the knee. Foam roll before squatting.

There are some options for you to try. See how things go. This is a shitty problem, but the fact that it had such a recent onset for you means you will probably get by it.

[Alex Kennedy]

Dan, how about that video from the rear? Jeremy is Jesus Christ.

[danlightbulb]

Thank you for the reply Tom.

Dan, how about that video from the rear? Jeremy is Jesus Christ.

I'd love to do a rear video - but I only tried to squat once since the pain started and the pain came back straight away. Hence no video as yet as I haven't squatted to be able to take one.

I haven't taken any ibuprofen because under normal conditions its not stopping me doing anything or painful during normal conditions. I try and avoid taking any medication unless I really need it.

I purchased the rubber compression bands that Jeremy originally suggested, but I've not tried stretching or foam rolling. I don't have any foam rolling equipment. Interestingly though on the stretching, squatting hurts but deadlifting makes it feel alot better as long as I get a really good stretch in my hamstrings. I have felt that I have some flexibility issues recently so maybe there are some links there.

I'll try and squat again on Sunday and take a video. I think it will be a significant deload though, as the last time I tried it felt very weak compared to where I was 2 weeks prior. I only did 60kg and knees started hurting.

[Tom Campitelli]

I already regret asking this, but how much does this actually hurt? Pain scale 1 to 10. Remember, 10 is the worst pain you could imagine. Absolutely the worst thing. Torture. You are on death's door at 10.

[Beau Bryant]

I suffered through this for 6 to 8 months maybe longer. I tried many things and nothing really worked. I just kept squatting and hobbling down stairs. It drove me crazy sitting and the only relief I had was to sit with a straight leg. I think two things resolved it.

1. I focused on initiating my squat with "chest down". I also widened my stance slightly.
2. Like all tendinitis it seems to go away the same way it comes. For no reason at all and when it's time.

[Bryan Dobson]

Just a few orbit from a 44 year old who has had patteller tendon pain off and on since I was a teen who squatted and did a lot of.bleacher runs. I would often suffer for months and it would resolve.

The past couple of years I have used high rep terminal knee extensions anytime I felt it flaring up. Such a small thing helps me continue to train and finish some tough squat training cycles. Definitely listen to the coaches, my experience is n=1, but a band and a few minutes a day may get you back to squatting. Squats or no squats never seemed to effect the rate of it resolving.

[Tom K]

2. Like all tendinitis it seems to go away the same way it comes. For no reason at all and when it's time.

That should be stickied somewhere.

[danlightbulb]

I already regret asking this, but how much does this actually hurt? Pain scale 1 to 10. Remember, 10 is the worst pain you could imagine. Absolutely the worst thing. Torture. You are on death's door at 10.

Very low on that scale. Only 1. I wouldn't really describe it as pain its more of a very strong ache. However it becomes sharper when I use the knee, i.e loading it or bending down etc. Yesterday I did some DIY and was on my knees a fair bit, and today its much worse again. I'm hobbling a bit and not walking normally down stairs etc.

The issue is not the ache/pain directly, but it has made me weaker. The joint feels less stable, weaker and I feel less able to generate force because of it.

However, yours is not a typical presentation. Patellar ligament (more correctly) pain normally comes on slowly and can often be present for months before it really starts getting in the way. Further, if squatting is bothering it, it is unusual that a 16 day cessation did not make it feel any better.

Actually I have had a slight ache for several months but it didn't effect me at all. It actually went away while squatting, and came back after. It's only since the inflammation has developed on the bone that Its affected my walking and obviously squatting.

[Tom Campitelli]

I wish I had a better answer for you. Tendinopathy is not so much a diagnosis, but a description of symptoms. It probably stems from a multitude of factors across different people. Try some of the stuff outlined above. See how things go.