Tibial Tubercle Pain

[Al2020]

I have been dealing with persisting Tibial Tubercle pain in my right leg for about a month and a half.
I am a 19. year old male. 5′9",132 lbs. Had ACL reconstruction on my right knee (Hamstring graft) about 14 months ago.
First time the pain appeared was in 12/2/2020 in the middle of the day after I Squatted 215 lbs for 2 sets of 5 and 1 set of 4 (Failed the last rep) with 10 minutes of rest between each set.
The next day basically every pressure I would put on that area hurt. Even getting up from a chair or stretching my quad hurt. So I didn't squat and deadlift for a week and the pain got better.
Went back to the gym and started doing my warm up squats and everything was okay until I reached 200 lbs and then I noticed the pain is coming back.
I didn't squat and deadlift for 3 weeks this time and then went to Volleyball practice(12/3/2020). Was able to to practice without pain but after practice I noticed the pain is coming back and the next day I felt it even stronger.Pain Improved with rest again but I didn't Squat,Deadlift or Play Volleyball since then but yesterday I noticed the pain came back slightly even though I didn't even do anything stressful. It's not as a strong as I felt it after squatting but I can definitely feel tenderness and pain in the Tibial Tubercle of my right leg.
I don't really know what it's causing the pain or how to treat it so I appreciate if there is any help you can offer and please let me know if there is any more information you need.


I assumed you would want to see a Squat form video so here is a link to one
http://<a href="https://www.youtube....k">YouTube</a>

(I know it's a high bar squat but I will be meeting with a SSC after the whole Covid-19 things end and transition to low bar)

[Nick D'Agostino]

The link to your squat form is not working. The exacerbation after volleyball practice looks like a too much too soon too fast problem. You are going to have to grade your exposure back to volleyball slower than you want to. Another categorization for this type of pain is known as jumpers knee. From your age and height, I think you should be eating more recover.

Start back squatting lighter weights progressing 2x/week. I would have a SQ/Press day and a Bench/DL day and alternate them. I would ramp sets of 5 to a top set, and if the tibial tuberosity is feeling good, do another set. If it is starting to distract you during the set, shut things down. It is ok to feel and nudge the pain during activity. Do not try to train through it or completely avoid it.

I've got a feeling you are going to need more specific advice than this forum is going to offer you, and I would recommend reaching out to either Will or me for a consultation. If that is something you're interested in, I will link my website below.

Hope this helps!

Emerge Stronger

[Al2020]

Hey Nick
First of all thanks for replying!
I will try doing what you said as soon as my gym opens again and keep things slow in Volleyball. If that doesn't seem to make things better I will consider reaching out to you or Will.
I agree on the eating more part. I suspected that the pain might have appeared because I was pushing too hard on the weights but didn't keep up with the plates. so it might have been related to that but the fact that it appeared on the same leg I had my ACL Recon does make me worry that it's something related to that because my other leg is good. I will definitely try to eat more and keep a better eye on my sleep too,
I don't understand what do you mean by ramping up sets of 5 to a top set so can you please explain that?
Also I will try linking my squat video again so tell me if this one works:
YouTube

[Nick D'Agostino]

By ramping sets of 5 I mean for all of your sets use 5 reps. This means do not taper your warmup. An example for squatting 205 would look like this: 45x5x2, 95x5, 125x5, 155x5, 185x5, 205x5x2.

The pain is appearing because it is trying to protect you by regulating your activity, not because of damage. If you teach yourself the low bar squat using the resources on this website, there is a good chance that your knee pain will immediately improve (hell it might even go away). Either way, I would recommend widening your stance to shoulder width. During the descent, focus on making your torso more horizontal and during the ascent focus on hip drive.