patellar irritation and soreness

[nlbauers]

Hi Mark,

This forum is one of the best examples I know of where I get WAY more than I pay for. Thank you for that.

I am about to begin my third attempt with SS this year. Each of my first two attempts ended with what I and a doctor agree were just cases of mild patellar irritation, which were getting worse after each workout. In both cases after about 2 weeks of squatting 3 times a week, I would start building up a vague soreness around and behind the knee cap that was really only painful when I got near and below parallel on a squat. The weight for these squats was less than BW (150 lbs. ~67% of previous 1RM) Doctor says the knees are stable, I have no previous knee injuries and the pain goes away after about a one week layoff.

I have never squatted with weight at anywhere near this volume before, but had been Crossfitting for around 9 months previous to my first SS attempt. I'm 34 and previous to Crossfit did little more than LSD jogging type exercise. None of which ever resulted in knee issues.

So on to my questions- assuming the knee issue is due to a big sudden delta in squat training, would you recommend a slower build up this go around on squatting? Does an irritation issue like this just require time to adapt to the training load? Should I be starting with less weight and more volume? Right now my knees travel out an inch or two past my toes, might a more vertical shin placement during the squat help this?

[Mark Rippetoe]

I'll bet you $300 that your form is the problem here, not your training load or change in emphasis. And that the problem is knees forward at the bottom. Post a video.

[nlbauers]

Man, if I had $300 bucks laying around to make bets with, I would have taken it, stolen the remainder from my grandma's purse, and shown up at a Barbell Cert. to get this straightened out.

Here is the video of my last set two weeks ago before deciding to head to the doctor to see if there was something screwy with my knee. I hope your right this a form issue- I just want to get on with the program.

http://www.youtube.com/watch?v=RYZmnE7LU4M

I'd done enough homework to be thinking knee travel was the problem, so I taped this from the side, and okay, I do catch a little knee sliding forward on the fifth rep. There is also some knee action backward on some reps when I am just starting to come up. I read the recent post about toe pointing and I'm thinking of trying to point toes out a little more. My right foot looks almost straight ahead in the video, it's not, but it could point out more too.

I'm sure I'm missing plenty more- Fire away please.

[Mark Rippetoe]

This form would not normally flag a problem to me, but if your knees hurt while doing them this way, you'll have to make a change. First, let's be sure you're not still running, because while you may not have perceived a knee problem while you were the range of motion is so limited during running that there may have been a problem you were not aware of until you actually started using your knees.

The best way to take stress off of your knees is to put it on your hips, which requires that the ROM currently being assumed by the knee has to go to the hip, which means that the knee angle at the bottom has to become less acute and the hip angle more acute. This is accomplished by keeping your shins more vertical and allowing your torso to lean way more forward. Your cue will be "knees back" at the bottom, or vertical shins if that works. You may need a wider stance and more toe angle out to get this done. The net effect will be that your knees don't travel much further forward than the middle of your shoelaces, visible as you look straight down -- the best way to fix this, really, is by visually identifying your knee position.

[nlbauers]

I'm not doing any running or any other work at all, outside the SS program.

I fooled around tonight with your suggestions and a PVC pipe and I think these will be helpful changes. But I'll know for sure after a couple weeks with weight. Felt like I would be reaching back even more with my butt and holding a little deeper lumbar curve too.

Thank you for your help.