Chronic Knee Pain

I'm a 34yo male, 6' 0", 192lb.

I've had nagging knee pain for the last 10 years. It's not enough to keep me from training, but it's just enough to draw my attention during training. I used to do a lot of CrossFit and running, but I haven't regularly done either in many years. Since then, the pain hasn't gotten any worse, but it's never really gotten better.

Pain tends to be above my kneecaps, though sometimes below them as well. It's most pronounced when doing lunges, specifically at the bottom of the lunge. Also when kneeling down to put dishes away, or when giving my kids a bath. I get twinges of pain when getting up from a chair or out of bed or putting on shoes, but it goes away fast.

Just in case the question comes up: I've been doing lunges on and off the past two months because of being forced to workout at home without a barbell. For my own health and safety, obviously.

When doing squats, the knees will hurt sometimes, and usually only on the way down. Once I'm at the bottom and coming up, it's fine.

When doing deadlifts, the knees will hurt during setup, specifically when bringing my shins to the bar. They'll hurt until I start pulling the bar off the ground.

Is there anything I can do about this?

If you are not wearing knee sleeves, I would start now. If you have been wearing sleeves it might be immediately helpful to use a light wrap that you can wear without adjusting for the entire session. Wraps are not a permanent solution but a way to quickly change your symptoms.

The most effective interventions for managing chronic situations like this involve taking a look at your entire life and coming up with a plan to take action on a bunch of different fronts—kind of like how its better to fish with a net instead of a pole. You can't just look at just physical loads. You also need to take a look at emotional and psychological loads. Sometimes something as simple as finding a way to sleep 8 hrs a night takes care of this type of thing in a few weeks. Other times it's a combo of taking a bunch of small seemingly unrelated actions that accumulate to produce a substantial decrease in pain.

As far as immediate strategies for exercising, I would try walking lunges (stepping forward) instead of lunges in place. Step-ups also might be another good option (both of these have different external moment demands on your knee than a lunge in place or a reverse lunge).

Thanks for the insight. On Monday, my normal gym reopened, so I can go back to the usual barbell program. No more lunges.

I don’t think environmental or emotional factors are to blame, but I’ve never tracked daily pain levels and tried correlating them to anything outside of the gym. I’ll give it a shot.

Knee sleeves don’t help much, other than offering some padding for when my knee touches the ground during a lunge. Would you guess my symptoms would eventually lead to something requiring surgery down the road? As it stands, my knees don’t affect my lifestyle; it’s just a nagging annoyance.

That's great news about your gym man! As it stands, you are probably not a candidate for surgery because you can still do all the things you want to do. Just to be clear, there is nothing in particular to blame. Every pain experience has multiple components contributing to it.

I'm not concerned about surgery now. Was curious if whatever I'm experiencing could eventually deteriorate into something requiring surgery. If so, are there steps I could take to help ward that off now?

The back and forth tells me this isn't something I should be worried about. The pain is only an annoyance anyway.

Thanks again!