Norm,s Patella problems

[Norm_N1GTX]

Coach Ripp, Please forgive my spelling and sentence construction as I never really learn how and it is very stressful and embarrassing for me but you will get my point. I am having patella issues because I did not know how to squat properly and have no one to blame but myself. I learned of you through the internet and have purchased SS & PP. Now that I do know how my injury is slowing me down. Went to the VA hospital emergency room because I thought I screed up bad. The doctor took x-rays and said my knees were fine just patella tendentious with fluid pools building up and to come back in two weeks if swelling did not go down no squatting and prescribed RICE and Ibuprofen. Two weeks latter no progress so back to the VA. This visit the doctor was on vacation and I got A nurse practitioner. She says there is no fluid build up but she has never seen the outline of A horse shoe in the inferior position under both patella's before and did not know what to make of it. So an emergency appointment was made the next morning with my primary care doctor. He reads my complaint on the computer and said he has looked at my x-rays and my knees are as good as A teenager but that I have swollen fat pads under both patella's. He then showed my some pictures of the pad in A book. He applied pressure with both thumbs around the outline on both knees and asked if there was any pain I said no. He then told me to squat up and down A few times looks ok he said. He also said do not let anyone stick needles in my knees and an MRI is out of the question as he does not want to subject my knees to the magnets. Over all you are probably one of the strongest fifty three year olds in this VA and all vitals are very good. Then like it was no big deal he says no more squatting for the rest of the year. I said fuck no! My doctor can swear behind closed doors better than any drunken paratrooper and I should know I used to be
one. How about I start off slowly and learn correct form like coach Ripp says as I had my copy of SS with me. It is going to take time for the fat pads to heal and some times the swelling wont go down and is permanent. I have known him sense 1985 and if he really means it he would have said it LOUD and DIRTY so I would know he means business. The next thing he did was stand up shake my hand with A big smile on his face and said now get the fuck out of my office 
and do not come back unless you have A real problem. So I took that as being green lighted for squatting and thats what I been doing for A week and A half. Fluid pools filed up A little but no pain. I do not no if this is one of those times to work trough it or not. Another problem for me is OHP can not do them with A barbell standing or sitting but I used to be able to use A OHP machine witch is better than nothing at all. How ever in order to do them I had to use the handles in front not on the side like holding A barbell. Now I can not do either due to some sort of right shoulder impingement. Every time my elbow is even with my shoulder I get A real sharp pain and its A controlled drop back down. I will be very grateful for any and all help and suggestions. Thank you. Age-53/Heigh 6 ft/ Weigh 250 lbs/Starting weigh from day one till seven months latter. Squat 1 RM 135 lbs now 270/Dead lift 1 RM 135 lbs now 250/ Bench-press 1 RM 95 lbs now 200/ Barbell Rows 1 RM 95 lbs now 150/ OHP Machine 1 RM 50 lbs now 90 but can no longer do them. Starting novice model - Strong Lifts for six months no longer making progress workout to workout. Now Bill Star's Intermediate model. Been using it for one month. I hope this document post's ok as this is my first attempt. So be forgiving if it does not. By the way N1GTX is my FCC ham radio call sign. 


[Mark Rippetoe]

I laughed when you said, "...and an MRI is out of the question as he does not want to subject my knees to the magnets." I had to remind myself that it is the VA. I think you jst have a little knee irritation from squatting incorrectly, and that it will go away if you start squatting correctly. It will NOT go away if you just lay off, so he was right about that. Read the section in the book about this on pages 51-56. Learn to think of the squat as a "hips" exercise instead of a "legs" exercise, and your knees will heal.

I'm more worried about you shoulder. What did the doc say about that?

[Norm_N1GTX]

Coach Ripp, He did not give me the opportunity to talk about my shoulder as it was an emergency appointment and basically kicked me out of his office so he could move on to his next patient. I saw him for like five minuets between patient's or it was his coffee brake time. I wont see him again till October. And from the heart Thank-You for answering my post. Its good to know that some people still care. GOD bless and good health to you.

[Mark Rippetoe]

Can you do chins? Probably not, at your bodyweight. Lat pulldowns with a chin grip? Do they hurt?

[Norm_N1GTX]

Coach Ripp, You are correct about the chins my bodyweight. But lat pulldowns are no problem and pain free with A palms forward grip never used chin grip with pulldowns.

[Mark Rippetoe]

Start doing those before you press, press light weights for sets of 10, make sure they lock out completely, and see if you can work through the pain.

[Will Morris]

Coach Ripp, Please forgive my spelling and sentence construction as I never really learn how and it is very stressful and embarrassing for me but you will get my point. I am having patella issues because I did not know how to squat properly and have no one to blame but myself. I learned of you through the internet and have purchased SS & PP. Now that I do know how my injury is slowing me down. Went to the VA hospital emergency room because I thought I screed up bad. The doctor took x-rays and said my knees were fine just patella tendentious with fluid pools building up and to come back in two weeks if swelling did not go down no squatting and prescribed RICE and Ibuprofen. Two weeks latter no progress so back to the VA. This visit the doctor was on vacation and I got A nurse practitioner. She says there is no fluid build up but she has never seen the outline of A horse shoe in the inferior position under both patella's before and did not know what to make of it. So an emergency appointment was made the next morning with my primary care doctor. He reads my complaint on the computer and said he has looked at my x-rays and my knees are as good as A teenager but that I have swollen fat pads under both patella's. He then showed my some pictures of the pad in A book. He applied pressure with both thumbs around the outline on both knees and asked if there was any pain I said no. He then told me to squat up and down A few times looks ok he said. He also said do not let anyone stick needles in my knees and an MRI is out of the question as he does not want to subject my knees to the magnets. Over all you are probably one of the strongest fifty three year olds in this VA and all vitals are very good. Then like it was no big deal he says no more squatting for the rest of the year. I said fuck no! My doctor can swear behind closed doors better than any drunken paratrooper and I should know I used to be
one. How about I start off slowly and learn correct form like coach Ripp says as I had my copy of SS with me. It is going to take time for the fat pads to heal and some times the swelling wont go down and is permanent. I have known him sense 1985 and if he really means it he would have said it LOUD and DIRTY so I would know he means business. The next thing he did was stand up shake my hand with A big smile on his face and said now get the fuck out of my office 
and do not come back unless you have A real problem. So I took that as being green lighted for squatting and thats what I been doing for A week and A half. Fluid pools filed up A little but no pain. I do not no if this is one of those times to work trough it or not. Another problem for me is OHP can not do them with A barbell standing or sitting but I used to be able to use A OHP machine witch is better than nothing at all. How ever in order to do them I had to use the handles in front not on the side like holding A barbell. Now I can not do either due to some sort of right shoulder impingement. Every time my elbow is even with my shoulder I get A real sharp pain and its A controlled drop back down. I will be very grateful for any and all help and suggestions. Thank you. Age-53/Heigh 6 ft/ Weigh 250 lbs/Starting weigh from day one till seven months latter. Squat 1 RM 135 lbs now 270/Dead lift 1 RM 135 lbs now 250/ Bench-press 1 RM 95 lbs now 200/ Barbell Rows 1 RM 95 lbs now 150/ OHP Machine 1 RM 50 lbs now 90 but can no longer do them. Starting novice model - Strong Lifts for six months no longer making progress workout to workout. Now Bill Star's Intermediate model. Been using it for one month. I hope this document post's ok as this is my first attempt. So be forgiving if it does not. By the way N1GTX is my FCC ham radio call sign. 


An orthopedic surgeon named Scott Dye authored a study in which he allowed his knees to be arthroscopically probed in an effort to map pain and sensory perception within the knee. Fascinating study, but of note in there, the fat pad your doc mentioned was assessed by Dr. Dye to be exquisitely sensitive to pain. In fact, the fat pad was so painful that the study was almost terminated. All that to say, an irritated fat bad can cause some pretty intense pain, but once the irritation / inflammation subsides, you should be good to go.

[Jordan Feigenbaum]

An orthopedic surgeon named Scott Dye authored a study in which he allowed his knees to be arthroscopically probed in an effort to map pain and sensory perception within the knee. Fascinating study, but of note in there, the fat pad your doc mentioned was assessed by Dr. Dye to be exquisitely sensitive to pain. In fact, the fat pad was so painful that the study was almost terminated. All that to say, an irritated fat bad can cause some pretty intense pain, but once the irritation / inflammation subsides, you should be good to go.

Substance P in the fat pad + rich innervation?

[Will Morris]

Substance P in the fat pad + rich innervation?

= the recipe for an exquisitely painful section of tissue. The fat pad doesn't get a whole lot of press, but we are definitely trained here to look at it as a pain generator in anterior knee pain.