knee/patella injury

[mcox06]

Hi coach,
I injured my knee/patella about 1 month ago doing 1 legged squats. I was doing them when i hit the bottom with my right leg I noticed a pain and noticed a little knot 1-2 inches below my knee cap. I went to the dr. and he told me to rest 10 days and take these anti inflammatory pills...said it was knee bursitis. I returned to gym 14 days later and it still hurt/reinjured. I did power cleans at 135 lbs at high reps which may have been too aggressive. I then rested 3 days and found this website. I started the muscle belly FAQ (w/ squats) and I just changed over from 25 reps to 15. At first the pain would go down to almost nothing on the last set. Now it is more painful in the beginning but gradually goes down each set. The thing that is most concerning is the feeling in the morning. It hurts going up stairs in the morning...not as bad as the initial pain but worse than the days doing 3 sets of 25. The doctor is useless and hope you can help me through this problem. I am 24 yeear old male 190lbs 12% bodyfat active in jujitsu lifting for 6 years with personal trainer on squat form. I am not doing anything active except the squat rxed in muscle belly faq.

[Mark Rippetoe]

You have a connective tissue injury, and the injury sticky seldom applies top these things. One-legged squats are famously hard on the knees, as are power cleans on this particular type of injury. It might be useful to get an MRI so that you have an actual diagnosis, but "bursitis" is just a word they learn in medical school that gets applied to everything they cannot immediately understand. Where precisely on the knee under the patella is the injury?

[mcox06]

It is below the knee cap 1.5" on my right leg. The area that bumped up is in the upper shin basically...it is in the middle slightly toward the inside of my leg. (would a photo help explain the area) I try and feel the area on my other leg and it definetly does not have a bump. Also a very small bruise/redish dot appeared at time of injury in the area and is still there. All the dr did was move my leg around to make sure it was nothing major (i think).

[Mark Rippetoe]

It sounds to me like you have avulsed a piece of your patellar ligament off of your tibial plateau. There is no surgery for this, and it will eventually heal while you squat. But don't power clean or do one-legged squats until the area is pain free. It will take a while, and the rehab sticky will not apply to this injury. Work on sets of 5 with weights you can stand to do, ice the area, up your calcium, Vit D, and C.

[mcox06]

Thanks for the help and quick replies. I purchased both BB and PP and training journal last week because I enjoyed the forum and your feedback posted here. I mean i had to pay the dr 80 bucks to tell me absolutely nothing about fixing the problem.

[Quintus]

Sounds similar (in terms of presentation, if not onset) to Osgood-Schlatter disease. I have large lumps under my kneecaps that are the result of lots of small avulsion fractures at the tibial tuberosity. In my case it was a chronic thing while I was a teenager with bones outgrowing tendons and ligaments, but sudden/acute avulsions aren't unheard of. At the peak, my knees were in a state of constant painful iflammation not unlike what you're describing. In really severe cases, I've heard of enough tissue/bone being pulled up to warrant a surgery to screw it down and let it heal properly.

In any event -- I'd at least try and get an x-ray if you haven't already. Even moderate damage of the sort being described is pretty easy to find on an x-ray.