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Thread: Knee pain

  1. #1
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    Default Knee pain

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    Hi!

    I struggled with quadriceps tendinopathy in my right knee for a while from November 2018 to May 2019. From June to the end of August, I didn't lift at all. My knee seemed to be healed. In September, I started squatting again, but just to be cautious I went on a very slow linear progression, starting 3x5 with just the empty barbell and 2.5 kg increments. I set a goal to squat 100 kg for 3x5 by the end of the year, believing that 4 months is long enough period for sufficient adaptations. I believed this to be a good approach considering the resources I have read/watched about quadriceps tendinopathies. At around 60 kg I started squatting twice a week instead of 3 times, and even smaller increments (2 kg) to be on schedule to 100 kg by the end of the December. Last workout was 3x5 @ 87 kg.
    Despite the slow progression, I started getting knee pain in my other knee (left knee) a couple of weeks ago and now it gets pretty bad. The weird thing is - I get knee pain only on warm-up sets. My warm-up is: 5xBody-weight squat; 5x20kg; 5x40kg; 5x60kg. Even with body-weight squats it hurts a lot. And 20kg hurts a lot too. 40kg hurts less, 60kg even less, and by the time I reach my 2nd work set, there is no knee pain whatsoever. After the workout the knee is a bit sore with movement. By the time I reach my next squat workout, the pain fades away, sometimes fully, sometimes mostly. Recovery also depends whether I have been sitting with my knee bent to 90 degree angle or not. If I keep my knees less bent while sitting, It recovers faster, but if I sit for even 30 minutes with knee bent to 90 degree angle, it starts hurting quite a bit again.

    What could be the case? Am I just developing another tendinopathy here? How should I approach this situation? I want to get strong, compete, squat for my lifetime and approach this in a smart way (which I thought I did with the slow LP). Here is my training log: Karel's 100% SS LP log

  2. #2
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    There’s an awful lot wrong with this post. First of all, the entire post, while voluminous, does not specify age, sex, training history, or injury history. Also, I have to question the working hypothesis of quadriceps tendinopathy, as EVERYTHING you say about your knee pain strongly suggests osteoarthritis. But, one cannot make any reasonable assumption here because of the lack of information.

  3. #3
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    I ran it down for you Will. Male, 26, Benches more than he squats after LP. Knee hurts.

  4. #4
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    Quote Originally Posted by Will Morris View Post
    specify age, sex, training history, or injury history. Also, I have to question the working hypothesis of quadriceps tendinopathy, as EVERYTHING you say about your knee pain strongly suggests osteoarthritis. But, one cannot make any reasonable assumption here because of the lack of information.
    My apologies for overlooking something as obvious as this.
    As Jeff Brophy mentioned, male, 26 years, height 5'11", weight 78 kg. I have always been doing some sort of sports since I was a kid. Until the age of 20 it was mostly aerobic, such as soccer, floorball, running. After that it was mostly gym and running, on and off. I've run a few half-marathons while I was in my best running shape, but now I have not been running for 9 months. Gym has been on and off with about 3 months break every year, once a year. Until age of 24 I did random bodybuilding-kind-of workouts and after that more strength training, but mostly random 5x5 programs and such, inconsistently. In September 2018, after 3 months away from gym, I found Starting Strength and started LP. Bodyweight was 80kg, I started eating more to gain weight. It took me 8 weeks of LP to get my Squat to 3x5@120kg. At that point I was about the strongest I had been in my life until then. Never had any serious injuries until then. It was about then or maybe a week before that, when my knees started troubling me a little. I kept lifting, believing that they would adapt. When it got worse, I tried to do less squats. That didn't help. Then tried to decrease weight. Pain came back when weight increased. Smaller range of motion didn't help either. Then I started LP on Front Squats, which was good at first, but eventually knee pain came back. During April and May, 2019, I just stayed away from any kind of squatting. And June-July-August I was away from any workout whatsoever. Period from September till now is explained in first post. My uneducated diagnosis for quadriceps tendinopathy was considering the way the knee pain developed. An extended period of time of frequent heavy squatting above my tendon's load tolerance level, causing more stress than I was able to recover from. I might be wrong of course. The location of the pain under patella, and nature of the pain not feeling very 'sharp', and everything else I read back then about knee pains seemed to match quadriceps tendinopathy more than anything else. However, current knee problem feels different. The pain is more sharp. And it is there if I bend my knee without a load as well. And it is definitely not too much stress over time, because my squat LP hasn't made it far and I squat only twice a week. Low bar. trying to initiate hip drive and keep pressure off my knees.

    If there is anything important I missed (or anything stupid I said), just let me know. Always willing to learn.
    Advice appreciated. Thanks.

  5. #5
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    Quote Originally Posted by Karelipoeg View Post
    My apologies for overlooking something as obvious as this.
    As Jeff Brophy mentioned, male, 26 years, height 5'11", weight 78 kg. I have always been doing some sort of sports since I was a kid. Until the age of 20 it was mostly aerobic, such as soccer, floorball, running. After that it was mostly gym and running, on and off. I've run a few half-marathons while I was in my best running shape, but now I have not been running for 9 months. Gym has been on and off with about 3 months break every year, once a year. Until age of 24 I did random bodybuilding-kind-of workouts and after that more strength training, but mostly random 5x5 programs and such, inconsistently. In September 2018, after 3 months away from gym, I found Starting Strength and started LP. Bodyweight was 80kg, I started eating more to gain weight. It took me 8 weeks of LP to get my Squat to 3x5@120kg. At that point I was about the strongest I had been in my life until then. Never had any serious injuries until then. It was about then or maybe a week before that, when my knees started troubling me a little. I kept lifting, believing that they would adapt. When it got worse, I tried to do less squats. That didn't help. Then tried to decrease weight. Pain came back when weight increased. Smaller range of motion didn't help either. Then I started LP on Front Squats, which was good at first, but eventually knee pain came back. During April and May, 2019, I just stayed away from any kind of squatting. And June-July-August I was away from any workout whatsoever. Period from September till now is explained in first post. My uneducated diagnosis for quadriceps tendinopathy was considering the way the knee pain developed. An extended period of time of frequent heavy squatting above my tendon's load tolerance level, causing more stress than I was able to recover from. I might be wrong of course. The location of the pain under patella, and nature of the pain not feeling very 'sharp', and everything else I read back then about knee pains seemed to match quadriceps tendinopathy more than anything else. However, current knee problem feels different. The pain is more sharp. And it is there if I bend my knee without a load as well. And it is definitely not too much stress over time, because my squat LP hasn't made it far and I squat only twice a week. Low bar. trying to initiate hip drive and keep pressure off my knees.

    If there is anything important I missed (or anything stupid I said), just let me know. Always willing to learn.
    Advice appreciated. Thanks.
    Pain is under the patella? Perhaps a picture of what region you are talking about would be helpful to make sure your understanding of underneath the patella is the same as mine.

  6. #6
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    Apr 2018
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    Knee.jpg

    The previous pain on the picture is what I described that I had last year on my right knee. The current pain is now on the left knee. If we were to view from front, both are about the middle of the knee cap. The current pain maybe just about 1/8th of inch towards side (towards the other knee).

  7. #7
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    Just an update trying to find a fix.
    1) I started doing box squats with fairly high box to control the depth. I can't go anywhere near parallel, but the goal is to decrease the height of the box progressively.
    2) I also decreased the weight to 60 kg down from 87 kg on last time doing full squats and I will keep it there for now.
    3) Also started squatting 3 times per week instead of 2.
    4) After a few weeks of trying box squats, seeing no progress, I started trying different foot stances, playing with both, stance width and toe angle. Surprisingly, I found that narrowing my stance to about where the inside of my heels were 8" apart and widening my toe angle to about 45 degree angle felt better on my knees. I got a little lower on my squats, but the progress halted soon and I this time I tried widening my stance. After widening it to a wide squat stance of moving both of my feet about 2 inches outwards from what seems to be the SS standard, I found a stance which feels a lot better on my knees. Based on observations of 2 workouts.

    Anyway, I have a plan and I hope to write a progress update after a few weeks.

  8. #8
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    starting strength coach development program
    Quote Originally Posted by Karelipoeg View Post
    Knee.jpg

    The previous pain on the picture is what I described that I had last year on my right knee. The current pain is now on the left knee. If we were to view from front, both are about the middle of the knee cap. The current pain maybe just about 1/8th of inch towards side (towards the other knee).
    This would be what we refer to as retropatellar knee pain. Post a video of your squat.

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