New Lifter; Knee Pain after squats

[Moxt]

I am coaching a new lifter. This is my third lifter to coach besides myself. She is having some problems with pain at the bottom of her knee after she squats.

She is doing the SS LP. Yesterday was her 5th day of training. Her knee felt a slight pain (1/10) about 10 minutes after completing squats, so we did the press but did not do deadlifts. 30 minutes after completing her squats, she had a knee ache (2/10 scale) that lasted about 20 minutes, then a shooting pain for 10 minutes (4/10 scale). Then it was gone and did not return the next day (today). We're going back tomorrow evening to do the 6th day of the program (squats, bench, deadlift).

Her form is not perfect. She's making it to depth 95% of the time and is sitting back well without her knees sliding forward very much. Her working weight on the squats are 70 pounds for 3 sets of 5 reps, which (in my opinion) should not be enough for these form issues to cause this pain without something else being wrong.

She is not obese or underweight, normal anthropometry, 5'3", in her early 30s, and sits at a desk professionally.

She has a history of knee problems, going back to her early 20s when she was diagnosed with osgood-schlatter disease. She did crossfit for a month or two in 2014 or so and had very bad knee pain from it. In response, she had an x-ray done and part of the bone had chipped off the growth plate. She had a follow-up x-ray on the knee and the chip had disappeared. She has not done strenuous training/exercise since then. Unsurprisingly, her doctor told her to not do squats again. She is ignoring this advice. She does not have knee pain in her daily life.

I'm not sure how to proceed here. My plan is to have her lift again tomorrow.

I don't have any idea what physical thing is happening that would cause the pain. Any ideas on how to prevent the pain? Is this a "work through it and it will go away" thing or is it something that requires medical intervention?

Thanks for any insights.

[stef]

Her form is not perfect. She's making it to depth 95% of the time and is sitting back well without her knees sliding forward very much. Her working weight on the squats are 70 pounds for 3 sets of 5 reps, which (in my opinion) should not be enough for these form issues to cause this pain without something else being wrong.

You'd be surprised.

Pay extra attention to getting her knees right -- no sliding forward -- if she's that sensitive.

I don't have any idea what physical thing is happening that would cause the pain. Any ideas on how to prevent the pain? Is this a "work through it and it will go away" thing or is it something that requires medical intervention?

Hard to tell much from your description.

Wraps are a reasonable place to start, especially given her history. Have a look at this video.

[Moxt]

Thanks, Stef. We'll concentrate on the knees in particular tomorrow and also take a look at getting her in knee wraps.

[jbackos]

Thanks, Stef. We'll concentrate on the knees in particular tomorrow and also take a look at getting her in knee wraps.

Do not add weight to the bar until she can get depth. Try using a box to start from. Andy Baker has some clips describing this method as do others on youtube.

[Moxt]

We were extra careful on form and she had very minor pain in the knees (1 of 10), which is a big improvement. Knee wraps came in yesterday and we'll be using those on the next workout.

[Moxt]

Do not add weight to the bar until she can get depth. Try using a box to start from. Andy Baker has some clips describing this method as do others on youtube.

Thanks! I agree that depth is necessary to protect the knees. She has the flexibility but is sometimes nervous to go to depth. Last time I had her go down until I told her to go up, and that fixed the depth issue. If we keep having problems I'll take a look at the Andy Baker videos.

[Atlas77]

I started having problems with severe knee pain a few weeks ago. I did some googling and discovered it was my petellar tendon and that typically it was a form issue or not correctly transferring the weight to my hips during the squat. I set up my bench in the rack to do some box squats and discovered that it was a width issue. I was apparently way underestimating my shoulder width. I did a couple of deloads because the wider stance was hitting the muscles differently but this week I'll have my squat back to where it was and I don't have any more pain in my knees.