Dear BBM Team,
I’m struggling with knee pain and how to deal with it.
Background:
- 36 y/o male, 176cm, 81kg
- Been squatting low bar for years (not particularly strong though)
- Read the article “Pain in training: What do?”; familiar with BBM content on pain in general
- High stress job (the one variable that I cannot change)
Symptoms:
- Right knee: Pain on the medial side. On the chart linked below, it’s around where the “C” is. This has been flaring up from time to time during the last 2 years and is particularly bad when doing single leg movements. Has become worse lately.
- Left knee: Pain on the lateral side. On the chart linked below, around where the “F” is. This is a new symptom that started around 2 weeks ago.
- Pain is noticeable, but often manageable during low bar squats (especially after warm-ups and when wearing sleeves), but becomes worse in the days after training to the extent that even everyday movements that involve squat movements can be painful.
- No accute trauma / accidents.
- No swelling, no blocking of joints.
Actions taken so far:
- Took a deload week with lighter tempo variations. Started new block with lower overall intensity. Unfortunately, no improvement.
- Took some diclophenac for a few days - no significant improvement.
- No doctor / imagery so far (takes weeks to get an appointment and further weeks for MRI, usually only to be told to stop squatting).
I was hoping to compete end of June, and training over the past weeks / months had finaly become more consistent again (after a lot of ups and downs over the past years). If somehow possible I’d like to avoid anything that would significantly derail this; however, if interventions are necessary, so be it…
What would be the best next steps of action in a situation like this, and how should I adapt my training?
Thanks in advance.
Hi,
- Took a deload week with lighter tempo variations. Started new block with lower overall intensity. Unfortunately, no improvement.
This is the area where we are missing the most detail. What, exactly, have you done during this period? How have you approached training adjustments in response to symptom fluctuations? One week of training modifications is unlikely to be enough to resolve years of fluctuating symptoms that are now progressed to the point of affecting daily activities, as you mention:
Pain is noticeable, but often manageable during low bar squats (especially after warm-ups and when wearing sleeves), but becomes worse in the days after training to the extent that even everyday movements that involve squat movements can be painful.
This also tells us that you are consistently loading the area in excess of its current tolerance / capacity. There are unfortunately no shortcuts or ways to “speed up” the rehab process here. I cannot estimate the likelihood of competing in June, but my mindset here would be that unless you are competing for a highly prestigious position (e.g., national champion) or a large sum of money, I would not prioritize any sort of competitive timeline here. I would instead focus on doing whatever is necessary to mitigate the symptoms that have been affecting you for several years now, and building from there.
My impression is that you probably have not pulled back far enough, for long enough. This is a common error, as mentioned in our Pain article. See another forum discussion https://forum.barbellmedicine.com/forums/pain-and-rehab-q-a-with-dr-derek-miles-and-dr-michael-ray/88518-strange-hip-painhttps://forum.barbellmedicine.com/forums/pain-and-rehab-q-a-with-dr-derek-miles-and-dr-michael-ray/88518-strange-hip-pain for similar. If you continue to struggle resolving this on your own, I am confident that a consultation with our rehab team would be a great next step to get you back on track.