Final steps of dealing with knee pain

Hey BBM,

Around 1.5 months ago I made a post asking for some direction on how to deal with knee pain. I’ve been running PB III for several weeks already at that point (squat was at 125 kg for 4 reps @ RPE 7), and I was feeling pain also outside of the gym when kneeling down or going up stairs for example. I’ve been coming back to squatting from a hip injury in the past year, and really ramped up my training in the last couple of months before I started getting knee pain, and I think that jumping from a sort of linear progression that I was doing to PB III was probably too big of a jump both in terms of the weights I was using and the volume.
To deal with the knee pain I’ve firstly took a week off of any squatting / leg press movement (though I was still doing deadlifts, leg extensions and such movements), and after that started with 1 squat day a week with 60 kg for 3 sets of 10 reps with a 2ct pause. This week i’ve managed to squat (without a 2ct pause) 100 kg for 10 reps @ RPE < 5 without any pain, and i’m planning on trying to leg press 12 reps @ RPE 5-6 later this week.

As for my question, what would be the next step that I should take now that i’m able to squat without pain? I was thinking of using the squat programming of the beginner template as a start, though I feel that it may be too early for 4 reps @ RPE 8 which would be around 130 kg for me. Would it be a good idea to maybe use the beginner template with a slightly higher rep range (say +2 reps on all squat / leg press movements) and a lower RPE (-2 for example for each squat movement)?

Hey Ben,

Sorry to hear about the knee pain. I suspect that both the LP and PB III were both a bit much after not really training the squat. I also would have preferred keeping in some squat and/or leg press variant after finding an appropriate entry point, e.g. where you had minimal pain, but it was challenging. Our typical rehab approach has the individual tackling the painful area multiple times per week in multiple different ways.

I suspect the beginner template phase I would be reasonable for volume, but I don’t know that 3x/wk squatting and exposure to the lower rep ranges is a great idea. If pressed to make a decision, I think I’d run 4-6 weeks of the knee rehab template and then go onto whatever template you want. You can check out the 1st week for free on the app if you like.

Hey Jordan, Thanks for the reply.

As a follow up question, i’d be happy to get some advice as to what template would be ideal for me to run next.

I’ve been dealing with a shoulder injury aswell alongside the knee pain (though I won’t get into it on this post), and the only lift out of the big 3 i’ve been able to do consistently over the past 2 years is deadlift. I’m currently running a modifed version of PB III (for the third consecutive time), with the changes i’ve mentioned above when it comes to squatting, and with the change of using different variations of close grip bench press (since a regular wider grip is painful even with just the bar), and with a slightly higher rep range and lower RPE to deal with the shoulder injury (along with not being able to do OHP, pull-ups and similar exercises, though I can get a decent amount of volume in with different variations where I don’t feel significant shoulder pain).

Ideally i’d like to use the deadlift programming from Strength III for my next template since I feel my progress slowed down now that i’ve ran PB III for a third consecutive time, and also because i’d like to try something new in this regard. When it comes to squatting, you mentioned that after running 4-6 weeks of the knee rehab template I could go onto whatever template I want, would that include Strength III or would you choose a different template as an entry point after the knee rehab template?
And as for upper body training, i’m currently not able to focus on strength due to the injury, so i’ll continue rehabing my shoulder while focusing on hypertrophy with the movements that I can do pain-free.

I wanted to edit the reply but was not able to so i’m replying again - I noticed that the knee-rehab template contains 3 phases and is 12 weeks in total. As of right now, the knee pain situation has improved and I don’t feel any knee pain in my day-to-day life and when squatting with RPE ~5-6 at a higher rep range (~10 reps). I haven’t tried any heavier weights than that yet so I don’t know if the knee pain is still there or not. Given this information, should the 4-6 weeks that I run of the knee rehab template be from week 1 of the template, or should I start at phase II for example?

I think PB and Strength III are probably some time away. Like mid 2024. I think it can be really tough to measure progress/make progress when injured as well. I’m not sure how you’ve been rehabbing your shoulder injury and/or what the issue is, but the shoulder rehab template might be a good way to DIY your rehab program there. Here are your options as I see them:

  1. Shoulder x Knee rehab hybrid template for 8-10 weeks. I’d run the balance of the knee rehab template from phase II. I see no reason to rush back into unrestricted training given your symptoms and most recent training history. I don’t know enough about the shoulder injury to make a recommendation, but I think this is sufficient. I’d follow that with PB I or Hyper I
  2. After either of those templates, you can do whatever you want :slight_smile:

Thanks Jordan, i’ll go ahead and do as you suggested.

Given i’ve been able to train deadlift consistently without pain for the past 2 years despite the other injuries, do you think it would be ok to just swap out the deadlift programming from the knee rehab template for strength III deadlift programming for example (meaning i’d only take the main and secondary deadlift programming from strength III), while keepinh the rest the same (in combination with the shoulder rehab template)?

I’ve been running PB III as written for deadlift 3 times in a row as I mentioned above, and my deadlift e1rm right now is around 215 kg, though I wanted to switch to a more strength focused approach for deadlift given this is the only exercise out of the big 3 i’m currently able to make progress with.

I think that’s fine provided your symptoms are and stay well controlled.