Apologies for all the forum posts, I appreciate your time is sparse and am grateful for the help. I think my other knee symptom thread is somewhat buried by now, but doing knee rehab template and am trying to properly gauge symptoms as per the rules laid out.
What I’m having a hard time with is a lack of adequate rest/recovery in conjunction with work demands. If I have a rest day and am hitting RPE targets in the knee rehab template, symptoms might be very mildly worse for a short period but typically recover within 24h. In conjunction with work there seems to be a cumulative effect that results in mildly worse pain “tweakyness” that resolves over weekends. A somewhat concerning symptom is occasionally effusion, which again resolves relatively soon and isn’t accompanied by a dramatic increase in pain or similar.
-Is effusion any sort of “worse” symptom than pain? Should I be backing off more, or is it generally okay to proceed with the next day’s rehab training day if effusion is present, and simply treat it like other symptoms?
-I assume the obvious strategy with the first issue (work activity + rehab) is simply to back off rpe slightly and really make sure I’m being conservative relative to other activity?
Stress and sleep have been issues for quite a while as well so I imagine attention to that should help to some degree.
Thanks for the post. It’s difficult to interpret an individual’s particular symptoms without knowing much about the individual, the symptom itself, and so on. I can’t say for certain what’s going on exactly, but a bit of swelling doesn’t really sway me one way or another. The swelling may be larger or more symptomatic than what I’m picking up from this post, but I can’t really tell from here.
Despite these limitations, I have little concerns with you continuing the training as laid out. If something changes, that recommendation may change as well. At some point, a consultation may be of use to you, though I am hopeful the template and published materials are sufficient
Thanks for the response. Definitely understandable. It’s mainly some puffiness above the patella without any redness or heat; I had similar when dealing with PFS (or patellar tendonopathy, whichever it was). It seems to resolve itself in a few days when it does occur, and reading up on effusion a bit more it may well just be a sign of overdoing it. Some discomfort/tightness/pain on the medial side of the patella, feels like the quad connecting to the tibia.
Specific to pain symptoms I seem to have a difficult time recovering from either volume or intensity. Some exercises seem to be less reliably tolerable than others, but the volume of leg push/knee dominant work seems is difficult to contend with. Haven’t been able to symptom manage as well as I had hoped. I’m not sure if I’m well into consult territory here, but would the general best bet be to modify ROM instead of intensity or volume (or some combo of ROM and intensity)? Nervous about heading into phase 2 at this stage.
Yea, none of this sounds particularly troublesome, though high levels of pain and subsequent dysfunction would alter my response.
I would reduce the weight before reducing the ROM, though at the 3-0-3 tempo for most exercises in this phase, the weight should be very light. I’d also consider exercise selection and conditioning mode(s) if the pain is significant.
If you’re not really having a lot of pain and this is more of just a curiosity thing, I probably wouldn’t change anything.
Okay good to know, thanks. Yeah it’s not a lot of pain, it’s mostly just occasionally violating the symptoms rule, but the subsequent symptoms aren’t debilitating unless they clash with work activity and even then it’s mainly the effusion and increase in pain I was worried about, namely that there was an increase, not the degree of increase necessarily (if that makes sense). My bike stopped working so conditioning has halted for now until I get it fixed as I don’t seem to be able to do much running, but inclined walking might be an option.
