Guidance Needed: Knee vs. Hip Rehab vs modified pb2 Template

Pain & Rehab Forum [Moderated]
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Hi team,

I’m seeking guidance on whether to transition to a rehab-specific template or continue modifying my current programming. I’ve been training consistently for 7 years and recently hit a successful recomp, which I’m keen to maintain.

Training History & Context:

  • Experience: 7 years consistent lifting.

  • Best Lifts: Low bar squat 190kg for 5 reps.

  • Prior Issue: Long-term knee pain (PFPS). I previously ran the Knee Rehab template with limited success in reducing symptoms, despite strictly following RPE and volume protocols.

The Biomechanical Shift:

I had an “a-ha” moment back in Dec ‘25 running the beginner template after the extended knee rehabbing: by consciously “opening my hips” more and allowing for more forward lean (sitting back into the squat), my knee pain completely vanished. I was able to build back up to a pain-free 170kg 1RM and sets of 155kg x 6. However, would still get some days some light aches in the knee which are tolerable.

Current Issue:

I transitioned back into Powerbuilding II and felt great for a 5 week period, but I seem to have hit a threshold. Now, my hips ache significantly once I reach parallel.

  • Pain Level: >3/10 at parallel in a standard squat.

  • Current Workarounds: Substituting box squats at ~120kg or lighter loads to stay under the pain threshold.

  • Recent Flare-up: After a heavy deadlift single and PBII volume yesterday, I have fresh aggravation around the top and sides of my left knee today.

Professional Input:

I’ve seen physios at AUT university here in Auckland, New Zealand who suggested that while the PFPS diagnosis is general, the root is likely related to hip/glute function, potentially exacerbated by a sedentary WFH setup over the last 5 years.

The Dilemma:

I am hesitant to jump back into a full Rehab template because I’ve made significant progress lately and don’t want to “detrain” or return to “baby weights” after an extended period of rehab/cardio focus. However, the pain is now migrating between the hip (at parallel) and the knee (after deadlifting).

Questions:

  1. Given this “Whack-A-Mole” symptom pattern, would the Hip Rehab template be more appropriate to build tolerance at parallel, or should I return to the Knee Rehab template?

  2. Alternatively, is it viable to stay on Powerbuilding II and simply move to aggressive substitutions (e.g., Box Squats, Tempos, or reduced ROM) to keep the intensity high enough to maintain my recomp while staying under the 3/10 pain threshold?

Thanks for the help.

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Howdy, good to see you back here…though I wish it were under different circumstances.

To me, this type of presentation (recurring overuse symptoms) suggests the training load continues to be too high. Now, sussing out the reason why the training load is too high - volume, intensity, exercise selection, etc.- is more challenging. I would put my money on exercise selection if RPE targets are being respected.

Here’s what I would do exercise selection wise for Powerbuilding II:

  • I would be running the non-comp version unless competing soon/wanting to test soon. I’d prefer to be further removed from an injury including singles.
  • You can keep low bar as the main squat after resolving this hip issue. For now, I’d swap to 3-1-0 tempo front squats or similar.
  • I’d advise a unilateral variation for the supplemental squat for at least 2-3 blocks of training. Box step ups or front foot elevated split squats would be my preference.
  • I’d increase variety of the pulling exercises too, e.g. doing a sumo variant after squats and conventional pull as your main lift.
  • I think the physios at AUT would have a challenging time supporting their diagnosis.

This should get you on the right track, though it is only ~ 10% of what we do in our pain/rehab consults. That may be of use to you in the future if needed.

-Jordan

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That makes a lot of sense. Looking back, I was actually running the first generation of Powerbuilding II; I’ve heard great things about Version 2.0 with the emphasis on rpe management, so I’ll ‘pull the trigger’ on that and implement the non-comp/high-variety swaps you suggested.

Your point about exercise selection resonates—I’ve actually had success rehabbing a sensitive hip in the past by swapping low bar for High Bar Tempo and moving from conventional to Sumo. It seems I fell back into a pattern of ‘over-relying’ on one specific movement until it hit a wall.

I’d love to do a full consultation, but unfortunately, the current exchange rate and economic climate here in NZ make that unfeasible right now. I’ll be making the most of the templates and the guidance you’ve provided here to get things back on track.

Regarding the AUT physios—fair point. It’s been a 2-year journey with this knee, and while I’ve seen the most consistent progress in the last 3 months, the ‘Whack-A-Mole’ nature of these flare-ups has been the main frustration.

I’ll get to work on those Tempo Front Squats and Unilateral movements. Cheers!

2 Likes
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Copy that. Let us know how it goes. Cheers!