Knee pain after switch to beginner program

Hi docs - sorry for long post!

Background: 42yo male, started SS in feb, around same time diagnosed with rheumatoid arthritis. Between meds and lifting, have felt much better. Have had form checked by an SSC in my area, progressed and gotten stronger slowly but steadily (still not ‘strong’ by any means).

Switched to BBM beginner template 4 weeks ago (the online phase 1, I plan to buy the full version), and was getting hang of RPE. Then knee pain hit. My guess is that it’s from increase squatting compared to what I was doing. I do low bar squats.

Symptoms: started in late week 3, sore inferior kneecaps and pain at distal-most vastus medialis, bilaterally and symmetrically. Tough to pinpoint as the quad tendons both have similar symptoms on some days.

Mild constant pain at rest and while sitting in a chair, worsening when rising to a standing position or walking. Some pain during warm up sets, mainly at bottom of the squat, but no increase in pain while squatting rest of sets. Actually, I feel better for 6-8 hours after workout but the 2 days after are getting bad.

Advice? I’ve read some of your guys’ stuff on pain, I’m getting thru the knee rehab sticky/comments, and Jason Eure’s article.

Should I drop the weight and do your 3x15 recommendations with 3-0-3 initially, then decrease volume/increase intensity, align with some isometric? Get the Knee rehab template? My confusion is if the pain is related to increased volume relative to SS, then wouldn’t sets of 15 be a bad idea?

Open to suggestions. Thank you!!

Sorry to hear you’re having some knee issues, hopefully we can help out!

There’s always many options to go about this, some better than others, so the confusion is definitely fair. It’s hard to say the increase in volume is the sole reason, not that you’re explicitly stating this, but with the load decrease that comes along with an increase in reps and tempo should protect against a negative response to what you’re suggesting. I think a simple way to start going about this would be bumping the reps slightly on the squat movements, to about 8-10 reps, adding the tempo (which limits the load), and then seeing if you can work your way back down to the working set reps prescribed in the beginner template over the course of a few weeks. Adding in some isometrics may help as well, certainly won’t hurt.

If symptoms are recent (~1-2 weeks, which is what I’m gathering, correct me if I’m wrong), taking a small modification for a week or two should give you a sense of factors you can modify and when you can return to the prescribed programming.

Thanks for the post, and let us know this develops and if you have other questions!

Mike, thanks for your reply, been eagerly awaiting your guys’ thoughts.

That makes sense. I kind of anticipated your suggestion based on other posts - have essentially done your recs for the last two training sessions. Starting with isometrics, then tempo box squats with pretty light load and higher reps, and finishing with some leg extensions like Eure’s article suggests. Seems to be going ok, and while it might be all in my head, my knees do feel better.

I’ll give this a go for the next few weeks and keep you guys posted on how things progress. I’ve had my share of tendinopathies in the past (elbow, shoulder, etc…) and I don’t want this to go how those did, so I’m very much open to the rehab template or formal consult, if needed.

Is there a percentage of load you recommend, both for tempo squats and extensions?

Thanks!
Tony