Knee Pain For Two Years (Anterior, Lateral, Medial)

Pain & Rehab Forum [Moderated]
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Hello! I am a 26 year old woman who, after running for 6 years (approximately 30 miles a week) switched to weightlifting due to anterior knee pain and pain on the upper outside of my knee that mimicked descriptions of ITBS. My anterior pain was the worst - I constantly felt like something was “stuck” behind my knee and if I could just crack my joint correctly, the pain would be released. it was not a baker’s cyst and I cured the issue by not running anymore. I also had extreme cramping in the back of my upper calf.

I started powerlifting two years ago and was relatively pain free the entire time. Recently, the anterior knee pain would come back from walking a lot. One day, while sitting cross legged, I pressed downward on my knee and cracked it. It felt good for a second, and then started to hurt along where the LCL runs (from the outside of the top of the kneecap, along the side of the knee, to the lateral side of the top of the calf). Between doctor’s visits, it seems I now have injured my LCL, and sitting cross legged or opening my hips with bent knees in any way hurt it. I continued to squat, as squatting itself didn’t hurt, but about a month ago, decided to stop, as I would get lateral pain (along the LCL) the next day.

During my time off from squatting, I did a lot of biking (in the gym and as my primary means of transportation). For the first time, I am getting medial knee pain, starting from the top of my inner knee and extending into my quads. I have also gone back to light squatting again (50% of my 1RM, sets of 10) and while I have no lateral pain, afterwards, my medial knee pain is so bad that it hurts to climb the stairs. My “good” knee has also started to hurt (medial pain, exact same description as the bad knee).

I have had 1 physio appointment so far, in which the therapist moved my knee around a lot and didn’t do much else. I could barely walk the next day. I had an MRI last week, but my doctor isn’t expecting it to show much. I am starting to get pretty desperate to get back to regular activity.

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Hey, I saw your post in the Facebook group and wanted to address this here. Reading this history I would highly recommend a consult with Mike or I as there does seem to be some things needing to work through. Running is not bad for your knees any more than squatting is. Sometimes we do have setbacks in training, but we typically have a good understanding of means with which to alter training and build in more capacity. For either ITBS or a diagnosis that would fall in the patellofemoral pain syndrome bucket a lot of the focus is on managing load and building more resiliency in the system. This is typically accomplished by working through a tolerable range of motion with an emphasis on the speed and intensity of movement. If the move every time something hurts is to manage by stopping the activity, eventually we start running out of activities we can do comfortably. This is not to say squat or run through the pain. Sometimes we need to work around a problem before we start returning to working through it.

What kind of programming for both squatting and running have you done in the past? Was the choice of 50% of 1RM for sets of 10 arbitrary? I would recommend starting with the attached links for some background on training and maybe looking into the Beginner Prescription. Often using 1RM if you have been away from training is not the best idea as if you have not trained in a while it is unlikely that is a fair representation of your true 1RM. This is why we typically advocate for using RPE to gauge intensity.

​​​​​​[Strength Training for Endurance Athletes Part I: Injury Risk Reduction | Barbell Medicine

​​​​​​](Strength Training for Endurance Athletes Part I: Injury Risk Reduction | Barbell Medicine)Strength Training for Endurance Athletes Part II: Principles of Resistance Training | Barbell Medicine

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Hi Derek, thank you for the response.

I am going to look into a consult, just trying to get financial stuff sorted and seeing if there is something that I can do in the meantime! But I agree, I think that would be helpful. I also wasn’t sure if I should look into doing the knee rehab template - right now with my finances, it’s an either/or situation - either a consult or the knee rehab.

I am unfortunately starting to get to the point where I can’t do anything comfortably. I didn’t even want to try with running anymore because I was getting to the point where walking for too long became painful. I have tried kinesology taping (which I know, doesn’t have empirical backing) and it seems to help a lot, so on long hikes, I would take my knee. I often have two or three instances of extreme pain along a hike or long walk (where something suddenly sharply hurts) but can work through it.

For running, I didn’t have any particular programming and I am also not convinced that I was running with proper technique, probably causing the bulk of my issues.

For squatting, I did StrongLifts 5x5 for a year. I then ran the Bridge (2 cycles) last summer. In the fall, I fell off the training wagon, but in the winter I started running Candito’s Linear Program, and have been doing cycles of that since January. I am training 5x a week, but only squatting 2x/week. I really like the program and have made great gains - I went from routinely squatting only about 80 kilos, to having my working sets in the 90s and got up to 112.5 1RM.

The reason that I chose (approx) 50% for sets of 10 was twofold: I wanted to do lower intensity/higher reps, and I wanted to do something in the RPE 6-7 range, as I felt, psychologically, like I was still working my body in this range (I am slightly heavier - 5’6, 165 and am finally no longer overweight/feel physcially fit because of my switch to powerlifting, so it sucks to feel like I am losing that).

I am not deadlifting, as I found that the set up position for conventional deadlifts, with knees only slightly bent, hurts more. Bending when my feet are forward facing/parallel hurts more than when my feet are turned out, but sumo has always hurt my knee.

I will read those articles, thank you for them!

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Have you had an opportunity to look at those articles? if so, do you have any thoughts at this point.