To give some background - I’m currently 22, and I’ve always had a bit of knee discomfort when my knee is in deep flexion (since long before i’ve been training), which I was told was because of flat feet. I was dealing with a seperate injury unrelated to the knee for a couple of years so I wasn’t really squatting, but over the past year i’ve been slowly getting back to squatting. I’m now running PB III for a third time in a row, though up until this last run of PB III I was changing the programming of day 1 squats with a sort of linear progression with 3-4 set of 5 since I was getting back form an injury and didn’t want to do singles, though I kept the rest of the program as written. Also, note that i’ve only started getting to a weight that was challenging in the past 8 weeks, since I started very light when I got back to squatting and worked my way up slowly.
During this run of PB III (I just ended week 4), I started feeling increasing knee pain which was even affecting my day to day life since going up stairs or kneeling on one knee was very painful. As I mentioned, i’ve always had some knee pain but never to this degree. For the past week i’ve taken a break from squats / leg press / bulgarian split squats (basically anything that is similar to a squat), and my knees feel much better though I still feel some pain if I try to squat (even without any weight). What should be my next move from now in order to get back to squatting? Is it enough to simply reduce the volume and potentially use the squat programming of the beginner template / PB I or II templates, or do I need to look into the knee rehab template?
I think that by pulling back on the absolute load as your first step (as discussed in the article), and potentially using other strategies (like those discussed in this recent thread), you can likely get the symptoms calmed back down. From there, being more conservative as you ramp things back up, and not jumping back to the full frequency or volume of training as outlined in the templates, but keeping your squat/“leg” programming a bit more separate from the rest of the template based on your tolerance.
If you aren’t sure how exactly to go about this for yourself, the knee rehab template is an option that gives some more specific guidance in template format, or the best option would be individualized consultation and guidance from our rehab team.
For what it’s worth, having both run the Knee Template and having done remote programming with Doctor Miles, the Knee Template is well set up and I made significant progress on my own this way. Dealing with more systemic and longterm nagging issues is what was particularly helpful with rehab programming, but I still reference the template if I’m stuck. Would highly recommend it as a tool in the toolbelt.
You could try stem cell therapy. It’s the only nonsurgical option and the only way to avoid invasive surgery and its attendant risks. If done properly, it is very safe.
It sounds like you’re really dedicated to getting back into your squatting routine, and it’s great to see how carefully you’ve been progressing. Knee discomfort can be particularly frustrating, especially when it starts affecting your day-to-day activities like climbing stairs or kneeling. It’s understandable to feel a bit uncertain about how to move forward, given your history of knee pain and recent increases in discomfort.
Given that you’ve been dealing with knee pain, especially during deep flexion movements, and considering the intensity you’ve been pushing through, it’s wise to approach this with a bit of caution. The fact that you’ve taken a break and are seeing some improvement is a good sign. It suggests that resting the affected area and reducing stress has been beneficial, but it’s also important to address the root cause to prevent this from recurring.
It might be helpful to incorporate some targeted rehabilitation exercises that focus on strengthening the muscles around your knee and improving mobility, especially if you suspect that flat feet might be contributing to your discomfort. Sometimes, issues like patellar tendinitis or irritation can benefit from specific exercises that improve patellar tracking and overall knee stability. Consulting with a physical therapist could provide tailored exercises to help with this.
As for getting back to squatting, starting with a reduced volume and intensity is definitely a prudent approach. You might consider easing into the beginner template or PB I or II programming as you mentioned, as this can allow you to build up strength gradually without overloading your knees. It’s important to listen to your body and avoid pushing through pain, even if it’s just a twinge.
Additionally, maintaining good form and possibly adjusting your technique to ensure proper alignment can make a significant difference. Sometimes, even subtle changes in how you perform the squat can help alleviate discomfort. For instance, making sure your knees track properly with your toes and not letting them collapse inward can reduce strain.
To manage your current discomfort, applying a pain-relief cream like this might offer some immediate relief. It’s designed to help with inflammation and pain, which could be beneficial as you continue to work on strengthening and rehabilitating your knee. Regular use of such topical treatments can provide soothing relief and support your recovery process.
Keep monitoring how your knee responds to these changes and adjustments. If you find that pain persists or worsens despite these efforts, seeking out a professional evaluation could be valuable to get a more comprehensive understanding of your condition and ensure you’re on the right path to recovery.
Your dedication and thoughtful approach to your training are commendable, and with some adjustments and care, you’ll likely find a way to return to squatting comfortably.