Following patellar tendinopathy symptoms, I embarked on a rehabilitation focused program several weeks ago. This comprised of an increased volume of tempo squats, slowly decreasing on a bi weekly basis, while aiming for an RPE of 8.
Prior to embarking on the treatment, I had experienced some painful sensations on the inside of the left knee, in the area of the conjunction between the shin and the knee. This followed a badly executed set of unilateral squats when unable to access a squat rack on holiday… this was back in August, and although the pain lessened considerably over the initial few weeks it has not resolved, indeed in recent weeks (moving from reps in the 12-15 range to 8-10 range) the pain has increased somewhat. The pain increases with the increase in flexion of the knee. Some crepitus that was not present prior to the injury has remained and has increased in parallel with the sensation.
However, it is not painful enough to not train, indeed, full squats don’t really put enough flexion on the knee to really hurt it, but I can’t help being a little frustrated that the actual squatting hasn’t helped resolve the irritation to the area over the last few weeks.
Other than this issue, the protocol seems to be working really well not only for the patellar tendinopathy but also for my general wellbeing, I’m finding the higher rep range quite enjoyable after fives for a year.
Assuming what I understand to be the Barbell Medicine approach to pain, I am going to concentrate on my tempo squat form, and should the pain increase this week I am going to return to the 12 rep week and restart from there. I’m not sure the injury I suspect I have (some sort of bursitis) is easy to resolve without rest?
I’ve done quite a bit of research on this as I’m dealing with the same issue and following the same protocol. If you haven’t returned to your baseline pain level in a day (two at the most), then whatever load you placed on it was not tolerated and should not be progressed and possibly dialed back. I’ve had to take a few steps back already, particularly with deadlifts which I’m learning is a prime contributor to pain in my case.
On on another note, I find 3-0-3 squats at 15 reps at RPE 8-9 absolutely miserable. Pulls in the same range are an experience as well.
Good of luck with your program, I’m sure the good doctor will chime in as well.
Hey Jeff, I’ve been watching your posts with interest. I have the suspicion that this issue is additional to the original tendinopathy, which seems to be abating. Got a feeling it’s the anserine bursa. I’m trying very hard to just break parallel, it seems to flare the deeper I go and if I sit with my legs in flexion at a desk for long periods of time (which is a typical thing in my job). I’ll break out the placebos from the ice tray tonight no doubt!
Deadlifts are the only thing I haven’t had to drop intensity on funnily enough, the movement pattern doesn’t seem to irritate the patellar tendon although I’m not sure if this latest discomfort is a result of DLs. I may have a fiddle about with those and see if it is related over the next few weeks if no significant improvement.
And yeah- 15 reps at RPE 8-9 was plain nasty, especially at the beginning of the protocol! Purely from the perspective of performing valsalva over 3-0-3 and over 15 reps! Felt like full on cardio, like running a 400 or something.
But I’m really liking the 10 and less sets loads, feeling a nice pump from those. It’s great when the treatment feels like I’m training properly.
Best of luck to you Jeff, hope you are vertical jumping soon!
Yeah. Sitting is horrible. I hit dead’s heavy on Friday just because I wanted to lift something heavy. Wound up pulling 495 for an easy beltless double. Then had to sit in a high school auditorium for an event for my daughter and I thought I was going to die…haha. My deadlifts aggravate my quad tendinitis.
Ill be be posting an update on my progress soon on here. Not much need for conditioning for sure. 185x15 @ 303 today was enough. Did it relatively pain free though.
Good luck to you too, I’ll be following your progress.
Hi Michael appreciate you asking, things abated somewhat initially but after a brief period continued to experience pain principally in the left knee.
I had continued to lift heavy on the deadlift as I did not associate the knee pain I had experienced with the DL- with a bit of rumination I realised that this association wasn’t made as clearly as with the squat because a) I was more warmed up by the time I came to DL, and b) the sets were shorter and sweeter.
So I have dropped the fives for the DL (which seems completely obvious with hindsight) and I have increased the reps to sets of 12 across the board for squats and deadlifts. And apart from the slight discomfort of deadlifting 12 times per set (I think I have a hiatus hernia which can be a bit of a pain holding valsalva over long sets) things feel good on the joints and even better on the muscles (a nice dose of DOMS, which I quite like).
So I’ll continue with the 12’s for another seven days and then continue to 10’s and so on.
I also seem to have hit 14 stone, which is a first for me at 5’ 8 and a bit, I’m pretty sure I’m not getting fatter- the higher reps seem to be agreeing with me
@Austin_Baraki
Regarding the hiatal hernia, this is out of my scope but might be worth getting checked out.[/QUOTE]
It got to the stage where I booked an endoscopy, but cancelled it- I looked at the results for surgery and understood (perhaps incorrectly) that outcomes aren’t all that successful most of the time.
I was also, if I’m being honest, not only keen on swerving the inevitable “stop lifting weights” lecture as I’m a bit of a sucker for a juicy nocebo but also on the whole endoscopy thing… yeah, it’s not my favourite