I have developed a bit of what I assume is tendon pain at the top of my left knee cap. It came on at the end of the second session of 1st week after a weeks holiday. Both session were quite light but I had changed to new boots with a higher heel so maybe that triggered it?
The pain is mostly felt on the eccentric of a squat at about parallel and is quite painful when acting as the back leg of a split squat.
I know advice in this senario would usually be to reduce vol/load but I hadn’t really been doing much anyway so I thought perhaps starting with light high vol tempo front squats (3x15) and building from there as recommended on here might be a better option?
My plan is also to leave out olympic lifts (I am a masters OL lifter) for a few weeks and to add a single leg quad exercise after the squats. Should this be something that is totally pain free? should I stick to the same criteria as the squat exercise or would doing it BFR be useful (I have a suitable device)?
And finally if the pain is only 2-3/10 on light squats should I just start with full ROM?
Many thanks for any help, this forum seems great i wish I had discovered it ages ago!
Sorry to hear about the knee issue. How old are you?
Your plan sounds reasonable. This may resolve quickly given the timing since onset has been short. Have you dealt with this same issue previously?
I wouldn’t set the expectation to be pain free but rather to train with tolerable symptoms (if symptoms drastically increase, leave you feeling debilitated, and last for 24 hours then it is likely you didn’t tolerate loading well). Regarding BFR, no this likely wouldn’t be useful given you are still able to externally load the extremity. Typically, the research is supportive of BFR in scenarios where we are unable to externally load the individual (example beginning stages of post-surgical ACL reconstruction).
I am 37, I did have some quad tendon pain a couple of years ago on this leg but that pain seemed to be focused a couple of inches above the knee whereas this is right at the top of the knee cap, sometimes feels a bit like it is the knee cap itself. Guess it’s all the same tendon though.
I did the first session yesterday, very light 3x15 squats with 40kgs and 3x15 step ups, 2/10 pain at the time but felt great last night and today so I guess that is positive. With the protocol I have seen mentioned on this forum (3x15 week 1, 3x12 weeks 2-3 etc.) should I just linearly add a few kgs each session or should I be going up to a more auto-regulated top set for the day?
Understood about the BFR, I will just do steps ups or leg extensions for the single leg movement, split squats still irritate the back leg quite a bit so I guess I could switch them in in a couple of weeks?
Gotcha.
Yep you are correcting about the week to week progressions. The additional factor is using RPE. Don’t worry about trying to hit particular weights each session or week to week but rather let the RPE guide the process. Because I typically program this at tempo (3 second eccentric and 3 second concentric), RPE can go to 10/10. The tempo will regulate the external intensity (load being lifted). Oddly enough, our knee rehab template should be out very soon and this would benefit you.
Split squats - I would try to dose them in to tolerance and perhaps shorten range of motion if symptoms are debilitating. Start with just body-weight.
So as you predicted this issue resolved very quickly, within a week or two I was pain free and enjoyed about 6 weeks training with no issues. However I seem to have run into another on the knee, After the first week of a new block I (and my knees) felt great, had two days off and right at the start of my next session I was getting sharp pain in the knee cap when doing any squatting movements. It didn’t go away over the session and has been with me since (about 10 days now). I backed off the volume and intensity immediately and have now reduced to only exercises that don’t cause more than 1-2/10 pain.
It’s a bit weird (at least to me), the way it came on and the way it hurts, seems related to position as much as load. top 3rd of a leg extension is excruciating even with just the pad whereas single leg press minimal pain even with decent load. Squats 2-3/10 pain (empty bar) and back leg on splits squats very sore. Probably not relevant but knee cap is very clicky and clunky, as more so than normal.
Any thoughts? I was about to order the template when symptoms died down before. Should I give it a bit longer again? Should I just stick to leg press and step up which don’t seem to upset it?