Recent knee issues

Hey docs, thanks for all you guys do and any help you can provide me with on this specific situation.

For a little background, I’ve been consistently lifting for about 4 years now with a focus on powerlifting for the last 18 months. I’ve been following your templates for the last six months and have made great progress towards my goals.

On Thursday 10/3, I was doing day 3 of week 3 on the strength 3 template. On my squat movement (squat with mini bands) I felt a little instability/weakness in my right knee while warming with the empty bar. I did a few air squats and felt the same thing but no significant pain yet so I started working up in weight. I worked up to similar weights as I had the previous two weeks without the symptoms getting any worse but still noticeable. I had no pain following that session but went through the same situation the next day on my pulling movements(block pulls and stiff legged deadlifts). Still no pain following that session so I assumed everything was ok.

The following day I was at the gym to play basketball, which I have played my entire life growing up and have consistently played every weekend for the past 5 years so I wasn’t introducing anything new to my body. I felt nothing jogging around and shooting before a game so my knee wasn’t even on my mind but as soon as a game started I couldn’t run or jump without my knee just giving out and causing pain whenever I tried to use it. I immediately pulled myself from the game and sat down.

Prior to this I have never had any significant pain or injuries from basketball or lifting so I wanted to tease out a few things before posting here. Now after leaving the gym, normal daily life causes no pain or problems and I can move my knee through a full range of motion unloaded without a problem. Body weight squats, stairs(up and down) and uphill walking caused the symptoms to come back but no issues with flat walking or cycling(comfortable pace or sprinting).

Personal info
Male
29 years old
Currently maintaining a bw of ~205 lbs (down from 330)
36.5 inch waist circumference

Any recommendations on how to proceed with my lower body training would be greatly appreciated.

Hey @Jfk11690 - thanks for the questions. Sorry to hear about the recent knee symptoms. Where on the knee are you having symptoms and what does it currently feel like?

My initial thoughts without more information is to primarily try to let RPE guide the path with training and make necessary adjustments to loading. Perhaps I’ll have more insight with a bit more information on your experience.

Thanks for the quick reply. Currently there is still no pain or issues during my daily life. It seems like the symptoms are isolated to the top end range of motion of squatting, or anytime I try to run or jump. The pain is felt right above and below my knee cap and it wraps towards the outside of my knee but only when I’m in that specific range of motion and it is not sensitive to the touch. It almost feels as if the muscles in that area want to stop producing force once I get into that quarter squat range.

Gotcha. Yeah, I’d start with managing loading through the provocative movements. Adjust RPE (which should theoretically drop external intensity), you can up the reps a bit, add in tempo, and if that isn’t helping then perhaps sub out for different exercises for a bit. Often the running and jumping may need to be initially taken away and then slowly titrated back up by gauging tolerance (usually a question of volume and intensity as well). We’d be happy to help guide this path with a consultation.

Ok great, thanks for the help. I’m going to try and adjust training for the next couple of weeks and see how things go. If there is no improvement then I’ll get back to you about that consultation.