Right Anterior Knee Pain during Tempo Squats

Pain & Rehab Forum [Moderated]
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Hello Rehab Wizards,

First a bit of background: I’ve had a pretty hectic week. Took my wife to L&D on Tuesday evening and she got admitted to Ante Partum unit so I spent the next two nights sleeping on a terrible hospital couch and being non-active especially compared to my usual day job working as a laborer in construction. Wednesday would usually be my first day of a training week but it was more important to be there for my wife so I didn’t lift and figure I would just repeat day two from last week today. Additionally, on that Tuesday I got an email for doing a pre-employement assessment with the local utility for a job I’ve been striving towards for most of this year and have continued to have items to move forward with in this process so my week has been an emotion RPE 11 with both eustress and distress. On top of all that, I have had some mild physical trauma on my right forearm in the last couple weeks when I’ve had to repetitively load carpet tile into a box on a man lift that unless I am very cautious and on purpose about the action involves bumping the underside of my forearm under some load against a cross rail on the box. Last night, when I was going to bed my wrist was hurting a bit more but it feels fine most of the time.

Now to today: Hypertrophy I Week 7, Second round and 18 weeks into my slow bulk. My paused bench went A-OK so I moved on to 3-0-3 Squats and everything felt fine at 135#. Moved on to my 185 x 10 for my next warm up, I had some reasonable discomfort in my right wrist but didn’t think there was enough loading on the wrist as it should be mainly holding the weight against my back but as I got to my last two reps I started experiencing anterior knee pain in my right knee. Wasn’t sure if maybe my stance was weird or something so I went up to my 210 x 10 @ 7 and the pain started kicking in at the 4th rep and getting pretty damn uncomfortable by the time I decided to stop at the 6th rep. Decided to stay at the same weight and mess around with foot stance along with hand placement for the next two sets to no avail. I have no squatting again until the upcoming Wednesday so a little bit of time going on there, Deadlifts on Sunday which I am assuming the null and will go through as normal until proven otherwise.

In the words of Jordan, what do? Am I reasonable in thinking that the wrist pain could be interconnected and negatively impacting stance or pressure? Should I be doing anything specific to try and alleviate the wrist symptoms? Do I try and go at my LBBSwBelt as normal on Wednesday until I experience symptoms again or would I be better off being proactive and trying to pivot to HBBS or Front Squat that may apply less pressure or different pressure on my wrist? Just want to have a solid plan in place so I can keep applying physical stress effectively and keep going.

Please let me know if you need any additional information and thank you so much for you insight as always.

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Hey, sorry to hear about all that, definitely a hectic week. Getting in some training during a time like this can definitely be beneficial, but obviously progress will sometimes take a backseat as life kicks you around. I’d recommend looking at this situation from two perspectives: 1) Do what’s tolerable for the wrist, whether that’s a high bar, safety bar or front squat right now. I don’t think that’s directly related to the knee, and you should be able to continue training some meaningful leg strength with any of those variations. 2) The knee pain you experienced is a classic case of: sometimes we will have days/weeks like this, especially given the amount of outside life stress, especially if this is a relatively new symptom. My first inclination, after messing with stance didn’t work, would’ve been to drop the weight, especially since it was tolerable at 135, and increased with weight and reps. I’d keep a neutral expectation going into your next squat session (using a variation that’s comfortable for your wrist) and be okay with modifying the load if need be. This will hopefully blow over over the next few days. Hope that helps and that everything else simmers down too, but let me know if you have other questions or updates.

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Status update:

Assuming the null on my 12/22/19 Deadlifts went just fine, I stayed on target with no knee pain.

I came in to my LBBSwBelt day on 12/25/19 aware that I might have to fiddle around to get through some decent weight. Started having some pain early on when going through my warmup progression at 95lbs, primarily in the bottom of the rep. Thought through some stuff and did a few things. One, I moved the pins on my rack up quite a bit to reduce range of motion to where I did not have any pain. Two, I switched to HBBS to try and have some different joint angles. Lastly, I realized it is pretty damn cold (60F or so) in my sunroom where I lift and that there may not have been enough localized blood flow and tissue warmth before engaging in these weight bearing activities. So I took a break and did 7 or so minutes on my stationary bike. I was able to work up to 215lbs x 8 @ RPE 8ish with no pain.

On 12/27/19, came in more prepared for my 3-0-3 Squats and I did time on the stationary bike first, moved the pins up slightly then did some smaller warm up jumps to get more reps and was able to get within 10lbs of my previous weights at similar RPEs so felt like a big win.

Yesterday was business as usual on Deadlifts and I even moved up 5lbs with similar RPEs.

I will see if some of what was effective for my 3-0-3 Squats can help with my LBBSwBelt.