Sharp pain in one knee whenever volume increases

Hi Dr. Baraki and Dr. Feigenbaum,

I got what I think is a tendinopathy from doing lots of squat volume while re-running week 4 of the Beginner Template. It’d have me squat three days a week with sets and reps as follows: 4x4, 4x7 and 4x10. Two weeks ago my knees felt cranky while doing high volume squats on the third day (4x10) and I bailed out on the last set of squats. Ever since then, I have this sharp pain in anterior, middle/upper part of my knee when approaching the bottom of a squat or getting out of there. Staying at the bottom is fine though. Which made me think it may have something to do with my quads.

I believe my form is fine, I posted lots of form check videos online and most people, including some BBM crew, said it was fine.

At first it’d hurt while sitting down and getting up from a chair, now it’s relatively better after a week of icing and rest but I still can’t do a few sets of squats with more than 4-5 reps. I can work up to a one rep max, no pain, but I can’t follow the template as I should because pain increases as I go through reps and becomes unbeareble after the third set.

Does it sound like tendinopathy, if so, should I follow what’s written here?

Also, should I keep re-running the week 4 once my knee heals? I was making gains but I suspect that that amount of squat volume caused this issue.

Thanks in advance.

If you can work up to a 1RM without any pain, this does not sound like a tendinopathy.

Our standard rehab approach likely applies here, and maybe you slow down the volume progression a bit more next time.

Thanks sir.

Since hitting depth and volume both cause discomfort… should I reduce the range of motion by setting the pins high and try to go lower from there each session, or do really low volume squats and try to up the volume from there each session?

I don’t think you need to reduce the ROM based on what you said above.

I also don’t think you need to do “really low volume squats”, but this will depend what program you’re running. You may benefit from a consultation with our rehab specialists for very specific guidance.

That said, if you wanted to restart the beginner template on phase 2 and swap out some squats for a less fatiguing movement, that’d be reasonable too. I also would point out that none of the squats are 4 sets across, rather they’re ascending sets.

It’s been another two weeks and it occasionally gets better and sometimes worse, for example yesterday I had to do 3x3 squats because the area where quads connect to the knee would flare up after the second or third rep even during the warm-up sets and I didn’t want to push it too far and cause some serious injury. The week before that I could do 3x5 with less pain. I can’t really figure out if it’s getting better or not at this point so I scheduled a rendezvous with an orthopedist for tuesday. If you’d like me to keep you updated I’d be more than happy to do so, because he’ll probably tell me to stop lifting after he diagnoses the problem.