Training with knee pain

Good day!

I’m a 41 yo male person, 6’0’ 188 lbs, approx. 22% body fat. I have a pretty good aerobic base. Basically your average joe. I’ve been doing a fair job with nutrition and conditioning (cycling and walking) and I’ve lost 50 lbs this year.

About 6 months ago I began SSLP with basically no weight training experience. After a few sessions I started having pain in my knees, between the kneecap and the joint, and at the top of the kneecap where it meets the quads. It wasn’t bad at first so I kept going, but it got worse, so I stopped. I’m pretty sure my squat form was a little off - I think I was holding myself too upright.

Over the last couple of months I also decided to try running again (I was a distance runner in high school and for a few years after). I was using Galloway’s run-walk-run method, thinking that starting slowly and easing in would be the way to go, but after a few weeks of very slow progression, the knee pain came back. So I stopped running, and took about 2 weeks off of any kind of knee loading. Knees felt better but not perfect.

A few days ago I decided to give SS another try. I’ve watched a ton of videos about squat form, and I’m pretty sure I’ve got it worked out. I started over at day 1 and built up from an empty bar to the point that the weight was slowing down my lift, as prescribed in the book. After the first session everything seemed fine. Knees were slightly sore but not painful. During the second session, everything seemed fine, until about 8 hours after, then the knee pain came back with a vengeance.

I’ve done quite a bit of reading over the last few months about overuse injuries, which is what I think I’ve got. I think that what I probably need to do now is rest my knees completely until they totally heal, which as I understand it could take several months. So no running, no squats, make my kids carry the laundry up from the basement. Then I can try again, starting with bodyweight squats and moving slowly up to goblet squats or something like that, very slowly increasing weight over a long enough time to give my knees time to adapt to the stress.

So my first question is, does that sound like a reasonable course of action, or is there something else you’d recommend for this kind of problem?

Second question is, should I go ahead and work the SSLP with the other lifts, omitting the squat, or would it be somehow detrimental to do only part of the program?

Thank you for your time!

Awesome work on your 50 lb weight loss! As for your question:

I’ve done quite a bit of reading over the last few months about overuse injuries, which is what I think I’ve got. I think that what I probably need to do now is rest my knees completely until they totally heal, which as I understand it could take several months. So no running, no squats, make my kids carry the laundry up from the basement. Then I can try again, starting with bodyweight squats and moving slowly up to goblet squats or something like that, very slowly increasing weight over a long enough time to give my knees time to adapt to the stress.

So my first question is, does that sound like a reasonable course of action, or is there something else you’d recommend for this kind of problem?

I would strongly advise against this course of action. You are not broken or as fragile as this makes you sound.

I would recommend listening to the last 2 podcasts we recorded and put out on your YouTube channel related to injury and pain management in lifters. You provided a good history, though there are still a few possibilities to explain your knee pain (e.g., patellofemoral pain syndrome and quadriceps tendinopathy being at the top of my list for now).

The key is to find the activity/movements that you can tolerate and train those, even if it’s not “The Program”. This might mean starting on the leg press, for example. Complete unloading is almost never the answer for long-term management of injuries. If you have access to see a coach in person, that would also be a good option.

Second question is, should I go ahead and work the SSLP with the other lifts, omitting the squat, or would it be somehow detrimental to do only part of the program?

We like to say that “Training is better than not training”. So yes, you should train the other lifts while working around this knee issue.

I’m 42 now and after several months of SSLP a few years ago my knees started hurting pretty bad. I’ve always had pretty crunchy knees, had Osgood Schlatters growing up. My knee pain wasn’t too bad while squatting but I would wake up in the middle of the night in severe pain. My pain was closer to the bottom of the patella. I bought some good knee sleeves (started with Vulkan now have Rehband) and the knee pain immediately went away and has never returned.

Cheetah, I can’t add to Austin Baraki’s advice. But as a lifter similar to yourself (age, size, recent weight loss, running habit) who occasionally experiences periods of knee pain, I would encourage you not to get too stressed out about it. Of course, if your pain is excruciating, my encouragement is pointless. However, if you can tolerate it (i.e. sleep and go about your daily routine), relax and train around it. I don’t know if this attitude shortens or decreases my bouts of joint pain, but just remembering that my knees will probably not disintegrate feels like a big relief. Also, ditto on the knee sleeves. Can’t say if it will have any effect on knee pain, but they are great anyway.

Thank you for taking the time to respond!

I found the podcasts about an hour after I posted my question, and I’ve been binge-listening all weekend.

Over the weekend, I did a few sets of bodyweight squats, to try to see if I could keep working in that range-of-motion. It was pretty uncomfortable at first, but after a few sets everything loosened up and the pain went down considerably. This morning I did the SS workout, but I did take my working weight for the squat down to 80 lbs. Everything felt fine, I made the predicted progress on my other lifts, and I’ll build my squat up from here.

Thank you again, and also to Dr. Feigenbaum, for all of the information the two of you have put out there. It’s given me the confidence to continue in the program, and I’m deeply grateful.