Volume, Stress and Tendon Fatigue

Medical Q&A [Moderated]
1

Gooooood Morning BBM!!

So, I’ve been rockin the Bridge (Un-Point-Oh) for about 4.5 weeks now (smack in the middle of the first high stress week), and I’ve developed some pretty rad patellar pain (where the patella adheres to the tibia).

I have four theories on the cause of this pain:

  1. Form sucks. Knees forward of my toes would increase stress on the patella, specifically at the tibia connection, however, I have form checked myself and with others and don’t think this is the issue.
  2. Nutrition. Is it possible that improper nutrition or being low on protein (rough work week, smaller meals than I would like and less frequent) is affecting tendon condition/recovery? I wouldn’t think tendons are impacted significantly by nutrition, but I’m not a doctor.
  3. Sub-optimal warm up. While I question the validity of “warming up tendons” to an extent, perhaps due to the ^^crap work week, less thorough warm-ups have left me unprepared to lift heavy. I do complete 4-5 warm up sets prior to each primary lift (5 reps, bar, 135, 225, 275, 315), perhaps this is not sufficient.
  4. High stress week is HIGH STRESS and these things happen.

My gut is saying suck it up buttercup, train at that level (80%) I can tolerate the pain, as patella tendons aren’t likely to explode spontaneously during a lift; next week will feel better.

However I would really appreciate your input and a sharing from your experience on how common an issue like this may be strictly due to a significant volume increase and any common cause I may not be addressing. Thanks so much as always.

2

Apeman,

Hope you are feeling better and thanks for the post!

I think that it’s unlikely your nutrition is contributory here, but it is possible that a form issue could be a partial cause of the issue. That said, if I had to put money on it I’d suggest that the fatigue is too high for your current level of training and subsequently, pain has manifested.

Management wise, I would see if taking 1 day of squatting out and lowering intensity by ~5% or 1 RPE would help this go away. I’d avoid other exacerbating movements at this time as well.

3

I kicked the RPE back 1 today for paused squats, seemed to help during the workout, but who knows what tomorrow holds. I’ve really enjoyed the Bridge so far, and purchased the 7 Wk endurance recently. Hopefully it’ll knock off the remainder of those LP pudgees. Thanks Doc, cheers.