Knee pain

[anthrax]

I injured my knee (probably patella tendinitis) years ago

Too much quads exercises, leg press & leg ext, running on hard surfaces etc

I changed my routine to stop those silly stuff
I had ART for a couple of weeks and the practitioner almost "fixed" it completely and I was able to use decent weight

Since then I *think* I've trained my lower body smartly enough to avoid the pain to re-appear (more hams-glutes work, less quads, no running)

Still, the pain's started to hit me again
I can no longer squat

What can cause this?

 

[Sir Isaac Lime]

quad imbalance? you doing your vastus medialis specific moves?

 

[musketeer]

I have patellar tendonitis in BOTH knes. This tells me that what it was doing wrong and not an accute injusry that got worse (which would have manefestied itself in just one knee). I have since reduced the volume of leg training and utilised a comprehensive stretching routine focussed on my lower body and spine. My knees are recovering ahead of the medical professional's schedule - probably because I'm doing everything I can to get better whereas the 'normal' population only do the bare minimum. If you can squat with very light weight, then do it because it will help. Once a week I do 20 sets of 20 squats with bodyweight, and then I stretch for 15 minutes (this is in addition to my usual workout routine). The rock bottom squats with perfect form are teaching my knees the correct groove. The trick to them is foot spacing. My feet are directly under the pelvis (so heels are about 5 inches apart) and toes are almost directly straight. I'm re-learning the muscle activation correctly and this is probably why I went wrong before because I used to use a shoulder width, toes at 45 degree stance. If I have undue soreness (more than a little) then I take a moderate amount of ibuprophen (400-600mg/day).

 

[coolcolj]

incomplete recovery for your current work capacity me thinks

 

[anthrax]

I'll try to reduce the volume and stretch more then

Musketeer, you're saying that a wider than shoulder stance (like PLer's) and feet in V is no good fore the knee's health?

Thanks!

 

[Gymgurl]

Hey Radar told me to use this stuff called Stopain on my knee and it helped a ton! I bought it at Walgreens and applied it and then wrapped my knee.

 

[musketeer]

My oesteopath and my physio agree! Feet should be directly under the pelvis so that the leg bones are straight up and down like columns. First time my physio told me this I laughed and said no way - I couldn't squat like that! It takes a while to retrain the muscles, but with lots of stretching they change quicker. It has something to do with the way the quads stretch over the patella and they way they pull on it if your legs are not straight.

 

[ridethesnake]

First, if I'm hijacking this thread, please ignore, don't want to be rude. But . . .

Muskateer: What stretches do you do and when do you do them? I stretch before I squat (after 10 min. on the ellyptical and about 20-30 body weight squats). Any advice?

 

[musketeer]

First, if I'm hijacking this thread, please ignore, don't want to be rude. But . . .

Muskateer: What stretches do you do and when do you do them? I stretch before I squat (after 10 min. on the ellyptical and about 20-30 body weight squats). Any advice?

I will answer you... I'm going to do it later and I'll put it in the training vault.

 

[JKurz1]

how do you train your lower body?

 

[gotmilk]

Sometimes, you create a situation where the patella bone no longer slides thru the trochlear groove properly. Even healthy knees can develop this problem. You eventually create a situation where your patella bone continuously grinds the cartilage that creates the trochlear groove.

Basically...you grind a wider groove that the patella passes thru as you flex and contract your knee joint. Pain can develop from the constant grinding, which creates a subtle inflammation of the knee joint.

Any changes in stance (changing the degree of range of motion) will not help because your bone still glides thru the groove.

Try a very low weight with high reps. See if the pain subsides while working out with less weight.

 

[kiosk]

I have patellar tendonitis in BOTH knes. This tells me that what it was doing wrong and not an accute injusry that got worse (which would have manefestied itself in just one knee). I have since reduced the volume of leg training and utilised a comprehensive stretching routine focussed on my lower body and spine. My knees are recovering ahead of the medical professional's schedule - probably because I'm doing everything I can to get better whereas the 'normal' population only do the bare minimum. If you can squat with very light weight, then do it because it will help. Once a week I do 20 sets of 20 squats with bodyweight, and then I stretch for 15 minutes (this is in addition to my usual workout routine). The rock bottom squats with perfect form are teaching my knees the correct groove. The trick to them is foot spacing. My feet are directly under the pelvis (so heels are about 5 inches apart) and toes are almost directly straight. I'm re-learning the muscle activation correctly and this is probably why I went wrong before because I used to use a shoulder width, toes at 45 degree stance. If I have undue soreness (more than a little) then I take a moderate amount of ibuprophen (400-600mg/day).

20 sets of 20 reps each?? dam, even with BD weight only that would thrash me......I have knee problems also, although never injured them they hurt after I sit down for a while, they also make crackin noises when i flex the knee.
I stopped doing squats because my form was a wreck, knees way beyond the toes wasnt a good thing. I am working on getting more flexible and also treating the knee pain with trigger point thereapy...

 

[anthrax]

The pain increases with the weight but even while warming up with an empty bar I feel that there's something wrong

As for my lower body movements the past 12 months:
Ass to the grass back/front squats
DL
Barbell step up
Pull through
GHR
leg curls

 

[musketeer]

Any changes in stance (changing the degree of range of motion) will not help because your bone still glides thru the groove.

I'm no physio, but this is what my physio explained to me:

Changes in stance relate to the activation of the different quad muscles and is much less related to the ROM. A wide stance involves too much adductors and vastus medialis. Somehow the patella is pulled out of line as one set of muscles gets stronger (or tighter) than another.

 

[gotmilk]

Changes in stance relate to the activation of the different quad muscles and is much less related to the ROM.

Only in ball and joint sockets (hip and shoulder) can you change the angles without causing a problem with the way the joint glides thru the range of motion. This is why you can change grips on biceps curls or dumbbell presses and still have a fluid range of motion.

In knees, you have a joint that only moves north and south. Imagine a train that moves up and down a track. Now imagine that same train being pulled abnormally towards a side.

The trochlear groove allows the knee cap to fluidly move north and south, but as one changes stance (wider), you create an abnormal torque on the joint. It takes a lot of pressure to do so, but with weight lifting, repetitive motion thru the plane (range of motion) creates "friction" at the joint....or in the case of the knee, the knee cap begins to slide out of groove. It's this "friction" that leads to a grinding of the cartilage.

A wide stance involves too much adductors and vastus medialis. Somehow the patella is pulled out of line as one set of muscles gets stronger (or tighter) than another.

In a healthy knee joint, you can vary your stance and not worry about changing the range of motion. With patellar tendonitis, you already have inflammation of the joint, which in turn becomes further inflammed as you create abnormal torque on the joint.

 

[musketeer]

So GotMilk,

are you confirming the narrow stance with toes forward as the correct stance to use?

 

[gotmilk]

So GotMilk,

are you confirming the narrow stance with toes forward as the correct stance to use?

For heavy squats, yes.

But as you change the stance by widening your legs, it would be healthier on the knee joint to reduce weight. You can widen your stance, but people with previous knee injuries should avoid doing so.