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As suggested to me in my Training Log, I am copying some info on knee pain I am experiencing. Any suggestions would be appreciated.
Quote:
The left knee pain I mentioned last week returned halfway through the first set of Squats. It was pretty severe, so I scrapped the rest of the workout.
The pain is just above the left kneecap. It only hurts when my knee is close to 90 degrees and I start to push up. Could this be a muscle weakness in the upper leg?
I searched the forums and came across this drop squat program. I am going to give it a shot and see how the knee feels at the end of the 8 weeks.
I will continue with the exercises in the Break In program except for the lower body. My main goal now is to get the knee pain-free.
I just saw an ART specialist for this exact problem and it turns out that the problem is my squat/lunge form. Knees were going WAY too far out in front of my toes. It was creating an enormous amount of sheer force on my knees and was painful.
We're working on firing the glutes better so that I'm not coming so far forward.
Julie, I don't have access to anyone that would know proper form. I lift at home by myself.
I could probably shoot some video and post it for evaluation. If my lifting form is anywhere close to my posture, then that is most definitely my problem.
Julie, I don't have access to anyone that would know proper form. I lift at home by myself.
I could probably shoot some video and post it for evaluation. If my lifting form is anywhere close to my posture, then that is most definitely my problem.
That is a good idea ... and you might want to post it in the Training forum as there are many folks there who will give you solid advice and they don't necessarily check the injury forum ...
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No offense intended to anyone, but I just want to clarify what everyone's talking about here, because I have a suspicion of some possible mis-education/mis-understanding.
Shear forces are translational forces. They occur when force is applied in the transverse plane. This is in contrast with axial forces where are in the longitudinal axis. Most commonly, we talk about shear forces when we talk about cartilage, but rarely about tendons or ligaments--especially in the context of knee pain.
So the questions are, why do you or your therapist think:
a) that there are increased shear forces when you have "overgoing" knees in a lunge, and
b) that this alleged shear forces causes pain?
c) and also, which structures are you or your therapist thinking of in terms of the tissue structures that are causing your pain?
I'm just trying to ascertain where this breaks down, if it does, because of all the reasons I've heard not to "go over the toes" in a lunge, I haven't heard this one yet.
I'm not saying that the recommendation is necessarily wrong, but that if you're applying a rehab principle about an underlying issue to create a rehab strategy or recommendation, that having the wrong rehab principle MAY result in creating a rehab strategy that won't actually produce the result you're looking for.
Brian, you can poke holes in plastic name holders like a champ, but when you try to poke holes via the forum you have to use english. I have absolutely NO idea what you said.
Bryan, I suspect that what that therapist meant was compressive forces through the patellofemoral joint ... for some reason, many therapists use improper terminology when translating medical terminology into laymans terms.
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Life's a Journey ... Enjoy the Ride!
I was wondering if that was what he/she meant. But I'm not aware that the compressive force increases by that much with "overgoing" knees. It has always been one of those "theoretical" risks (we initially had the precaution in our PFPS rehab protocol for our study, but then after much debate amongst ourselves, couldn't really justify it), but I haven't seen any good arguments to support it with respect to contact between the patella and the femur. There are other reasons for _some_ people to not go over the toes, but I'm not sure I'm convinced that PF mechanics are one of them.
--And to think I was hungover while poking holes in plastic name tag holders so effiiciently!
I was wondering if that was what he/she meant. But I'm not aware that the compressive force increases by that much with "overgoing" knees. It has always been one of those "theoretical" risks (we initially had the precaution in our PFPS rehab protocol for our study, but then after much debate amongst ourselves, couldn't really justify it), but I haven't seen any good arguments to support it with respect to contact between the patella and the femur. There are other reasons for _some_ people to not go over the toes, but I'm not sure I'm convinced that PF mechanics are one of them.
--And to think I was hungover while poking holes in plastic name tag holders so effiiciently!
I certainly agree that there is no good foundation for why many therapists and trainers teach this (avoid bringing the knees in front of the toes), but I know for me from personal experience (I had a right ACL reconstruction 14 years ago using a modified Clancy prodecure with a bone-tendon-bone patellar tendon autograft. The lateral incision in my right ITB/VL produced a tremendous amount of scar tissue, and I developed PFPS from it with abnormal mechanics of the PF joint) that if I squat or lunge with too much ankle dorsiflexion (ie letting my knee go out over my toes) that it aggravates my PFPS on the right. Whether that is due to compressive forces or if it is because that allows my glutes to be lazy and my TFL to contract to compensate, who knows. I tell my patients to do what feels comfortable, but if I am trying to get their glutes firing, I get their weight back and keep their knees behind their toes.
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Life's a Journey ... Enjoy the Ride!
Here are videos of my squat form. My left knee did not hurt during this video, but I clearly did not go down all the way. Does anyone see anything wrong (besides the empty bar )?
It depends on where the pain is coming from in your knee. Many people who have kneecap pain have some sort of patellofemoral pain syndrome, which is attributed to mal-tracking of the kneecap.
Your hips and calves are very stiff, right moreso than left (watch your right foot progressively turn out as you perform each rep).
You're also very quad dominant in your squat technique.
Bottom line is that you lack sufficient flexibility/mobility to perform a deep squat so one area that does move may end up absorbing more repetitive stress (the knee perhaps?).
My guess would be that a wide stance, hip dominant squat (performed to your current level of hip mobility) is much less painful.
Improve your hip flexion, internal rotation, stretch your quads with hip extended, and stretch your calves with both knee bent and knee straight. Follow with mobility work. Emphasize single leg work to help with right/left imbalance issues attending your mobility limitations. Use longer eccentric tempos. Try some ASTM on the patellar tendon especially prior to mobility and strength work.
You need to get in shape to get in shape.
Bill
P.S. Pain when the knee extends beyond the toes is a symptom, not a cause. Compressive forces at the patella in a deep squat is normal and we are typically well designed for that. If it's painful, it's usually a problem somewhere else.
Knee Pain - Squats/Lunges
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