Knee pain, squats safe?

[Ad Fortitudo]

A quick history:

Age: early 30s
Training: Some dumbbell lifting in the past, not much barbell
- Lots of jogging for about 15 years

Issue: Pain in left knee, gets worse when I run. Possibly caused by jogging itself.


I've done some weightlifting over the last 5-10 years, but I've never really done a true weightlifting program. I just began doing Starting Strength and I'm now learning barbell lifts. The problem is that after years of jogging, I have some knee pain in my left knee (and it's really aggravated by jogging now, so I don't run at all). My knees also "crackle" a little when I walk up and down stairs.

I asked my primary care doctor to take a listen, and he said that it wasn't arthritis. Sadly, I can't remember exactly what he diagnosed it as, but he told me that the problem was likely caused by weak quad strength relative to hamstring strength and suggested that I "do leg extensions" a few times a week.

I've been doing the leg extensions, but want to start adding in squats, since they're integral to Rippetoe's program.

That said, I still have some knee pain and it became more pronounced after I tried a set of light squats last week.

QUESTION: Are squats safe? Is there anything I should be doing? Should I get an opinion of a sports medicine doc?

[jonesBones40]

Expert opinion wouldn't hurt just use clean form and lesser weight. Don't flare the knees either

[asooneyeonig]

yes get the opinion of a sports medicine doctor to determine what exactly is the cause for the knee pain.

many times squats can help to ease pain and strengthen the knees so there is hope.

[Rodja]

Expert opinion wouldn't hurt just use clean form and lesser weight. Don't flare the knees either

No, you will want to flare the knees to reduce the flexion of the joint and to put more of the weight on the hips.

[Ad Fortitudo]

Thanks for the comments.

I'll try to go to a sports medicine doc.

In the meantime, should I hold off on squats?

[MichaelMurphy]

Absolutely get a professional opinion. I would stick to Leg press until you speak to them, but if you are dead set on squatting, try and work your way down to parallel. Only go as far as you can without any pain and begin to work your way lower with each session in the gym.

[Rodja]

Absolutely get a professional opinion. I would stick to Leg press until you speak to them, but if you are dead set on squatting, try and work your way down to parallel. Only go as far as you can without any pain and begin to work your way lower with each session in the gym.

Leg press would be a bad idea since it is a fixed plane of motion. Going off of common knee injuries and squat technique, most will do the Olympic style where you break at the knee and have a moderate stance. In your situation, it would be advantageous to learn the powerlifting style of side squat where you break at the hip first to reduce the torque and load on the knee joint.

[NYiron]

Where exactly is the pain? Is it pin point or wide spread? Is it tender to touch? Any swelling or reduced range of motion? What activities outside of squats or running cause discomfort? Any reference from the main area? There are so many questions to better help us understand what's going on, those just scratching the surface.

My initial thought process on whats going on would be IT band syndrome or runners knee based on the MOI you have described. This is purely a guess based on the little info you have given. Regardless, I highly recommend you seek professional care.

http://www.emedicinehealth.com/iliot...article_em.htm

With that said, I would shy away from anything that causes pain and definitely drop the leg extensions from your program. Even when the knee is healthy the biomechanics involved with a leg extension raise areas of concern with regards to joint health and integrity. If you must keep them focus just on TKE and keep them light. I too, personally would avoid the leg press but there are opinions that go both ways as with anything.

[Luke_PNI]

Get it checked out man, i had the same thing and kept training and just during a warm up squat my knee went out on me and had to have surgery. train smart/be smart.

[Ad Fortitudo]

Where exactly is the pain? Is it pin point or wide spread? Is it tender to touch? Any swelling or reduced range of motion? What activities outside of squats or running cause discomfort? Any reference from the main area? There are so many questions to better help us understand what's going on, those just scratching the surface.

My initial thought process on whats going on would be IT band syndrome or runners knee based on the MOI you have described. This is purely a guess based on the little info you have given. Regardless, I highly recommend you seek professional care.


With that said, I would shy away from anything that causes pain and definitely drop the leg extensions from your program. Even when the knee is healthy the biomechanics involved with a leg extension raise areas of concern with regards to joint health and integrity. If you must keep them focus just on TKE and keep them light. I too, personally would avoid the leg press but there are opinions that go both ways as with anything.

Good questions...

Localization: The best I can localize it is that it's towards the front of my knee, on the inside. It doesn't feel like kneecap pain so much .... it feels as if the pain is "inside" if that makes sense. I don't have any pain on either side of the knee, or the back.

Timing: It's not constant. I'm almost certain to have a problem if I go jogging (pain for a couple of days). When it's a problem, the pain is most pronounced when I step on my left leg. But, if I sit down and extend my leg, I get no pain. It got particularly bad this last summer for about 4 days after I did a "mud race" for a charity. During the race, I really pushed myself and did great for about 2 miles. After that though, the pain started up and got bad enough that I sort of walked with a limp for the few days after.

Squats and leg presses give me a little of that pain, but they aren't nearly as bad as jogging. Just enough trouble from squats to make me wonder if I should get it checked out.

[jimbuick]

Sounds like patella femoral pain syndrome. I have the same problem and what has helped me is fixing my running technique, foam rolling all the muscles of the leg, and doing powerlifting technique on squats as opposed to the Olympic style.

The pain sounds like its in the same spot as mine and since I've spent some time doing these things I have not had as many problems as I was having previously.

[Ad Fortitudo]

Leg press would be a bad idea since it is a fixed plane of motion. Going off of common knee injuries and squat technique, most will do the Olympic style where you break at the knee and have a moderate stance. In your situation, it would be advantageous to learn the powerlifting style of side squat where you break at the hip first to reduce the torque and load on the knee joint.

Thanks for your comments....

Are there any good ways to find accredited powerlifting trainers or someone who's likely to know what they're doing?

I go to a local gym (local small-business gym) where a lot of powerlifters hang out, but I'm not sure about the personal trainers there.

I've searched for coaches in Mark Rippetoe's Starting Strength coach directory and there's someone about 80 miles from me. Other than that, there's a few big box gyms and crossfit boxes, but no serious powerlifting coaches that I can find.

[Jawbreaker24]

Leg extensions, they build quads up they will act like shock absorbers for your knees, but always seek professional medical advice. Good luck.


"Victory is Reserved for those willing to pay its price"

~Unknown~

[Inarius]

Thanks for your comments....

Are there any good ways to find accredited powerlifting trainers or someone who's likely to know what they're doing?

I go to a local gym (just a mom-and-pop place) where a lot of powerlifters hang out, but I'm not sure about the personal trainers there.

I've searched for coaches in Mark Rippetoe's Starting Strength coach directory and there's someone about 80 miles from me. Other than that, there's a few big box gyms and crossfit boxes, but no serious powerlifting coaches that I can find.

You can always ask someone for help or look online. There are plenty of videos and articles at elitefts.com that talk about how the squat should be performed. I too had some knee pain in the past. I would go see a sports medicine specialist but in the mean time, you can work on your squat form with light weight to get the motion down. You can also look into picking up a joint product like Joint Mechanic by MST (I'm currently logging it now and I am enjoying it) or any other product. I've used Animal Flex, SuperCissus, and Jointment Sport in the past.

One last thing... Before and during each workout I wear Tommy Kono Knee bands to keep my knees warm and supported. I really enjoy them and my knee pain has been minimal since using them for every squat session. They are cheap and work wonders. I put them on about 5-10 minutes before my squat session to get my knees warmed up.

[NYiron]

Good questions...

Localization: The best I can localize it is that it's towards the front of my knee, on the inside. It doesn't feel like kneecap pain so much .... it feels as if the pain is "inside" if that makes sense. I don't have any pain on either side of the knee, or the back.

Timing: It's not constant. I'm almost certain to have a problem if I go jogging (pain for a couple of days). When it's a problem, the pain is most pronounced when I step on my left leg. But, if I sit down and extend my leg, I get no pain. It got particularly bad this last summer for about 4 days after I did a "mud race" for a charity. During the race, I really pushed myself and did great for about 2 miles. After that though, the pain started up and got bad enough that I sort of walked with a limp for the few days after.

Squats and leg presses give me a little of that pain, but they aren't nearly as bad as jogging. Just enough trouble from squats to make me wonder if I should get it checked out.

It makes a lot of sense. That is a crucial bit of information. Have you ever had your patella tracking evaluated? If not i suggest you bring that up when you have it examined, and do not settle for a brace look into proper PT to augment any treatment prescribed.

If the pain you are having is anterior and centered and feels deep this could be a potential contributing issue. Coupled with the chronic forces associated with jogging a patella that isn't tracking correctly will be subject to increased wear and a variety of problems may ensue. It seems the doc you had seen alluded to a muscular imbalance. That is something I would continue to look into, specifically in the quads, as that could be cause for the tracking of a patella to be off and the source of your signs and symptoms.

http://www.emedicinehealth.com/patel...h/page3_em.htm

[Rodja]

Leg extensions, they build quads up they will act like shock absorbers for your knees, but always seek professional medical advice. Good luck. "Victory is Reserved for those willing to pay its price" ~Unknown~

NO!!! Leg extensions will place unnecessary torque on the knee due to the angle created by the apparatus. OP, what kind of shoes do you wear while training? The type of footwear used makes a huge difference.

[NYiron]

NO!!! Leg extensions will place unnecessary torque on the knee due to the angle created by the apparatus. OP, what kind of shoes do you wear while training? The type of footwear used makes a huge difference.

And the biomechanics of a distally loaded knee joint during extension.

[Ad Fortitudo]

It makes a lot of sense. That is a crucial bit of information. Have you ever had your patella tracking evaluated? If not i suggest you bring that up when you have it examined, and do not settle for a brace look into proper PT to augment any treatment prescribed.

If the pain you are having is anterior and centered and feels deep this could be a potential contributing issue. Coupled with the chronic forces associated with jogging a patella that isn't tracking correctly will be subject to increased wear and a variety of problems may ensue. It seems the doc you had seen alluded to a muscular imbalance. That is something I would continue to look into, specifically in the quads, as that could be cause for the tracking of a patella to be off and the source of your signs and symptoms.

Awesome..... I'll be sure to bring up patella tracking once I get an appointment with a proper sports medicine doc. Thanks man.

[Ad Fortitudo]

NO!!! Leg extensions will place unnecessary torque on the knee due to the angle created by the apparatus. OP, what kind of shoes do you wear while training? The type of footwear used makes a huge difference.

I deadlift barefoot, but for everything else (standing press, Pendlay rows, and the squats I tried last week) I wear a pair of Puma Speed Cats.

Should I get a pair of weightlifting shoes for the squats? Anything in particular I should look for?




Also, note that when I used to run, I wore a pair of shoes that were supposed to be best for people with my type of gait (overpronation) though I probably didn't replace them as often as I should have. That might have contributed.

[NYiron]

Awesome..... I'll be sure to bring up patella tracking once I get an appointment with a proper sports medicine doc. Thanks man.

No problem hope everything goes well. Keep us updated.