T Nation

Knee Pain

I’m going to be 40 next month and have been lifting for 25 years. In the last year or so my knees have been hurting a lot after leg days. The pain is in my kneecaps. Right on the front part of my kneecaps. It gets to the point where I can’t sit for more than 10 minutes without having to get up and stretch etc. and hard to walk in the morning.

The exercises I mainly do are rock bottom squats, lunges w/ weight while moving across the room, and one-leg leg presses. I can also do one-legged squats.

I would put up with the pain if I knew I wasn’t doing damage to my knees. Who I am going to ask? A doctor? They’ll just tell me to stop using weights. I managed to get through football, rugby, and wrestling without any knee injuries so now I am, like, what the fuck?

Aside from losing strength, size and muscularity from not doing these exercises, I would really miss doing them because I like doing them!

Any suggestions? thanks!

[quote]1BADMF wrote:
Any suggestions?[/quote]

Well, just off the top of the head, stop doing so much quad work! You didn’t mention any posterior chain work at all.

A few questions come to mind here (even though I don’t like “diagnosing” injuries over the internet):

1 - What’s your flexibility like in your quads? Your hip flexors?

2 - Do you have anterior pelvic tilt?

3 - How much posterior chain work do you implement into your programming?

4 - Is the pain just after sitting, or do you get it when you are performing the movements?

Let us know and we can hopefully narrow this down a little!

Stay strong
MR

Sounds like possible a cartilage issue. Over time and use it wears away so your cushion is gone. Do you take glucosimine or fish oil or shark cartilage supps? This might help.

When was the last time you had blood work?

My brother was recently complaining of knee pain. He went to the doctor and had some blood work.

His blood sugar was way out of whack.

See a doctor and get everything checked out.

First, thanks for all the responses. I appreciate it.

I’ll get a few of these out of the way to begin with:

  1. I do use glucosamine/chondroit., flax seed oil and fish caps. Not that many fish caps though.

  2. I had recent blood work: FBG was 95 and AIC’s were around 6%. No meds either.

  3. Very flexible. Years of martial arts.

  4. My knees only hurt a few hours after leg days and it last for about 2 days. No pain when pefroming movements.

  5. Not exactly sure about all of the “posterior chain” exercises. I did a search and I think deadlifts are the only one I do now.

  6. Am I doing too much quad work? I do 9 sets on leg days which is about every 5th or 6th day.

  7. Not sure what anterior pelvic tilt is either. I tried doing a search and didn;t come up with enough to answer that question.

Like I said before, I could deal with the pain as long as I knew I was damaging anything that will catch up with me in a few years.

Thanks again for the help.

My knee pain has always been due to slightly incorrect form, usually knees bending in with last reps is squat. Check this. Also, in shower after training simply spraying the knees with cold shower for 1 min is beneficial. Your id implies you can take it c o l d.
I’m 45.

AJH,

I’ll try the cold water on the knees. Also, I go real low on the squats until my butt is almost on the floor so I don’t know if that’s hurting them. Maybe.

It may be worth trying with Powerlifting style squat, thighs parallel with floor, for a month or so just to see if it gets better. Especially if you feel that you are sorta sitting on your heels in bottom since this may bend the kneecap open a bit. I do rockbottoms with about 60% 1RM only and I try to watch carefully that the motion is not stopped by anything but thigh muscles. It would be so easy to bounce from bottom.

I’m no expert but you could try the following:

  1. Read Ian King’s article “End Needless Knee Pain” which is excellent. Bascially, you may need to address tissus lenth/tension especially in the hip flexors, quads and iliotibial band.

  2. I’d also agree with the recommendation to squat with more of a powerlifting style (feet wide, more flexion at the hip). Not only does it seem to stress the knees less (as its less quad dominant) but you will probably be able to shift more weight!

Good luck.

BADMF
For more on diagnosing anterior pelvic tilt check out the No More Neaderthal series (Robertson & Cressy). It is complete with pics to compare yourself to.

That series has a good suggestion for adressing many of the common trainee imbalances, which can be a big factor in knee pain. I’d pay particular attention to the glute activivation suggestions. Robertson also has an article “Get your butt in gear” that focues on the posterior chain.

If it seems like that is where you want to focus, some additional movements to consider (in addition to deads) are good mornings, glute ham raises, reverse hypers, rdl’s and pull throughs. I’d organize a program to have a 2-3:1 ratio (posterior chain: quads) for volume as a specialization.

I found pain relief in my own old knees from just such an approach.
Best of Luck,
old dogg.

I’m 53 and had similar symptoms with my knees. I was squatting 5 sets of 5, 3 sets of cybex machine squats & leg press all in one workout plus deads on back day. I bought a pair of knee supports (Trufit brandname) which really help keep my knees warm (plus I wrap them). I cut back to squatting 3 sets of 8 for 4 weeks and my knees feel great. I remember Lee Haney always used these knee sleeves and he claims he never had knee problems.

Food for thought brother.

Rick

Now if only I do the same for my elbows…

Hi there,
New to site…
I can relate to your post…
I began lifting weights at age 16, so 23 years off and on… about 15 years serious…

Few months ago, I started hearing my knees creakin’ like an old door… when I climbed “up stairs”. Started with just the noise… but now, beginning to feel some minimal sharp pain just under the kneecap… especially after leg presses (not squats). Now, I’m not a fan of going ass to grass on squats, just to parallel or slightly below… I did some research and it sounds like what is called: Petello-Femoral Syndrome… very common for athletic guys in our age group…

I haven’t taken any supplements yet, but willing to try Glucosamine/Chondroitin… Heard good results with “deer velvet” as well…

A pysio that I train with said that it’s a matter of leg muscle imbalances…their pulling the joint out of alignment… and best remedied by specific stretching exercises and by utilizing bracing/taping. Also, RICE.

Gonna try to stretch more… and use the Glucosamine… and wait and see… before going into see the physio.

Attached URL to assist.

http://www.semisportmed.com/Article/200309-1.htm

Good Luck…

-Hiero

[quote]1BADMF wrote:
I’m going to be 40 next month and have been lifting for 25 years. In the last year or so my knees have been hurting a lot after leg days. The pain is in my kneecaps. Right on the front part of my kneecaps. It gets to the point where I can’t sit for more than 10 minutes without having to get up and stretch etc. and hard to walk in the morning.

The exercises I mainly do are rock bottom squats, lunges w/ weight while moving across the room, and one-leg leg presses. I can also do one-legged squats.

I would put up with the pain if I knew I wasn’t doing damage to my knees. Who I am going to ask? A doctor? They’ll just tell me to stop using weights. I managed to get through football, rugby, and wrestling without any knee injuries so now I am, like, what the fuck?

Aside from losing strength, size and muscularity from not doing these exercises, I would really miss doing them because I like doing them!

Any suggestions? thanks! [/quote]