T Nation

Knee Popping Around 90 Degrees


#1

My left knee seems to have tracking issues when it bends more than about 90 degrees. I can squat to just above parallel without issue, but when I hit parallel or below, something seems to shift laterally, and then pops back (sometimes with sharp, stabbing pain) when the knee is straightened.

I first started noticing this when doing high bar back squats, and when I tried using raised heel olympic lifting shoes, I started getting the stabbing pain on straightening.

I thought this may be based around an imbalance between the quads and the hamstrings and glutes (based on plenty of squatting, but minimal pulling), so I spent several months focused on quad and glute work only, without the knee hitting that 90 degree point. However, this hasn't made the issue go away when I try to squat. (I haven't squatted as part of my programming for several months now.)

What things should I try in order to "fix" this issue? I don't have much understanding of what's going on.

Would I be well served to spend a period of time working on weighted step ups or bulgarian split squats, or would I be better off just heading to sports medicine or something immediately?


#2

That kind of pain, I have only ever had when my ITB or adductors were especially tight. I’d suggest foam rolling a lot, doing some glute med activation work, etc.


#3

You’re on the right track re: correcting an imbalance.
There are several possibilities for imbalance within the anterior chain, and although it was probably a good idea to focus on glute + hamstring dominant exercises for a while if you had been squatting much more often previously, to optimize patellar tracking you’ll want to target some other tissues as well.
The IT band attaches to the kneecap through the lateral retinaculum, and that’s how a tight IT band influences patellar tracking during knee flexion. Foam rolling is a start, and you can find IT band stretches on the internet as well.

At the point in knee flexion range where you’re describing pain, the tissues behind the kneecap are under the greatest compression that they experience. You might benefit from quad stretching.
Although compound, multi-joint closed-chain exercises are the most effective for developing strength, if you have an imbalance you might benefit from open chain knee extension for VMO facilitation. You could add in a few sets on the knee extension machine and see if that helps.


#4

All right, so I did a bit of reading around.

When you say foam rolling, in this case, are you meaning along the IT band and/or TFL?

I found some IT band stretches that I’ll be giving a go.

For Glute Med activation, something like side lying clams (or their variations)?


#5

Since the only thing I have ever experienced that sounds like that is a torn meniscus I think you should have it imaged. I’m not a doctor, an expert, a trainer, etc. Just an engineer with a torn meniscus…


#6

[quote]LoRez wrote:
All right, so I did a bit of reading around.

When you say foam rolling, in this case, are you meaning along the IT band and/or TFL?

I found some IT band stretches that I’ll be giving a go.

For Glute Med activation, something like side lying clams (or their variations)?[/quote]

Foam rolling the IT band, TFL, and glute med. And your adductors (muscles of the groin). GLute med stuff could involve, lying clams, lying side leg raises, double and single leg glute bridges, band walks, etc.


#7

Just wanted to pop back in here to say thanks.


#8

Things going better?


#9

[quote]nkklllll wrote:
Things going better?[/quote]

Somewhat. I’m slacking on rolling my IT band, because it’s just so painful, but the glute med work is helping.

I’ve been working on overhead squats too, and that seems to have helped me iron out some issues as far as movement patterns. I apparently was doing some stuff that loaded the knees more than necessary; not sure whether that was happening with the hips, knees or ankles, but my body seems to be figuring it out.