Some Stretch I'm Missing?

Learned a lot from reading/searching this site since finding it last summer. Started O-style lifting in Aug05. Initially had lots of joint pain. Found a lot of info here and elsewhere to get me past that joint pain. I’ve recently started using knee wraps which have helped a lot, too. I’m 48 and female.

My question is about a pain just above my knee that starts up later in the day I lift, when I’m sitting. For example, if I’m driving around after lifting that morning, the pain starts after about 30-45 minutes of driving. If I shift my legs so they point straight forward from my hips, the pain eases up and mostly goes away. If I let my legs “flop” apart a bit, the pain starts back up.

Is this caused by some stretch I’m not doing that I should be doing? I do quad/ham stretches after warming up and between the first couple of sets of warm-up bw squats. Warmup is about 20 minutes including rowing, stretching and bw squats. My workouts last an hour after warmup and include some of: squats, snatch, C&J, shrugs, OHS, good mornings, dl and pullups. I’ve worked my way up to snatch (35kg) and C&J (45kg).

Any suggestions for what causes and how to fix this problem?

Thank you for all the great information sharing!

I cant drive in my car for more than half an hr without stoppin and walkin around either or my leg goes numb. Id try external rotation and internal rotation, and also abduction and adduction of the hip and see if one of those seems limited in ROM on one or both sides.

You might want to ask Mike Robertson on his thread in the “Author’s Locker Room.” He’s written several articles on stretching and anatomy, and I’ll bet he’d be happy to help you out.

It is tough to give you an accurate opinion of what you may be dealing with, but I will give it my best shot. First off answer these questions to give me more to work with

  1. Do you have pain going up or down stairs
  2. Do you have any associated sounds when bending your knee into flexion? (ie, popping, grating and or grinding)
  3. Does it ever feel like it “catches” or wants to “lock”?
  4. Do you have “knock-knees” or are you “bow-legged” (Check in a full length mirror)
  5. Do you have relatively wide hips as compared to your knees?
  6. Is the pain sharp, shooting, dull,or achy?
  7. Do you only have pain when you sit with your knees bent for a long period of time?

Answer these and I will be able to give you more info.

Alright I will take a stab in the dark at what you might be dealing with.

It sounds as if you mave have developed “quadriceps tendonitis”. The four quad muscles form a common tendon immediatley above the patella (knee cap). The patella is within the tendon. The tendon then becomes the patella tendon, which inserts on the front of your tibia (the big shin bone). Tendonitis is the “inflammation of a tendon”. This inflammation is often due to overuse (ie. too much repetitive activites such as running and or weight-lifting)
This can generally be corrected by a full lower extremity flexibility program that includes stretching the hip flexors, hamstrings, piriformis, IT Band, gastrocnemius and soleus muscles. You can also take anti-inflammatories such as Aleve, motrin, advil or any generic ibuprofen (3-200mg tables 3 times a day is what I recommend to my athletes.)

The other condition you may have is chondromalcia patella aka anterior knee pain and patellofemoral pain syndrome. There is a layer of cartilage that lines the backside of the patella. The purpose of this cartilage is so that the patella slides smoothly over the groove at the end of the femur. As we age, this cartilage can soften and can begin to deterioate. This can create pain under the patella and in the back of the knee joint. This condition is more common in women due to having wider hips. You can google “Quadriceps angle” and get a explanation (I don’t feel like writing that much). This condition can progress and get worse if not treated properly. It can be treated with ice, stretching (one’s mentioned earlier), and Vastus Medialis Oblique strengthening and anti-inflammatory medications.

If these sound familiar to what you are experiencing Google “Quadriceps or Patella tendonitis” and “Chondromalacia Patella” to get more in-depth explanations.

I am sure I have bored you by now, but I hope that helps you!!

obatiger11, that was probably the most helpful post I’ve ever seen. props man

[quote]obatiger11 wrote:

  1. Do you have pain going up or down stairs[/quote]

bic: yes on the day of lifting decreasing to none the day after.

[quote]
2. Do you have any associated sounds when bending your knee into flexion? (ie, popping, grating and or grinding)[/quote]

bic: no

[quote]
3. Does it ever feel like it “catches” or wants to “lock”?[/quote]

bic: no

[quote]
4. Do you have “knock-knees” or are you “bow-legged” (Check in a full length mirror)[/quote]

bic: Slightly knock-kneed if either.

[quote]
5. Do you have relatively wide hips as compared to your knees?[/quote]

bic: hmmm, I’m female…probably. One of the earlier things I tried that seemed to help some was/is to use a wider stance.

[quote]
6. Is the pain sharp, shooting, dull,or achy?[/quote]

bic: Sharp

[quote]
7. Do you only have pain when you sit with your knees bent for a long period of time?[/quote]

bic: Yes, but pulling knees together while sitting significantly relieves the pain. Walking around is no problem.

[quote]
Answer these and I will be able to give you more info.

This can create pain under the patella and in the back of the knee joint. This condition is more common in women due to having wider hips. [/quote]

bic: Sometimes, with ATG squats there is pain behind my right knee. More stretching of hams w/ unweighted squats to warm up more “fixes” this pain for that session.

[quote] I am sure I have bored you by now, but I hope that helps you!! [/quote] bic: Thank you so much, obatiger11, for taking the time to answer so thoroughly. This helps me with the names of things to google and an idea of what to try re: stretching. I'd already planned on giving the knees a break next week so I'll try warming up and stretching as you suggest with no leg work beyond walking.

Yikes!

While following up on obatiger11’s advice I found myself on Elitefts.com. An article on “Antibiotics can cause muscle tears!” caught my eye as I’ve been taking Levaquin for about a month. Levaquin is a quinolone and is specifically named in this article as contributing to muscle and tendon tears. It says “if you are active in your 40’s or 50’s or whatever, it will come after you.”

Here’s the article:
www.elitefts.com/documents/antibioticscausetears.htm

I’m going to add this article’s recommendations of “take around five grams a day of glucosamine sulfate and chondrotin sulfate to counter the effects” to the recommendations of obatiger11.

With the advice I had been following, I thought I had this problem beat but the last week or two, it got much worse again. I didn’t correlate the worsening with the start of the quinolone. Thank you again, obatiger11, for showing me the path for follow-up.

Based on your answers to those questions, my guesses would be either tendinitis or a torn meniscus, depending on how sharp the pain is and exactly when and how it sets in when exercising. How you described the pain coming on while stationary sitting for a while would likely indicate tendinitis. An ART practicioner will work wonders for you if this is the case. If indeed a meniscal tear exists, be prepared to either live with it or go under the knife.

At any rate, have you seen a doctor or gotten x-rays!? I know we’re all smart and stuff, but I’d still go check it out with an M.D.

Just looking at your answers. I feel it is safe to say that you have begun to develop quadriceps tendonitis. This may be secondary to the use of the medication you are taking or could simply be due to trying to do too much in the weight room.
I would definitely go with the stretches. Tendonitis can be very pesky to get rid of so don’t expect any drastic changes immediately.

Make sure you are going through a very thorough warm up consiting of maybe 2 minutes of light jogging or walking followed by some dynamic flexibility exercises before you begin your workout. Save the static stretches for after your workout, later in the day (after your workout) and on your day’s off.

I beleive it is safe to say that at this point you have not torn any fibers of the quadriceps tendon. If you had, you would have a constant pain that would not go away and working out would be very painful.

Chronic tendonitis that goes untreated can lead to tendon ruptures which gets you a date with the surgeon and his scalpel.

I am not familiar with that medication, so I would not be justified in giving any feedback as to it’s side effects. Is this antibiotic something you are having to take long term or short term?

So again, stretch 2-3’s per day, take anti-inflammatories, lighten your weight or volume in the weight room, and see how the knee responds.

If it gets worse over the next 2 weeks, I would look into seeing an Ortho and maybe he can write you a script to get some Physical Therapy.

In all honesty, an Ortho won’t be able to do much for you for tendonitis. He can do an X-ray (which won’t tell you anything about any soft tissue damage) and possibly an MRI (which will give you an image of the soft tissue and anything that might be going on with the quad tendon), but he can write you a script for PT. I don’t know how it works in other states but in SC you have to have a script from a Dr. before you can be seen by a Physical Therapist. That may be different in your state.

A Physical Therapist or Certified Athletic Trainer will be able to perform Ultrasound treatments (different than the one’s pregnant ladies get) and/or other modalites which will help to rid you of this problem.

Good Luck!!!

Darn. I’m planning on attending my first meet mid-March. I’ve been doing the O-lifts on M, F and added a W of just upper body over the last month.

So…
I row for a bit until I just break a sweat. Keep using the knee wraps.

I drop the static stretches before lifting for dynamic stretching per:
http://www.T-Nation.com/readTopic.do?id=495189 Move the static stretches to after lifting.

After lifting, ice the front and back of each knee area a couple times during the day.

Between lifting days, I walk around for 2-3 minutes to warm up and repeat the dynamic stretching several times a day.

I’ll add Body Ammo Joint Connection to offset the quinolone. (I’m already taking EFA). Take ibuprofen as needed.

I’ll see how I feel after 2 weeks of this new approach.

I change my goal for the meet from snatch(40kg) and C&J(50kg) to maintaining 35/45, respectively.

Thank you!