Topic: hurt my knee and back squatting

[Chris [.5gibbon] Stevenson!]

first off i would like to state that my squat form is not very bad. im not mark rippetoe, but im also not doing anything terribly wrong. with that said, lately i have been trying to squat in my room, but i don't have a rack or a spotter so i just stuck to weight i could clean and jerk then squat.  also i have a very small mirror that pretty much doesn't help at all. so today i was squatting and my knees felt like they were not tracking very well even though they were so i tried re positioning a couple times and on the last set it started to feel uncomfortable and now about 4 hours later my left knee hurts just on the medial side of my patella. i can feel a structure where the pain is coming from and i think it is the medial patellar retinaculum.  also almost every time i squat or deadlift i can feel pressure in my back after im done with each set.  its just like that feeling you get when you stretch forward for a while then lay down flat and it takes a few seconds for your back to equalize, but it takes a little longer to feel normal.   im pretty pissed off right now because im squatting to get over another injury and i just ended up creating a new one.  also i don't know if i should ice my knee or not. i don't care about pain management i just want it to heal asap.

[Dr.M]

Icing your knee will help with decreasing pain, swelling, and promote increased blood flow for healing to the joint. Additionally you can ice your back for all of the same reasons. Pain typically indicates inflammation (swelling, pain, warmth, redness, etc.) that can be managed with icing. I posted an article last week and I think it is still in the forum for injuries on the proper way to ice.

For your squat it sounds like you do not have core stability when you are squatting. This results in increased pressure forward on the spine during a proper squat. A video of your squat, preferably with you talking your way through what you are thinking in the squat would be the most helpful in analyzing whether there is something wrong with your form.

For your knees, it sounds like more soft tissue restrictions and possibly weak muscles that are contributing to the patella possibly not tracking properly. This would be best assessed by a chiropractor or PT (same for your back). Remember that that tracking of the patella is controlling through the VMO (quad) and the external rotators of the hip. If your hip rotators are not the in correct position or asymmetrical, then it will influence your knee. I would recommend toeing out a little bit on your squats. That will create a safer position for the knee if it is the patella.

Get it checked out for complete answers.

[Shae Perkins]

Ah man, that is rough :/ So sorry to hear that.

Do you think over-training could be the culprit? I'm having a hard time believing that you could suffer an acute injury to your medial patella from squatting a weight you can C&J. Also didn't you say you were squatting to work around another injury? Hmm... too much squatting?

None-the-less, don't do anything that hurts. I suggest working around the pain, not through it, and if it doesn't clear up in a reasonable amount of time then see someone.

[Chris [.5gibbon] Stevenson!]

ya i would put a video up, but i dont want to squat right now i have an older video in which i do a few squats that ill link at the botton, but my form has improved a little since then. this not tracking business just happened all of the sudden today and i have never had this feeling before or this injury before. also i remember thinking my toes are point out pretty far, but knees were tracking over them just fine. for some reason it felt like i needed to point them out even more.  if i would have gone anymore my feet and groin angle would have been almost a 90 degree angle so i didn't and thats when it started hurting.    

for my back, i know my anterior core muscles are stronger than my posterior. i have been trying to strengthen my lower back with back extensions, but it gives me the same feeling as squats even though my form is fine.  a couple days ago i tried an exercise where you lay prone and lift your feet and hands off the ground and static hold for 5 seconds and repeat 3x5. i felt no pain, but i wasn't sure if it was a safe exercise because it causes you to kind of hyper extend.

[Chris [.5gibbon] Stevenson!]

although i have been squating alot lately i don't think it was an over training injury.  i think my form was just off today for some reason.  my other injury was/kinda is ITBS so i have been squating ect. to strengthen my posterior chain and it was working well until today.  also the weight i was squating was only 115, however i usually squat with 135 so i guess you could say it wasn't too light for me.

[Dr.M]

The exercise that you mentioned is a safe exercise as long as it doesn't cause you pain. Your back is meant to have extension beyond netural. Another exercise that will strengthen your back is single leg lifts while lying on your stomach. This will work more the extensors of the lower back and lower thoracic instead of all of the extensors that the exercise you described will recruit. As far as your abs being stronger than your back, it is more important for your sides to be stronger (obliques, transverse abdominis) to give proper support to your back.

If you are looking to rehab your ITB then I would look toward more single leg activities like lunges, single leg squat, single bent leg dead lift, and side stepping with resistance band around the ankles. You can also work on unstable surfaces (pillows, dyna discs, BOSU, sand, etc.) with all of those exercises to work on greater stability through ankles, knees, hips, and core. The good thing about this is that you can continue to add challenge without adding much if any weight and still gain the stability that your body needs to tolerate stress through the ITB.

If your toes were pointed out too far then that can also impact the motion of the patellofemoral joint and result in abnormal joint compression. I would try a free squat with no weight with toes straight forward and slowly work out from there to find the most comfortable position for your feet to squat without causing you pain or the weird tracking sensation.

[Chris [.5gibbon] Stevenson!]

oops i forgot the link to my squats http://www.youtube.com/watch?v=iO8yGVjkHic  im the skinnier one with tattoos.  since then i have gotten better at not rounding at the bottom and i can go a tinny bit deeper.  also i was squating with my  feet pointed out more than this so i think thats what did it.  i have been doing all kinds of stuff for my itbs some of which i got from you and some from steve and chris. that all happened about 3 or 4 months ago and now im pretty much getting back into doing what i want.   i will definitely be adding for core strengthening exercises to my workouts now.

 also i wonder if you could explain to me how ice helps speed up healing time. i was always under the impression that people use ice to constrict the blood vessels and thus reduce blood flow, swelling, and pain. that makes no sense to me as a way to speed up recovery, but you suggest ice increases blood flow.  could you please explain

[FastGuppy]

You're doing a  few things wrong. Your head is looking up when it should be looking at a spot 6 feet in front of you and the bar isn't on your scapulas. Place the bar further down on your back and make sure your grip is close. Put your thumbs over the bar and not around the bar.

On dead-lift you need to lift with your back first. think of your lats pulling on the bar and don't think of extending your hips. Your back should be more at a angle and you need to think a bit more as if you're lowering your hips down, not lifting your chest. After the legs are over your knees your hips should extend. Remember not to shrug. It's important to note for you to make sure your beginning position is correct. Your scapulas on your back should be directly over the bar. Probably the same angle as your squat.

You still have a lot of work to do.

[Chris [.5gibbon] Stevenson!]

ya i have since fixed my head position, but i can not bring myself to do low bar placement for two reasons. first i don't have the best shoulder flexibility (im working on it) and second the thought of leaning forward anymore than i do scares my back.   but for the deadlift that makes a lot of sense i will try this when i heal up.  i have already changed my deadlift a ton since then, but this just put what i was moving toword into words. thanks alot!  and yes im am not under the impression that i am anywhere close to good.

[Steven Low]

Box squats...

front view sucks btw

[Chris [.5gibbon] Stevenson!]

could you be a little more descriptive?

[Steven Low]

Box squatting is the way to make sure you're squatting righr

[Dr.M]

From watching the videos, both of you are snapping your knees back with squatting and dead lifting. This puts increased pressure over the knees and means that you are lifting with your quads and not as effectively with your gluteals (primary mover for squats and deadlifts). You are also rounding your back at the bottom of the deep squats and from the starting position of the deadlift, and you core looks shaky at the bottom of the squat. The shaky core isn't necessarily bad form, but it is risking damage to your lumbar spine. I personally don't like heavy straight leg deadlifts because of the stress that it puts on your back and puts increased pressure on your hamstrings (not bad just information). The rounding of your back at the bottom of both the deadlift and the squats is putting a lot of unnecessary stress on your lower back. If you can't perform the exercise while maintaining lumbar spine position you should change the depth of the exercise or for the dead lifts, raise the starting position of the weights.

[FastGuppy]

From watching the videos, both of you are snapping your knees back with squatting and dead lifting. This puts increased pressure over the knees and means that you are lifting with your quads and not as effectively with your gluteals (primary mover for squats and deadlifts). You are also rounding your back at the bottom of the deep squats and from the starting position of the deadlift, and you core looks shaky at the bottom of the squat. The shaky core isn't necessarily bad form, but it is risking damage to your lumbar spine. I personally don't like heavy straight leg deadlifts because of the stress that it puts on your back and puts increased pressure on your hamstrings (not bad just information). The rounding of your back at the bottom of both the deadlift and the squats is putting a lot of unnecessary stress on your lower back. If you can't perform the exercise while maintaining lumbar spine position you should change the depth of the exercise or for the dead lifts, raise the starting position of the weights.

When you say snapping your knees back do you mean sliding your knees forward. For the most part they were good. As for the rounding of the back, they were pretty good as well. I didn't see much shakiness or rounding of the lumbar spine either.

[Dr.M]

What I meant by the knees snapping at the top was that the knees were locking straight forcefully at the top of the movement. This means that the knees became the primary mover instead of the gluteals. This puts increased stress through the patellofemoral joint. The rounding of the spine and core shakiness were subtle. The rounding of the spine only happened at the very bottom of the squat and deadlift and means that the the stress is translating to the last 1-2 segments of the lumbar spine, which are the most commonly injured areas of the lumbar spine. Since the rounding is happening at the bottom of the spine, the hip extensor muscles (gluteals, piriformis, hamstrings) are possibly tight. Its also possible for the multifidi to be weak in the lumbar spine, which would result in decreased extensor strength between levels and if asymmetrical it would cause a subtle rotation of the vertebra and cause possible low back pain. Sorry for all the run on sentences. Hope this answers your question. If not, I would be happy to elaborate.

[FastGuppy]

I think I see what you're saying about the knees. However at the very top of the movement are your knees suppose to lock out?

And with the back, his back didn't seem round. Maybe it wasn't as rigid as it had been. Is it really that important if it rounds a tad bit at the bottom if his lower back is still straight?

[Dr.M]

I find the rounding at the back to be important, particularly for someone who is complaining of back pain. If the pain is from the lower back, statistically its the lowest two segments and putting extra stress on the lumbar spine without any real reason to go to that depth (you can stop 2 inches higher and avoid it and still get the same workout) doesn't seem like the best idea.

As far as locking out the knees, you can lock out the knees at the top, but the motion should come from the hips extending and not from the quads popping the knees back. If you are doing a one rep max, then you would want to try to lock out the knees to allow the bones to effectively support the weight, but if you are performing repetitions, then there is no need to lock out the knees by snapping them back. The bones can still support the weight and be straight without locking out the knees. If you are leading with the gluteals/hips, then you can reach the top of the motion and have the knees go straight without the "snap" at the top.

[Chris [.5gibbon] Stevenson!]

wow a lot of info.  ok so i will def. stop snapping at the top. i try my best to keep my back from rounding at the bottom, but it just happens. i think it is a mix of both lacking back strength and poor flexibility in the hamstrings, but i have been stretching almost daily for the last few months with little improvement.     can any one give me a few good exercises to strengthen my back in a way that would help my rounding problem?   also i would still love a good description of the effects of icing if you don't mind.  im getting conflicting information on google.

[Chris [.5gibbon] Stevenson!]

never mind on that last part. i just read your icing article. good stuff

[FastGuppy]

keep good posture. Foam Roll your back. Do mark Rippetoe's stretch in the SS book (you can find it in the squat section). Wall extensions do the back stretches suggested by muse. A really important suggestion is when stretching your hamstrings keep your back straight. When you’re bending down to touch your hands to the floor, keep your back straight.

Better posture helps I think. I had Kyphosis I found as my posture improved in my upper-back my posture in general would improve. If you're interested in trying, Steve has some pretty good dynamic stretches in the posture thread. Won't hurt and you said your shoulders aren't too flexible.

When you warm up on squats maybe you could do bridges.