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Author Topic: Vastus medialis pain in deep squat  (Read 103 times)

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Offline dskirkham

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Vastus medialis pain in deep squat
« on: July 18, 2020, 05:18:00 PM »
Hi everyone, new here and looking for some advice on a weird knee issue I've been having. For reference, I'm 21, 185cm and weigh about 90kg. I don't have any history of knee injuries apart from a short spell of patellar tendonitis that lasted about a week ~2 years ago. I switched sports from rowing to weightlifting around that time and have been weightlifting 4/5 times a week since and either swimming or cycling for cardio in total 2/3 times a week. I've put on about 10kg in the last 2 years, if that's relevant.

About 4 weeks ago now I was going through a period of heavy front squats ~3 times a week. I made a 1 rep max attempt and felt a bit of tightness in my quads afterwards, but nothing serious, and continued my workout without issue. I had some muscle soreness the next day but I assumed this was normal and continued training. Over the next 5 or 6 sessions, the pain worsened to the point where it was painful to squat below 90 degrees even with no added weight, but in the sessions leading up to this I had no pain after warming up. I've changed my training since then, and working on the assumption of quad tendonitis have been doing leg exercises which require less bending in the knee (box squats, split squats, step ups) which have been painless, even with heavy loads. I've been trying to treat the problem with gentle quad stretches and massage ~3 times a day on top of my usual stretching. I've had some improvement but the pain is still there and I now doubt that the issue is quad tendinopathy. My main symptom is a burning pain in VMO area, closer to the front of the leg about 3 or 4 inches above the patella, when quads are activated below 90 degrees in a squat. Some other symptoms I might expect to have that I don't are:

- No tenderness to touch (in the VMO itself or on top of the patella)
- No pain or stretching feeling sitting in a deep squat
- No weakness or loss of strength

After a deep quad stretch, fully extending my legs causes some pain in the area that goes after a minute or so, and the same occurs after I do a few bodyweight squats to full depth. It feels like the tightness I'd get after a set of 50 bodyweight squats, but with only 5 reps.

I made some changes to my recovery and stretching routines recently which may have contributed to the development of the pain. I've been doing a lot of yoga and deep stretching through the quads and the hips. My hip mobility has improved which I think has caused my knees to widen at the bottom of a squat such that they are now outside the feet. My quads, hip flexors, and hamstrings are also considerably looser than they were before I developed this pain.

I suspect I have a slight strain or tear in part of the VMO on both legs. I got in contact with my physio but I still have a wait of a week or so for a consultation. Until then, if anyone in the community has had experience with -- or experience treating -- an injury like this, I'd hugely appreciate some advice. I've been searching all over but I've struggled to find any instances of this specific problem and keep finding suggestions to strengthen my VMO. I don't think that's the problem here, but I'm happy to include some pictures to show quad development if that's useful! Again, I massively appreciate anything that anyone here can do to help.

« Last Edit: July 18, 2020, 05:33:33 PM by dskirkham »

Offline The KNEEguru

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Re: Vastus medialis pain in deep squat
« Reply #1 on: July 18, 2020, 05:40:40 PM »
I suspect that you are fitter than most people here who are rehabbing - so you may not find too many others with the same problem. If you are taking steroids you need to be extra careful with pushing your programme too far is the only contribution I feel I can make.

Offline Dave33

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Re: Vastus medialis pain in deep squat
« Reply #2 on: July 18, 2020, 11:19:38 PM »
Heh, maybe I'm reading this wrong, but if I understand correctly, you're 21, and you have pain for approximately 4 weeks based upon a weightlifting squat in which you overdid it.

I'm reminded of the old joke where the patient says to his doctor "it hurts when I do this", and the answer is "well stop doing it".

My guess is that you've done some soft tissue damage while overdoing it, and the rehab you're doing isn't allowing the injury to settle and heal. Maybe completely leave it alone for 3 weeks, and then gently start up again.