I find it important to start off by making it known that random internet articles cannot always be trusted to accurately diagnose an injury. Diagnosing injury requires a doctor and one that is looking for the patient’s best interest, so please do your research and seek a professional before you start down the rabbit hole of self-diagnosing on the internet. Seek out help from Doctors in the CrossFit community, like Airrosti, Active Life Rx, Mobility WOD, Smashwerx, or if you are in the DFW area, The Sports Pod with DR. Blake Wu. So once again I am not diagnosing any injury!
The first thing that you should do to check out the health of your knees is to take the lower body assessment at performancecarerx.com, specifically the kneeling butt to heel, prone heel to butt, and supine hip flexion assessments. If you feel actual pain in those positions, you need to go to a professional before you just continue to do squatting motions. Specifically, the knee pain that I am speaking of in this article is not due to a ligamentous tear, but rather overuse. This pain is usually a dull ache either above or below the knee cap. This almost always tends to be an inflammation of the quadricep tendon (above the knee) or the patellar tendon (below the knee) due to a high volume of squatting motions or jumping.
There are three types of tendon injuries that athletes suffer from; tendonitis (acute Inflammation of the tendon), tendinosis (chronic micro-injuries to the tendon with the absence of inflammation), and tendinopathy (the disease of a tendon due to prolonged degeneration). Thankfully these injuries have legitimate steps to help alleviate some of the symptoms. That all being said, here are a few things that are almost always going to work to help alleviate your pain.
Be careful, that four letter word is the ultimate no-no in our community right? NO!! I know how hard it is for CrossFitters to understand the concept of rest because of the insane notion that more always means better! Low-intensity training is a beautiful thing to help your body recover, as well as a day of complete rest is often a phenomenal idea. When it comes down to it, most pain accrued from exercise is your body telling you that you need to just stop and rest. Just stop what you are doing and relax for 3 days to allow the healing inflammation to go down. If you have rested for more than a week and you are still in pain then it is definitely time to seek out professional help. If you are confused on how to rest from exercise check out this super cheesy video!
2. Eccentric Elevated Squats
Studies have shown that elevated eccentric exercise relieves patellar/quadricep tendon injuries by strengthening the surrounding muscles specifically at the tendon. Specifically, when you perform these squats, the quads are strengthened to help reduce stress on the tendons. You should substitute your normal squat days with elevated eccentric squats at least once a week (4x4 with 4 seconds descent) and also add it into your warm-ups (4x8 no weight and 4 seconds descent). You can be creative with how you decide to get into this elevated position, but, specifically the elevation needs to be steeper than a weightlifting shoe, so shoot for 3-5 inches. Instead of trying to squat out of a rack, either use only your bodyweight or grab a light kettlebell.
3. Self-manual Therapy
This method is very easily performed, but not always easily tolerated. When you have a muscle tissue problem, it can definitely show up as pain when you perform manual-therapy. Very rarely do I see this alleviate pain in the long term, but it does help with the short term to feel better. Some very practical things that you can do involve: rolling a barbell on the quads (try not to cry during it), wearing a compression brace, or flossing your quads with Voodoo bands. All of these methods are going to help release some of the underlying muscle fascia (think of plastic wrap around a sausage that somehow while in the refrigerator got all crumpled up) that gets stuck down onto the actual muscle belly, making things very tight and restricting movement. My personal favorite is using the voodoo bands to help achieve this as well as it acts just like a compression sleeve to use while exercising, which also alleviates the pain. When you decide to start rolling out your quads make sure to try not shy away from the areas that are super painful. When you find a painful spot, flex your quads to the best of your ability for 5 seconds and then relax for 10, and run through that at least 3 times.
I am on a mission, and that is to let people know that they do not have to live in pain. There are legitimate things that can be done to not only rehab pain but you can also prevent it. If you are hurting during a movement, please do not just ignore it, seek out help, be smart, and get to work.