Squatting to Parallel with history of subluxating patellas?

Years ago (okay decades) when I used to be a dedicated runner, I was told to quit running or face surgery/then quit running. I was told my kneecap was prone to going off track and would result in the back of the patella getting ground off. It was explained that this was because the lower attaching tendon was at an angle and would pull to the side somewhat and my hips were wider (being female) causing a slight pull to the side from that geometry as well. I was experiencing debilitating pain and had to use crutches for a few weeks. I did the recommended rehab (lots of terminal leg extensions with weights to strengthen the VOM - the tear drop shaped muscle on the inside of the legs which was allegedly weaker compared to the rest of my quads). I followed the recommendations to never do kneeling exercises. Never do exercises that had my knees at right angles while exerting and to only ride bikes at 60 rpm or faster.

It's been okay, but I still had problems with pain sometimes and had to wear braces on longer hikes to prevent the pain. I started doing squats and then with heavy weight, and my incidences of knee pain decreased. But..... I have not been squatting all the way to parallel because of that old advice from ortho/sports med doc (when I was an early teen), so I'm not getting the full benefit to my posterior chain. I was told recently by a bodyworks instructor that if I did my research, I'd probably find out that the thinking on this has changed a LOT over the years and that terminal extensions, etc. are no longer recommended.

So, I'm just wondering... what have y'all heard about this? Have any of you had trouble with subluxating patellas and tried doing full parallel squats heavy? Did it get better or worse? I worry about the imbalance of strengthening the quads and not the posterior in balance by not going all the way to parallel. But, I'm also worried about trashing the knees? Do I just try it and then let the pain guide me as to whether it was a good idea? Dilemma. Input, please!

Replies

  • Maddius
    Maddius Posts: 78 Member
    Similar dilemma here, no answer to assist as I'm feeling my way with it all as well, sorry. Both of my knees are 'interesting' (perhaps pathetic would be a better description of my reluctant, recalcitrant patellas), but recent months has seen my right knee go to a new level of misguided function with associated pain.

    Physio tells me right patella is quite keen to track laterally and do the rebel thing. Still maintaining circuit training, recumbent bike, boxing and weights, including squats aided and abetted by knee brace. I don't go anywhere near parallel weighted squats due to pain though. Normal training doesn't seem to greatly exacerbate pain, but I am concerned. I'm off to Adelaide next week to visit orthopaedic surgeon who'll advise me post MRI. I'd like to get into road bikes and add some running in too, but fearful of pushing into new territory that may have adverse effects.

    Good luck with sorting yours.
  • Doberdawn
    Doberdawn Posts: 732 Member
    Do come back and post after your appt if you learn anything new. Anyone else out there with input?
  • michelle34152
    michelle34152 Posts: 17 Member
    I have a similar problem and when I was in boot camp my doctor told me to keep my legs very, very strong, especially my quads if I wanted to run and walk a lot without pain. It worked for me.

    I do *kitten*-to-grass squats after I read a bunch of reports/articles on how squatting just to parallel puts more strain on knees than going past that point - like it releases the tension on the knee. I'm 42 now and find that if I keep my legs strong I have zero knee pain.
  • cafeaulait7
    cafeaulait7 Posts: 2,459 Member
    I have the exact same problem and hypermobile tendons/ligaments in the knees as well. I do hip thrusts/glute bridges instead of squats and find that my particular patellas take that well. I do most weights with straight leg moves, though, not the typical moves weight lifters do. I use thigh weights or cables.

    As long as I'm not bending my knee much, I can work the muscles to much greater weights than I can take in bent-knee moves. So I do those more. The exception to me does seem to be a full kneel. My knees don't mind the way the weight is distributed or how the floor limits patellar movement or something. So things like Russian Hamstring curls are in for me. I don't know if that's the same for everyone, though!
  • Doberdawn
    Doberdawn Posts: 732 Member
    Thanks for all the input... any more out there?
  • JTick
    JTick Posts: 2,159 Member
    Same diagnosis, but it's my IT band that's doing the pulling. I take a wider squat stance and point my toes out a bit more than normal allowing my knees to track in line with my toes. This helps me a lot and lets me drop to parallel...I literally just don't bend that far in a normal stance.
  • Doberdawn
    Doberdawn Posts: 732 Member
    Same diagnosis, but it's my IT band that's doing the pulling. I take a wider squat stance and point my toes out a bit more than normal allowing my knees to track in line with my toes. This helps me a lot and lets me drop to parallel...I literally just don't bend that far in a normal stance.

    What is the effect of turning the toes out? Does that change the muscles being worked in the squat? I've seen some folks talk about sumo squats vs. standard squats, and what you're doing sounds like the sumo squat.
  • JTick
    JTick Posts: 2,159 Member
    Same diagnosis, but it's my IT band that's doing the pulling. I take a wider squat stance and point my toes out a bit more than normal allowing my knees to track in line with my toes. This helps me a lot and lets me drop to parallel...I literally just don't bend that far in a normal stance.

    What is the effect of turning the toes out? Does that change the muscles being worked in the squat? I've seen some folks talk about sumo squats vs. standard squats, and what you're doing sounds like the sumo squat.

    I'm not sure about the effect of the muscles being worked, but for me it helps take the strain off my knee.
  • Doberdawn
    Doberdawn Posts: 732 Member
    Same diagnosis, but it's my IT band that's doing the pulling. I take a wider squat stance and point my toes out a bit more than normal allowing my knees to track in line with my toes. This helps me a lot and lets me drop to parallel...I literally just don't bend that far in a normal stance.

    What is the effect of turning the toes out? Does that change the muscles being worked in the squat? I've seen some folks talk about sumo squats vs. standard squats, and what you're doing sounds like the sumo squat.

    I'm not sure about the effect of the muscles being worked, but for me it helps take the strain off my knee.

    I did try it this morning... only did a few squats with no weight... but with the toes turned out, I was able to go @$$ to the grass and get back up. No pain yet, but I'll wait and see.
  • JTick
    JTick Posts: 2,159 Member
    Hopefully it helps! I can't handle even a bodyweight squat in a normal stance, but with the modifications I've made 150 lbs is no problem.
    Same diagnosis, but it's my IT band that's doing the pulling. I take a wider squat stance and point my toes out a bit more than normal allowing my knees to track in line with my toes. This helps me a lot and lets me drop to parallel...I literally just don't bend that far in a normal stance.

    What is the effect of turning the toes out? Does that change the muscles being worked in the squat? I've seen some folks talk about sumo squats vs. standard squats, and what you're doing sounds like the sumo squat.

    Hopefully it helps! I can't do even a bodyweight squat in a normal stance...too much pain. However, with the modifications I've made 150 lbs is no problem.

    I'm not sure about the effect of the muscles being worked, but for me it helps take the strain off my knee.

    I did try it this morning... only did a few squats with no weight... but with the toes turned out, I was able to go @$$ to the grass and get back up. No pain yet, but I'll wait and see.