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Adding Leg Size With Knee Issues

I’ve been lifting for about 25 years and with that comes some injuries and just plain old wear and tear. I can’t really squat free weight anymore as my knees hurt too much. However, I can do the leg press, squat machine, smith squat, leg extensions, and stiff legged deads.

I’ve lost a lot of size in my legs over the years and I’m currently doing a Test/NPP blast to add some muscle. Anybody have any suggestions/routines/programs to add muscle mass in my legs?

Without knowing your specific knee issues, it’s hard to say. An IT band issue is different from patellar tendonitis, which is different from irritated bursae, which is different from arthritis, etc etc etc.

But that being said, it sounds like you’ve found a few things that work for you. You didn’t mention it, but can you do leg curls? If so, I’d just keep it simple, and do something like this: 3-5 sets of 10-20 on the leg press (I like a lot of rep freedom in my programming, and I like variety), 3 sets of 10 leg curls, and 3 sets of 10 stiff leg deads. You can grow just from that. Just keep it simple, and keep the reps high, there’s no need to go heavy on any of these. I’d do that once a week. If you want to do more work, I’d add bulgarian split squats at the end (if you’re able to do them).

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Thanks @flipcollar. Yes I can do leg curls and extensions. Pretty much anything excepts squats and I think its because of the balance required in my knees. (does that make sense?)

I usually do about 6 sets on the leg press loading up to 6 plates on a side. I also vary my foot position as well. What do you think about hitting legs twice a week? One heavy and one light?

got pain with bulgarians and lunges too?

I haven’t done lunges in a LONG time and never tried bulgarians but based on what I’ve seen, that would put a lot of pressure on my knees.

No idea if this would do, but if you try and it does let us know!

Either way, Id try with bulg smith, then just bulg… same for lunges. Rest youre pretty much doing it

I saw this article and didn’t read it at the time. Thanks!

actually not as much as you might think, provided you get a good vertical shin angle. If you let your knee drift forward over your toes then it’s snap city, but keep it vertical and you should be ok.

I’ll give it a try. Thanks brother!

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yea agreed with yogi. lunges are hard to do without putting excess pressure on your knee, because you’re taking a new step for each rep. but with the bulgarians, you get to set up your position and stay there the entire time, so you can ensure proper shin angle.

Step ups are a great overall builder for quads, hams, and glutes.

I’ll agree with Yogi and Flip on the lunge/Bulgarian comments. I’ve got pretty cranky knees myself, and Bulgarians don’t seem to bother them at all. Lunges can be hit or miss.

Yeah, Bulgarians are actually pretty knee-friendly if done properly. FORWARD lunges are tough because your knee flexion is based on the distance of the step you take, but reverse lunges, I.e. stepping backwards, let’s you base the whole movement around that 90 degree forward leg angle. Also, hip thrusts.

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Pretty much any of John Meadows/Mountain dog training articles in the archive minus the squats.

Posted this recently and gets brutal workout out of light weight…

Snatch grip deadlifts engage the quads a lot, along with a ton of other benefits (lots of hamstring, lower back, forearms and lats involvement, and a fuckton of upper back work), and they do have a good margin for progressive overload too, in case you wanted to still have a big barbell movement to focus on before isolation stuff.
I’m not sure how they’d affect your knee issues but knee flexion and “balance” on knee are definitely reduced compared to squats.

Great idea. I still deadlift regularly with minimal knee issues. Thanks

I am a little late to the party, but have you tried box squats? I have quadriceps tendonitis in my right leg and issues with alignment of the patella in my left knee and I can do box squats with no issues (traditional squats have been out of the picture for several years). Even though I used to be able to squat a metric crapload of weight, I started off with a TM of just 115 in my 531 program to focus on form and went up slowly per typical 531 MO.

The main focus was controlling the eccentric and keeping my shins as vertical as possible.

Thank you for the response. I used to do box squats as part of my leg program. Right now the smith machine, leg press and leg extension seem to be hitting the quads without pain to my knees.