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Age/Injury Adapted HIT Exercise Program For Legs

Dr Darden and other forum participators,

Posting here since I entirely rely on HIT in my training. Good to know I’m 46 years old.

Suffering from right knee problems since many years due to previous heavy spinning cycling intervals. Lately crepitations has occured in the joint, indicating early stage arthritis. This has prohibited use of leg extension (which instantly makes it worse, no matter what leg ext machine I use). Found comfort in usage of squats and legpresses.

Now, I yesterday did a regular cadence 4/4 leg press set, fairly heavy NTF procedure, when on the 9th positive repetition suddenly felt a snapping, cramping sensation in my left groin, upper inside of leg - which terminated the set. I can still stand up, walk decently, do bodyweight squats - but have a hard time adducting and somewhat flexing my left leg. Diagnosed myself with adductor longus strain, which means I will need to rest for a couple of days, followed by a careful lifting strategy for the next month or so.

Considering my age, I realize I can’t lift like I used to any longer - which is why I’m asking here for advice.

What does your age/injury adapted leg excercise program look like? I can remember someone mentioning statics, 30-30-30 as beneficial methods. Maybe raised intensity with light weight supersetted excercises? High reps? Please share your thoughts and advice. What do you recommend, Dr Darden?

Your own advice is sound: a combination of statics and high reps.

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I’m curious as to the nature of your knee issue, as I have had several myself. If it is arthritis, which structures are involved?

I ask because quite a number of years ago, I believe I developed what is typically called chondromalacia patella. I had a lot of pain behind the knee caps when going up stairs, for example. At times, it sort of felt like sand under the knee cap. It developed after I had joined a gym, and began cranking out pretty heavy (for me) leg extensions. Of course, I was also using an elliptical machine, and doing some leg presses. But it seems like the leg extensions were most problematic. And once I had it, getting rid of it was not easy. Fortunately, the issue did eventually go away.

When it was a problem my leg program consisted of static wall sits, leg presses with light weight and a lot of reps, and some cycling on a stationary bike, again using low resistance and high RPM. Probably not optimal for building muscle. But I wanted to do something for my legs, and do it in a way that didn’t make the knee cap pain worse.

What I don’t understand is why it seems to have largely resolved itself. If it was an arthritic sort of issue, I didn’t think those normally get better.

FWIW…

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Several years back I saw a physical therapist for “achy knees”. I had an X-ray which only indicated mild arthritis which was common for my age. I was about 44 at the time (49 today). Basically, it came down to overuse. But she told me to avoid leg extensions at all cost. I’ve heard before the “lockout” position is probably the worst on the knees. And given I train at home with a very mediocre leg extension, that was easy enough since I barely used it and was focused mostly on using DB one legged squats and a leverage leg press. My grandmother had a knee replacement, and on the other side of my family my Aunt. So there are always genetic factors.

However, the IT bands were very tight, so she showed me how to use a muscle roller which I also use on the quads after cardio or leg training workouts. I do plenty of stretching after any kind of training (for all muscles) and then ice pack afterward. This has resulted in about an 80% improvement or even more. I also find my knees do better by changing up what I do: so maybe biking one session, power walking on treadmill the next. This gives relief versus doing one or the other exclusively. It’s probably good to do for weight training too. I suspect different aspects of the knee are involved depending on the activity.

Now, a couple of years ago, I was walking in the grocery store through an empty checkout isle, but some genius working there decided to have a thin cable about 15 inches off the ground (color matched the tile) and I didn’t see it as I was walking and took the hardest fall of my life on my left knee. Fortunately, nothing major appeared as my Dr. checked it out but the knee has never been the same since and can get a little irritated once in a while in one particular spot beneath the knee cap. I always wondered what this might be?

I also use faster, more brisk reps. I find slow reps on my knees (even 4/4) seem more bothersome. I suspect with faster reps, I am moving in and out of the “bad grooves” of the knee not to irritate them. I use at least 12-15 reps as well…willing to go up to 20.

Finally, there is a supplement called Glucosamine which some find to help with knees. Others don’t. I never tried it.

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Look into bpc-157. Very helpful for my thumb which is bone on bone.

Increased rep speed = Increased hydrodynamic pressure, resulting in synovial fluid being driven into cartilage tissue. Therefore, the joints have an increased ability to handle pressure.

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It is good to hear something in favor of faster rep speeds . I do enjoy faster reps more than slower ones.
Scott

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Maybe Dorian Yates several warm up sets and Dr. Darden’s calisthenics warm-ups prior to main HiT sets were good ideas.

We even hear of Ken Hutchins use of non-progression exercise while using the rotary torso to alleviate pain. Joint fluid hydrodynamic pressure is important.

The speed was brought up to a walking pace. What was the percentage of that pace initially? What does that correlate to for lifting? 2/2, 2/4, 5/5, 30/30? It think that study leaves more questions than it answers. It could be 2/2 is better than 1/1. Could be 4/4 is better than 2/2. Could be 3/3 is TOO fast! So it doesnt really answer that question clearly enough to make that statement.

Agreed!

The concept seems supported by a variety of evidence: some amount of movement and loading helps preserve the health of cartilage by squeezing fluids into and out of the tissue. It also seems to produce some kind of an adaptive response, particularly with younger people (the cartilage may grow thicker).

But how much load, how fast for the movement, and how often should it happen? Those are much more difficult questions. Fast is a relative term. For exercise prescription, you need much more quantification.

It might be worthwhile to experiment and find what works best for you. I quit using 4/4 for everything a long time back. But I hate slow reps in general or adhering to some arbitrary number of seconds.

I never liked real slow reps after my bad experience with the ‘old’ SS stuff many years ago, and couldn’t even think about 30/10/30 . It left such a bad taste in my mouth that doing a 30 second rep is something I cant even consider. .

But I did come across another great way to do a set and like even better than Zones which I’ve always liked.

You do two slower reps ( 4-5 second up , 4-5 second down ) followed by two normal speed reps and repeat it for an 8 rep set. Got it from Christian’s site and love it. ‘Slow’ combined with normal , the best of both worlds.

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What was your bad experience with super slow? I keep hearing mixed reviews of it.
Scott

It’s funny to talk about the knee

The only time I had knee issues is when driving a stick shift, squat and hack squat…I would have problems with my left knee…

never have problems with the leg extensions or leg press…especially now with 30-10-30

Weird how we all have different experiences

It certainly is weird! For me my knees tolerated any abuse I could expose them to - before I went to a spinning class with an instructor doing start-stop cycles repeatedly (some 10 years ago). After that my right knee started behaving, with a baker cyst and got lightly swollen after too much excercise. This same knee started making crepitating sounds when I began doing heavier leg extensions again, a couple of years ago (also whenever I climb stairs). It was like the quadriceps was much stronger than my knee. No pain, still strong as ever - but I have come to the conclusion I am not 45 years old anymore! LOL

Looking at the strength/load curve for leg extension, I am not surprised I have a problem with it. The load upon the patellar tendon is significant! I would not advise anyone to go heavy on the leg extension, though probably a great excercise with lower loads.

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I’ve written about it too many time on the old board so I’m not getting into the details again. But basically I lost lost size and conditioning over a eight month period that people who saw me thought I had given up training ! I was so driven and dedicated about doing the ‘next big thing’ in HIT that I was blind as a bat on the negative effect it was having on me. It took friends who didn’t know the difference between a barbell and a dumbbell ( other than this dumbbell ) to point it out to me.

It was kind of funny having friends who never lifted anything heavier than a large pizza , pointing out to me laughing that …

" Well Einstein , that ain’t workin’ ! "

Until about my 50s my knees tolerated anything I threw at them from bike racing , to running , leg work etc etc. I never had an ounce of pain in my knees or any other leg muscle before that . Then one day at a golf tourney I was video taping I got hit in the knee with errant golf ball and that started my legs decline. It made me favor that leg and soon my other leg started feeling pain until I tore a meniscus in it. The about that same time I had chemo for cancer and I think it damaged nerves in my feet and lower legs. After that I was never able to run and or do much of anything sports wise. My upper body feels young while my legs feel old.
Scott

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I like how this thread develops. Good to have something else to think about (SuperSlow, how fitting) after my injury two days ago. Remarkably I am making a quick return to an almost normal walk, and no pain apart from when trying to adduct my left leg. Noticed as I’m writing this a blue discoloration around the light swelling of my inner thigh. Ok, this reassures correct diagnostics of adductor longus strain, maybe a partial rupture.

Done some reading which confirmed this as one of the most common injuries in sports. I wonder how common this is during leg presses? Know two other similar cases. Is the angled leg press more injury prone than other versions/angles? Is the Petersen press a way of making a return to the leg press? I think I can manage 90 degree squats without any problem - and will proceed doing a high rep attempt tomorrow (along with squeezing a ball rehab). If this works I am thinking about trying the Darden leg emphasized 30-10-30 routine (superset of dumbbell squats, probably Petersen presses in my case and lastly standing isometric wall squat). Any considerations/suggestions?

One other thought is I would have expected injuries during the first rep - not on the ninth! If I remember correctly this is what Dr Darden wrote re injuries in the new HIT (which cadence/strategy I followed).

Thanks for sharing, Scott!

I have a similar experience that my legs are the first thing to deteriorate. A shame since I have built a decent foundation in legs, and started to like the feeling of murdering them through excercise. I wonder if this age decline in legs is true in general re middle-aged men?

My legs were always my strongest asset , I remember my dad saying you’ve got those VanDeventer legs that are as strong as a horse. They are still strong but just get to aching when I do a lot of running around. Recently I started just walking an hour or so each day until I noticed my lower legs just got to aching to much. I went back to my exercise bike but that’s just so dang boring! Sort of like doing SuperSlow, ha ha ! Anyway it’s funny how a little golf ball can cause so much damage. I think I heard somewhere that as your legs go so goes your health. If that’s true I won’t be around too long.
Scott