T Nation

Broken Femur, Need to Regain my Size


#1


It's been seven months since I clean snapped my left femur in half. It was a lower distal break, and I had a titanium rod inserted in from the knee. I have rehabilitated my tendons and muscles, and there is only small amounts of residual pain and/or difficulty in working it through a ROM.

I am now ready to start the process of rebuilding my legs. I have been back squatting and deadlifting for months and only find difficulty in focussing on distributing the weight evenly across both legs. There is a one inch difference between both left and right calves and thighs.

I was thinking about working my way into Mountain Dog training, but wondered whether anyone else on here had gone through similar things and had insight or advice as to how to really slab it back on my thighs and calves.


#2

[quote]joeychowe wrote:
It’s been seven months since I clean snapped my left femur in half. It was a lower distal break, and I had a titanium rod inserted in from the knee. I have rehabilitated my tendons and muscles, and there is only small amounts of residual pain and/or difficulty in working it through a ROM.

I am now ready to start the process of rebuilding my legs. I have been back squatting and deadlifting for months and only find difficulty in focussing on distributing the weight evenly across both legs. There is a one inch difference between both left and right calves and thighs.

I was thinking about working my way into Mountain Dog training, but wondered whether anyone else on here had gone through similar things and had insight or advice as to how to really slab it back on my thighs and calves.[/quote]

Mountain Dog training is an excellent method and Coach Meadow’s paradigm is one I have a high level of respect for. Before you explore his methodologies, consider what I have to say.

Here is your statement we need to focus on:

“…only find difficulty in focussing on distributing the weight evenly across both legs…”

A broken femur (to state the obvious) is an incredibly traumatic event. From the time of injury, surgery, and rehab, your body has adapted to compensate. Some of the compensatory actions would be obvious to yourself and those observing. Other compensatory actions would be imperceptible - even to a trained set of eyes. It’s an inevitable evolution that you must not ignore.

Based on your post, it sounds like you dove straight back into bilateral movements. You can try this approach with a regression in weight/volume and hope that your left leg catches up in strength and size.

Or you can incorporate unilateral training to specifically address the matter.

Do NOT think of this as rehab. Think of it as the bridge between rehab and the type of training you eventually want to return to.

The subsystems that have atrophied include (but are not limited to): posterior oblique; anterior oblique; the lateral. And do NOT be misguided by the word ‘oblique.’ The subsystems involve more than that. Much more.

Exercises that you should consider include:

Clamshells using bands

Terminal Knee extensions. Do not neglect the right side but focus on the left.

Staggered stance RDL holding weight in contralateral hand.

Progress when ready to…

Unilateral RDL holding weight in contraleral hand, use ipsilateral hand to gently brush up against a solid object to aid in balance.

Progress when ready to…

Standard unilateral RDL holding weight in contralateral hand.

RFESS holding weight in ipsilateral hand.

RFESS holding weights in both hands.

Reverse-band one-leg squats. This is NOT a pistol. The reverse band allows a more pronounced sitting back, a tib/fib angle that may be less provactive to the knee, and accomodating resistance.

Unilateral cable punch outs. Set up a cable station so the handle is approximately shoulder height. Grab the handle and, in a controlled motion, perform a motion that resembles a straight left punch. This means the left leg will be in the supporting position when working the left side (ipsilateral). This involves significant recruitment of the ipsilateral side. Do not neglect the right side.

Unilateral cable pull downs.

Don’t laugh off the upper body work. Among other things, it will teach your body to transfer force between upper and lower body in an efficient manner.

Also, if you have access to a machine that matches your body, unilateral leg curls (especially the stand up variety) is recommended. Don’t listen to people who tell you that RDLs, good mornings, etc are all you need for knee flexors. The biceps femoris short head does little to no work in hip extension but does play a role in knee flexion. Also, the popliteus - an often forgotten stabilizer to the knee - is also a knee flexor.

And obviously, calf work should also be performed in a unilateral fashion.

Each exercises I mentioned are worthy of separate posts to detail the justification. I simply don’t have the time for that. If you are curious regarding a particular movement, post on this thread and I’ll do my best to get to it when I can.

As you progress, you can gradually reintroduce bilateral training. In fact, to gain optimal hypertrophy, bilateral work is mandatory. However, the classic disconnect is that bilateral work is all people do.

One thing the unilateral-only camp doesn’t understand is that, at some point, bilateral work must be done as the stabilizers can only do so much.

One thing the bilateral-only camp doesn’t understand is that, at some point, imbalances must be addressed and a barbell is not always the best answer.

The answer, as is often the case in life, is somewhere in the middle.

Take note the exercises listed is not comprehensive. But they are something you should consider if you want to get back in the game.