T Nation

Leg Work for People w/ Bad Knees?


#1

Last summer I had some persistent debilitating knee pain that finally required an MRI to diagnose. The verdict was at age 37 I was already suffering from the family curse of osteo-arthritis; which had contributed to severe degeneration of the cartilage in my knees.

I was advised to use only light weight and no more deep squatting of any kind...So for the past year nearly all of my 'leg work' has been on a stair mill or elliptical machine, or occasional rear lunges [which don't seem to hurt my knees much].

I switched to front squats almost exclusively a few years ago as I really liked the way they felt...especially for my low back; which always felt a little insecure doing heavy back squats [maybe because of my long torso 6' tall with only a 30" inseam].

I can't remember where I read it, but I thought I saw somewhere that lifting weights actually stimulates cartilage growth. Anyone know some more about that? See I'm wondering if I did some specific low wear and tear movements for my legs if I could actually be helping my bum knees...???


#2

Weights to stimulate cartilage growth - No.

Suggestions
1 - heavy isometric work. Work through range of motion with isometric contractions (hold at fixed positions). This will work to strengthen muscle throughout range of motion and increase size, not as effective as dynamic movement.

2 - dynamic work; restrict your ROM (yes, I went there) so you never load the knee in terminal flexion or extension. Machine based leg exercises can accomplish this

3 - fish oil provides an anti-inflammatory effect that can help alleviate issues with swelling you should be experiencing with this pathology.

4 - maintain joint flexibility with regular stretching. Joint related damage (that you are experiencing) can lead to CNS inhibition of muscle around the joint, and you need to pay attention to tissue stiffness with regular stretching work.

Good luck.


#3

Sled pulling/Anterior lunges, reverse lunges as you are doing also put a lot less pressure on the knee. Foam roll the shit out of your IT Band and focus on single leg training.


#4

You can do weight bearing 1/4-1/3 squats, lunges, front squats, split squats etc., and knee extentions through the first half of the range of motion (after that the shear force is too great and the patella takes on a lot of force in a small area).

Both of those exercises limit the amount of forces that act on the knee and allow you to train through the full range of motion. Also weight bearing terminal knee extensions will help with your VMO which will not be getting the work it needs to keep up with the rest of your quads


#5

I definitely have noticed greater knee pain the further my knees get out in front of me...so was happy to find I didn't have pain with the reverse lunges.

Thanks for the additional tips everyone...it sucks getting old.


#6

Interesting. I think this is very true and probably happened to me.


#7

As already recommended, restrict ROM to work in a pain free range until you are able to perform a larger ROM pain free. Work on mobility at your ankles, hips, and t-spine. Work on stability at your knees and lumbar spine. Muscle flexibility and soft tissue quality drills of your lower extremities will help as well.

I would focus on posterior chain activities as well, which shouldn't place as much stress on your knees. Reverse lunges are a great option as they decrease the anterior forces placed on the lead knee during a traditional forward lunge.

From your history (knee pain, "insecure" back w/ back squats), you likely have multiple imbalances occurring. If possible, see if you can find a qualified practitioner who can perform a movement screen to figure out what imbalances (mobility and activation) are present.


#8

Besides all the good council here esp. from Levelheaded, please consider getting an assessment done in person with a movement specialist - let me know where you're located in a PM if you're interested, and i'll see if i can recommend someoen close by.

We do not have your full history here, haven't seen you move, and we're just best guessing in general terms. You deserve real attention to move out of this.

The take away is however that you can actively work out of this, and out of the pain.

osteo arth is not a life sentence. We are rebuilding tissue ALL the time, based on use.

and if you're in the interim looking for mobility approaches you can follow along,
here's an overview of one i use with folks i coach
http://begin2dig.blogspot.com/2008/09/z-health-r-phase-not-your-daddys-joint.html

mc

http://begin2dig.com


#9

Perhaps Bulletproof Knees is a good book for you based on what I've read on this site about the multiple benefits of the book.


#10

Thanks for the further replies MC and MarioX. I don't know what it is with this sites email notifiers...but it never tells me about reponses to threads I'm subrscribed to until AFTER I visit again. So I'll probably get notice that you two replied tomorrow after this post.

I'm in Minnesota about an hour south of the Twin Cities if you know of any specialists in the area MC. So with proper treatment I may be able to reverse some of the damage to my joints and nullify some of the Osteo Arthritis? I'd love to be able to run and squat again without worrying about whether I'm going to be laid up and out of work for a few days again. Sometimes my knees will just start aching badly when I can't even think of a thing that I'd done to inflame them.


#11

With proper treatment and rehabilitative services, you should be able to run to most activities at varying levels.

Here is a great article, Joint-Friendly Training by Nick Tumminello that gives some great exercise for those trying to work around specific injuries.
http://www.T-Nation.com/free_online_article/sports_body_training_performance_repair/jointfriendly_training


#12

Main person i'd suggest in MN is Mike T. Nelson
of http://extremehumanperformance.com
he's a z-health master trainer, phd candidate in kinesiology. nice guy

Phone:
(763) 458-1756
Email:
michaelTnelson@yahoo.com

let him know mc recommended you.

best
mc
http://begin2dig.com


#13

I one of those guys that suffers of bad knees and aching pains once in a while
but i train legs heavy and try to keep the rhythm every week. In my experience I noticed that not working out my legs was actually hindering them more than the actual workouts. I decided to put a whole routine around having to constantly have to squad and leg press, which were the more given exercises to give me pain. long story short i have 28in legs and I'm 5'7.