T Nation

Leg Workouts w. Osteoarthritis

Just wondering if anyone else has a similar problem and how they may have overcome it…

After four knee surgeries as a result of competing in judo and soccer my whole life, plus heavy squatting, I have bone-on-bone osteoarthritis in my right knee, and arthritis behind my left knee cap.

My leg strength and mass has just plummetted, because I’m finding movement/mobility difficult if I’m not scarfing down ibuprofen and it is a downward spiral, because as leg strength decreases the joints have less support and get sore more often.

I remember many years ago reading about Mike Ashley having similar issues with his knees as a result of doing paratroop sky drops in the military, and he used giant sets.

Does anyone have any ideas on what the best method is to keep the leg strength and mass up on the legs, without overstressing the knee joints?

Thanks

[quote]BrahmaBull wrote:
Just wondering if anyone else has a similar problem and how they may have overcome it…

After four knee surgeries as a result of competing in judo and soccer my whole life, plus heavy squatting, I have bone-on-bone osteoarthritis in my right knee, and arthritis behind my left knee cap.

My leg strength and mass has just plummetted, because I’m finding movement/mobility difficult if I’m not scarfing down ibuprofen and it is a downward spiral, because as leg strength decreases the joints have less support and get sore more often.

I remember many years ago reading about Mike Ashley having similar issues with his knees as a result of doing paratroop sky drops in the military, and he used giant sets.

Does anyone have any ideas on what the best method is to keep the leg strength and mass up on the legs, without overstressing the knee joints?

Thanks[/quote]

Unfortunately the only way to keep the legs strong and large is to use them. If the arthritis is painful (as it seems to be from reading your post) you may be kind of stuck unless you can work through the pain. Some people have been able to use lighter weight and higher reps coupled with a change of squatting style - hip dominant vs quad dominant - to keep strength up. But it comes back to painful experimentation on your part as to what will work.

first question is do you take any fish oil? makes a HUGE difference. ive got piss poor knees as well, bone on bone on the right, bone spurs on the left. the fish oil really helps, the bad days do take about 400-600mg of ibuprophen but thats after some sled pulls or other craziness. the sled has done me wonders, start light and build up from there. for lifting try box squatting, this has allowed me to progress without the overall destruction on my knees free sqautting-personal opinion only. single leg exercises also work especially well to get a good pump.

I’m still trying to figure that out myself. I have osteo in my right knee (bone on bone) and ankle, and left elbow (due to old injuries). I take fish oil, glucosamine/chondroitin, and have been using the Curcumin 500 as well. I just ordered some sissus quadrangularis, but haven’t tried that yet.

For me, doing medium intensity leg extensions seems to help some. My theory is that strengthening the muscle around the joint helps. I also think that some walking, cycling etc seems to help “lubricate” the joint.

I used to run marathons and ultras, but that’s a thing of the past now.

I try to stay away from ibuprofen as much as possible. I will take it to get me through long hikes, but I don’t do those too often. I have read that it can interfere with building muscle, it’s hard on the stomach, etc, etc.

When I squat or deadlift too heavy, I can feel the knee really grind. Seems like around 250 lbs is sort of a limit for me.

I try to keep my lifts fairly heavy (for me), and fill in the gaps with more volume.

The docs say Knee Replacement, so I try to stay away from them!

Box squats work for me. Check Louie Simmons Westside Barbell video on you tube for a how to. I have kenn arthritis and a artificial hip and can squat pain free. If you pre-exhaust these with leg extensions you get a great workout. Just be careful that the knee does not travel past the toes.

Here’s a how to video:

Thanks all - super posts and appreciated.

I have not taken any fish oil for a while now and have been too sporadic with the glucosamine chondroitin mainly because I haven’t noticed anything after taking them for a couple weeks at a time. But I will resume the regimen and hope that maybe commitment to it on a longer term basis will produce some benefits. I had not heard of Curcumin but will look into it. Any other supplement advice is appreciated.

I usually resort to ibuprofen after a workout, but only briefly because I’ve heard it can damage the liver if you use it heavily long term, and I’m only 40 - I anticipate trying to be active for many years yet and would rather limp badly than need a liver transplant.

A big problem I’ve noticed is that after workouts my groin and hips hurt because my lines are off and other muscles are getting overly stressed trying to balance.

My leg workouts now are Squats x 5 sets, Leg Presses x 4 sets, Stiff-Leg Deadlifts x 3 sets, Swiss Ball Hamstring Curls x 3 sets, I try to go heavy as I can for minimum 6 reps, heaviest squat lately was 275 (this a far cry from the 495 I squatted 15 years ago - ah life). I will give the box squats a try. My doctor (I know I know) has told me to avoid any single leg lunge or step movements as those movements tend to have 7-8x stress on the knees vs. standard two leg in tandem movements where the stress on the knees is 4-5x weight being lifted.

Initial results with cissus quadrangularis are promising.

You could give that Supple beverage a try. It has helped my knee arthritis significantly. It’s a glucosamine/chondroitin/juice combo. No amount of tablet form glucosamine/chondroitin helped me in the past. Something about how its suspended in the pear juice that increases the absorption. They have a money back guarantee so you can’t lose anything by trying. www.supplebodies.com. I usually take it mixed with a scoop of whey protein.

I’m in a similar situation. I’m going to try Mike Robertson’s ‘Bulletproof Knees’ and foam rolling and fish oil. My Ortho and PT (basically idiots) told me to take copious amounts of Aleve until he does me the favor of a double knee replacement.

(I don’t think so at this point.)

But I do wonder how a double knee replacement will affect my training if it comes to that.

Ortho says heavy weight training would be over after he does the deed.

Has anyone here had a single (or double) knee replacement and how has it impacted your training?

From everything I understand about knee replacements, any strenuous weight bearing exercise on the knee joints is out… you can only get one knee or hip replacement in a lifetime (unless they improve technology in the next few years) and there is a finite life/use on the knee replacement, so unless you want to be back to square one in a few short years, you lay off the heavy exercise and take up golf/swimmming. Sad - how come they can develop heart replacements that last indefinitely, but can’t come up with synthetic knees.

My doctors recommended I get an osteotomy on my right knee - basically realigning the knee so the weight bearing is on the part with cartiliage, which is supposed to buy you another 10-15 years of function. But the surgery is severe (they take out a wedge from your tibia to shift the weight… six months on crutches). I ended up saying no because a) there is some question on the ability to get a knee replacement in the future if your knee has been realigned and b) I have young kids, I can’t be chasing them on crutches, even if it is for only 6 months.

All this sucks. I’ll continue to slug through twice a week leg workouts and hope that I can keep the supporting muscles strong, I’m swimming twice a week for my cardio work, and maybe I’ll strike on a supplementation plan that help with the inflammation and joint lubrication. I will give Supple a try.

I think too that if I dropped weight - (currently 6’3", 228) maybe the knees will feel better.

Another bit of info to add to this list and for all to consider. I am unfamiliar with the surgery to realign the knee, but there is a new technique out that is called Articulate Cartilage Replacement, this is basically a major micorfracture surgery, they grow cell patches from your cartilage, and sew those onto the bare bone, this does have an enormous recovery time, about 8-12 months of assisted walking, but its superior to knee replacement.

the surgery runs about $80 g’s, My dr here in springfield is one of the few to do this, ive passed thus far, they can hold the cell samples for up to 5yrs and my last surgery was 2yrs ago. knee replacement isnt the way to go, mention this to your dr next time around, see what he says.

[quote]bennidiesel wrote:
Another bit of info to add to this list and for all to consider. I am unfamiliar with the surgery to realign the knee, but there is a new technique out that is called Articulate Cartilage Replacement, this is basically a major micorfracture surgery, they grow cell patches from your cartilage, and sew those onto the bare bone, this does have an enormous recovery time, about 8-12 months of assisted walking, but its superior to knee replacement.

the surgery runs about $80 g’s, My dr here in springfield is one of the few to do this, ive passed thus far, they can hold the cell samples for up to 5yrs and my last surgery was 2yrs ago. knee replacement isnt the way to go, mention this to your dr next time around, see what he says. [/quote]

This is excellent help. (And it must be my lucky day as well.) I was born and raised in Springfield. (Currently live in NWA.) Could you pm me with the doctor’s name or post it here as I am desperate for an alternative regarding the knee replacement route.

Thanks,

~ Red

[quote]BrahmaBull wrote:
From everything I understand about knee replacements, any strenuous weight bearing exercise on the knee joints is out… you can only get one knee or hip replacement in a lifetime (unless they improve technology in the next few years) and there is a finite life/use on the knee replacement, so unless you want to be back to square one in a few short years, you lay off the heavy exercise and take up golf/swimmming. Sad - how come they can develop heart replacements that last indefinitely, but can’t come up with synthetic knees.

My doctors recommended I get an osteotomy on my right knee - basically realigning the knee so the weight bearing is on the part with cartiliage, which is supposed to buy you another 10-15 years of function. But the surgery is severe (they take out a wedge from your tibia to shift the weight… six months on crutches). I ended up saying no because a) there is some question on the ability to get a knee replacement in the future if your knee has been realigned and b) I have young kids, I can’t be chasing them on crutches, even if it is for only 6 months.

All this sucks. I’ll continue to slug through twice a week leg workouts and hope that I can keep the supporting muscles strong, I’m swimming twice a week for my cardio work, and maybe I’ll strike on a supplementation plan that help with the inflammation and joint lubrication. I will give Supple a try.

I think too that if I dropped weight - (currently 6’3", 228) maybe the knees will feel better.[/quote]

Thanks for the head’s up. I feel for you. It looks like we’re all in this together. I’d like to keep this thread going b/c this is an issue that is super important for guys who want to train and stay active like us.

Google “knee replacement surgery” and read about it. Everything I’ve read says

  1. No running.
  2. No lifting over 40 lbs
  3. Premedication required for any type of surgery (even a simple trip to the dentist even if it’s Prof X!)
  4. For the rest of your life.

I do believe it is possible to repeat a knee replacement after it wears out. As I understand it, it is the bearing surfaces that wear out.

For me, knee replacement would be a last resort - only if I get to the point where I essentially can’t walk any more, and there is nothing else that can be done.

Not sure about knee, but I had total hip replacement in 2006. Also have osteoarthritis in both knees. I can squat for the first time in almost 15 years. Can’t run-or at least I don’t- but you can regain some strength. I won’t be squating 400 any more, but I do feel that I can have strong legs again. 'd guess that some type of leg extensions are possible. Get a good sports medicine physical therapist or corrective exercise specialist and try to get as good as you can.

Hips can be redone if need be. They just replace the parts that wear out. The main hardware-titanium and ceramics- stay the same.

Are knees similar?

[quote]mathineer wrote:
Google “knee replacement surgery” and read about it. Everything I’ve read says

  1. No running.
  2. No lifting over 40 lbs
  3. Premedication required for any type of surgery (even a simple trip to the dentist even if it’s Prof X!)
  4. For the rest of your life.

I do believe it is possible to repeat a knee replacement after it wears out. As I understand it, it is the bearing surfaces that wear out.

For me, knee replacement would be a last resort - only if I get to the point where I essentially can’t walk any more, and there is nothing else that can be done.[/quote]

Thanks mathineer,

The 411 on knee replacement prognosis post-op definitely sucks for someone that wants to stay active and train to the degree that I do. That is why I am desperately seeking alternatives.

Currently (typically) I am unable to get up from a seated position without upper body assistance or climb stairs without same.

I know that rom and strength gains from hips to ankles will help in my case as I have just started training to rehab / strengthen the lower chain and am having success with things like climbing stairs already.

Unfortunately this will not make the OA go away but could / should eliminate it as a daily factor with these issues ~ and /or at least allow it to be managed enough to avoid / put off knee replacement and let me get back to training my lower body hard(er).

I came back from a snapped tricep about 10 years ago that nobody believed I could come back from and was able to rehab it to full rom and strength ~ (obviously not OA but same ortho /pt said it couldn’t be done) ~ so I have hope that there is an answer for the knee problems as well.

~ Red

Red,

I was at the point in 2007 where I had trouble going up and down stairs, getting out of a chair, etc. I started doing very light leg extensions, and other exercises to strengthen the muscles around the knee joint. (Chose leg extensions because that is the rehab exercise the doc had me doing when I injured the knee 30 years ago. That injury eventually led to the OA. They tell me that the medial compartment is bone on bone.) Anyway, I discovered glucosamin/chondroitin and fish oil. Those both helped a lot. I also take curcumin. It helps some. I don’t run anymore, but walk and do exercycle, lift weights, etc. I built up gradually, and I don’t go too heavy. Everybody’s different. I hope you find what works for you.

[quote]mathineer wrote:
Initial results with cissus quadrangularis are promising.[/quote]

Mathineer,

Forgot to ask you how is the cissus quadrangularis working out for you so far. (Also) What brand and how much are you using?

~ Red