T Nation

Potential Drawbacks of Limited Exercise Selection?


I’d like to ask a question of the forum regarding any potential drawbacks of a limited exercise selection enforced by injury. Any help would be greatly appreciated.

First for background, I am late 40’s, I’m five nine, 190lbs, 21% bodyfat. I’m interested primarily in hypertrophy and reduction of bodyfat. Within the constraints listed below I would like to be as ambitious as possible.

Formerly I did combat sports, rock climbing, marathon running, triathlon, okay-ish weight training in my early 20’s (330lb for 8 to 10 ATG squats). The net effect is wear and tear on both knees but particularly the right knee on which I’ve had a scope previously but it didn’t clear the problem 100%.

Due to family and running my own small business, the most practical option for me is home training. I have a bench, a bar, adjustable dumbbells and heavy kettlebells.

My issue is with leg training generally and more specifically quad development. I have found through elimination only a limited number of exercises do not seem to aggravate the knee and as a separate issue bring on patellar tendonitis.

The exercises I CAN tolerate are moderate height step-ups, front squats to a chair and RDLs.

I have tried reverse lunges, lunges, rear foot elevated squats, deadlifts, deep squats, trap bar deadlifts etc. I thought initially that reverse lunges would be a good exercise and was tolerating them reasonably well but after doing three sets of 15 reps on each leg last weekend (with 1 minute rest after deadlifting the day before) the patellar tendonitis was particularly bad and the general lateral knee pain was quite bad.

I am doing a push/pull, 6 days a week i.e. 3 each a week with low enough volume on each day, the CT format without the specific intensification techniques. I do a general and specific warmup and then afterwards do 15 minutes of stretching including calves, quads and hamstrings.

So, my question is if I am limited to moderate height step-ups, front squats to a chair and RDLs, is there any issue that I should be concerned about regarding imbalances which will effect either everyday function or hypertrophy.


You have a good hip hinge movement in the RDL, an anterior focused front squat and a posterior focused high step up. Looks a lot more balanced than a lot of leg routines I have seen.

If you feel like your not getting enough glute work (weak glutes can sometimes be a problem area) than perhaps consider barbell hip thrusts.

Have you had issues with muscle imbalances in the past?

Thanks for the suggestion of hip thrusts.

I haven’t been ‘diagnosed’ with any imbalances - some physics over the years have said that my VMO was under-developed and the outer thigh was doing a lot of the work in everyday life, they felt that if I could develop it, it may help act as a cushion for the knee pain which is most chronic on the inner knee.

I remember when I first got into personal training back in 2006 that weak VMO’s was all the rage. Everyone was doing lunges (static or reverse) while someone pulled on a band from the outside. It forced them to use their adductors to keep their leg from moving outward. It was some attempt to get the VMO to fire. The quadriceps is just that–four (quad) muscles that insert at the same point. I still don’t understand how one of the four parts of the muscle can lag behind. And I don’t understand how the VMO can be responsible for lateral knee pain. Perhaps the adductors are weak and the abductors (more likely the tensor fascia latae) is tight and/or overactive.

As stated, you have a hip hinge, a good quad movement, and a unilateral movement. I’d say you’re doing fine in the balance category. I caution you to go light and focus on the elevated leg on step ups. It seems that most people push off the floor with their rear leg instead of pulling themselves up with the “working” leg. Control the eccentric too. If you really force the elevated leg to do its job and slowly lower you back down then you might not need weight at all. You can basically turn it into a single leg squat. If you just tap your toe to the floor after the eccentric then you will successfully put all of your weight on the working leg and get the most out of the exercise.

Do you do any foam rolling, stretching etc? Wear knee sleeves?

I wonder if having done deadlifts the day before is what caused knee pains after the reverse lunges. I would consider trying them again as they are usually a good choice for people with knee issues.

I have experienced knee pain from time to time (hockey injuries). What helped me was a combination of lower body mobility, thorough warm ups before lower body work as well as high rep body weight squats and split squats for a couple weeks just to get blood in there for recovery. As well have you tried sumo deadlifts? Hope that helps

Thanks very much for the suggestions and confirmation that the exercises are reasonably balanced. It’s a great forum and I’m appreciative of the shared knowledge.

I agree with the suspicion that the deadlifts had pre-fatigued the tendon and then the high-rep lunges compounded it rather than caused them in themselves.

I will really focus on the eccentrics of the step ups. I am doing some warmup and mobility pre-workout and foam rolling included in the stretching post-workout.

Thanks again.