Leg Excercize For Damaged Knees

[[old] chudwell]

I have bad knees, want to do more strength training, and don't want to cause damage.<br /><br />I know that leg extensions are no good for me (snap, crackle, pop)<br /><br />Free-weight deep Squats are a no-no.<br /><br />Then there are the two ramped sled machines that are very similar in design. <br /><br />*Hack Squat machine: your feet are on the lower pad, and you push a sled up the ramp, shoulders first.<br /><br />*Leg Press: your butt is on the lower seat, and you push the sled up the ramp.<br /><br />Is either machine better for those of us with bad knees?<br /><br />Both of those machines have large foot pads. For knee protection, I think it is best to have my toes out in front. The pressure on my knees seems more intense if my heels are directly in line with my butt. Is this right? Thanks for input.

[[old] slo_boat]

Ah, the wonderful knee. <br /><br />Here's a few thoughts.<br /><br />Squats: Unless you have serious degenerative issues or damaged ligaments that preclude you from doing squats, there is nothing wrong with them other than a few generations of bad advice from well meaning but ignorant coaches. However, people frequently hurt themselves by using poor form. Keep your knees pointed in the same direction as your toes. Do not let your knees extend past your toes when you descend. This may require pushing your butt out. Wide or narrow stance is up to you. Slightly wider than shoulder width with your toes pointed out slightly works well for most people. <br /><br />Leg extensions are fine. Again form is the culprit. most leg extension machines allow you to use a very large range of motion. You should only be lifting from about 90 degrees to straight out. If you have "bad knees" there's a good chance that you have weak a vastus medialis. That's a common cause of something called patellar tracking syndrome which is sometimes called runners' knee. That muscle is a tear drop shaped muscle on the inner part of your thigh near the knee. If is not strong compared to the rest of the quads, then you get tracking problems. It starts with pain, and progresses through chrondramalagia (a fancy sounding term that means abraided cartildge under the knee cap). To work that muscle, concentrate on the last 10 degrees or so of the leg extension. You can also do leg raises lying on your back with your leg straight.<br /><br /><br />Whether you work the leg press or the sled, the big issue is (you guessed it) form. Keep your knees pointed in the same direction as your toes, and do not let your knees extend over your toes. On either machine, you'll accomplish this by putting your feet in front of you. You do not want your heels under your butt. Wide or narrow foot placement is up to you.<br /><br />You may find that weight exercises help strengthen connective tissue and there is some speculation that the loading has stimulated cartlidge growth (big argument potential there).<br /><br />Don't neglect the rest of the muscles in your legs. The gastroc crosses the knee and may help with stability. Short movements may help strengthen the popliteal (a muscle behind the knee that initiates "unlocking"). You also need stong hamstrings, adductors and abductors.<br /><br />Best of luck!<br /><br />BTW, It's up to you to run all this through your own BS meter. If it makes sense to you, and if it works, great! Otherwise it's just words.<br />

[[old] Yoda1]

In my humble opinion. Note: I said "HUMBLE". I would stay away from squats and leg extensions. I would only use the leg press until your strength is regained. If you do decide to use the leg press then your foot position should be near the bottom of the push plate. Probably the worst peice of equipment to use would be the hack machine.<br /><br />I don't want to start World War III here, but this is where Super Slow shines. I hope that you would want to use SS protocol in your program, at least until you regain that strength.<br /><br />Let me back up here a bit. Squats would probably be okay if they were body weight only. I would avoid them with weight.<br /><br />No Yelling here!!!!<br /><br />Yoda

[[old] pduck]

Usually, people have sore knees because of weak quad muscles and inflexiblity. If you can strengthen the quads, your knees should improve. Slo Boat gives some excellent advice regarding form. Form is essential when doing squats, especially not letting the knees go in front of the toes. I've been doing full squats with just body weight (like Yoda said) and have had no problems. I usually have my feet slightly wider than shoulder width and with the toes pointed slightly out and this emphasizes the vastus medialis. I do them slowly, though maybe not Super Slow, go all the way to the bottom and push up with my heels...no bouncing.<br /><br />I had an sports orthopedic surgeon tell me to do leg extensions to strengthen the vastus medialus. He said to keep the weight light (it's very easy to overdo) and to not lock the knee...in other word, do not straighten completely. The sports trainer where I coached didn't really agree that I should do leg extensions, but she wasn't about to argue with a surgeon. Proceed with caution with this one.

[[old] slo_boat]

A quick note on the super slow: I've found that slow eccentric contraction has been a key to rehab of my knees and a shoulder. Super slow seems to make a lot of sense. It was a big part of what my PT had me doing for a hamstring injury and for rehab after I had my knee scoped.<br /><br />BTW, I'm not claiming any particular wisdom or expertise here. I'm just sharing what has worked for me.

[[old] Xeno]

If you can row the erg than try this exercise:<br />By using the slide you can row with one leg. Which makes the load of the leg which is being used heavier. The leg that you don't use stays out to the side so that you don't hit your chin on the lower edge of the footboard. Keep the "anker leg" in a constant right degree angle, your knee stays above the ankle.<br />My indoor rowing workout DVD features this exercise extensively.<br />All my best,<br />XENO<br />www.gorow.com

[[old] seagulldc]

Can you guys elaborate on the super slow protocol?<br />Thanks<br />Rachel

[[old] pduck]

<!--QuoteBegin-seagulldc+Feb 16 2005, 09:43 PM--><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td><div class='genmed'><b>QUOTE(seagulldc @ Feb 16 2005, 09:43 PM)</b></div></td></tr><tr><td class='quote'><!--QuoteEBegin-->Can you guys elaborate on the super slow protocol?<br />Thanks<br />Rachel <br /> </td></tr></table><br /><br /><br />Here's a good article on the subject:<br /><br /><a href='http://www.pponline.co.uk/encyc/super-s ... ining.html' target='_blank'>http://www.pponline.co.uk/encyc/super-s ... tml</a><br /><br />The author points to more studies which favor traditional weight training over SS, but I still think SS has a place, especially when it comes to injury recovery.

[[old] chudwell]

Good responses. thanks! Body-only squats sound OK, just don't want my gym buddies to see that. Restricted range leg extensions sound worth a try too.<br /><br />I should have told you, I had major ligament damage in seperate accidents as a teenager, and my olympic career was cut short :^) I have also had other leg injuries due to bikes, one parachute accident (hey, I walked away, but not very fast) and one chainsaw accident. I am 34, and getting older fast, but want to keep moving before any degenerative conditions set in.<br /><br />I have not read such an informative article on Super Slow. Thanks for that. Sounds interesting.

[[old] Yoda1]

chudwell,<br /><br />If you punch in Super Slow and do a search you will find a lot of information about SS. There are many folks that don't believe some of the results obtained by using SS, but I for one have seen some pretty amazing results. I have been teaching SS for about 10 or 12 years after too many years of the traditional training. In my opinion, and it's just my opinion, it is one of the best methods of training whether it is for rehab or for sport.<br /><br />No Yelling!!!!<br /><br />Yoda

[[old] chudwell]

Yoda, I appreciate your opinion, and will not hold you personally responsible for any misinterpretation on my part <br /><br />I will work it into my workouts and see how it goes. Like rowing, I bet the main variables are the form and discipline. I am an impatient person, but I need a change in the same old routine. This should help.