Working out with bad knees.

  • Posted by a hidden member.
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    Jun 20, 2007 10:21 AM GMT
    Many years ago I was a mad keen cyclist. Now I've got crook knees (3x arthroscopies and a cruciate ligament reconstruction). This makes it difficult to do a full range of exercises, as repeated bending of the knees, especially with any weights involved will do major damage. Running, even jogging is out, even for really short periods. I've tried some isometric exercises, and they do work, but I've been told that they are bad for your blood pressure, and heart. Has anyone out there heard of any exercise programs, for general fitness, that cater for people with this problem? I'm sure there must be some, as there would be many men with knees that just can't take a normal routine.
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    Jun 20, 2007 11:22 AM GMT
    OK not the same but when it comes to squats I cant actualy do them full range because of an injury to my adductor muscles. However I am able to do partial range without causing a problem.

    I ran this past one of the top Sports Conditioning Coaches in the US and he said that this was the right approach to take. ie do what yuor body will allow as you will still gain from what you can do rather than what you cant.

    So what I am saying is dont rule anything out without knowing what you can do? if that makes sense.

    Will non load bearing exercises be better ie prone bikes as opposed to upright?

    When it comes to major compounds a straight leg dead lift maybe ok for you too.

    best person to work with on an answer for this is a physio tho
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    Jun 20, 2007 4:50 PM GMT
    I ended up with knee problems a few years back (torn ligament in high school and running injuries)--a physical therapist worked with me doing isolated strength training (one leg at a time, high rep, low weight, slow count) to get me back to the point that I can run a few times a week (nowhere near as much as I used to). Swimming and walking are terrific, low-impact alternatives for cardio.
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    Jun 21, 2007 1:22 AM GMT
    Hey, Jayme. About a year and 3 months ago, I ruptured the patellar tendons, which hold the kneecaps in place, in both legs. I had emergency surgery and was in the hospital for 3 weeks, in braces another six weeks, on a walker and crutches for several months, in excruciating pain for many months, etc.

    And the surgery was botched. Both my kneecaps moved up, so that when I sit, they face upward rather than forward. It's called "patella alta." "High kneecap." Eventually, this will likely create unbearable arthritis and I will have to have the surgery done again. In the meantime, I cannot walk downstairs without considerable pain and difficulty, and ordinary squatting, even sitting down, is often painful. Otherwise my movement is unrestricted.

    I was back in the gym two weeks after I got out of the hospital. The injury hasn't affected my upper body workouts. (I also did a couple months of rehab. I had miserable rehab therapists who did more harm than good through their ignorance and laziness. I won't go into all of that.)

    I found that I can compensate for not squatting in a variety of ways. I use the abductor/adductor machines and others that don't stress the knees. I've completely maxed out on them, so I have to do ridiculously high volume. Also, leg curls do not stress my knees, since they are supported during the movement. As is usual in such injuries, my hamstrings have grown to compensate for my weakened quads.

    For directly working he quads, I do leg presses, often one leg at a time (this seems to work better; why, I don't know). As I've said in a zillion threads here, I use HST. It works on the principle that the actual weight doesn't matter as much as the progressive addition of weight. So you calculate the maximum weight you can bear and then back it up x number of weeks, so that you progress slowly to it. It is gentler and more effective than other training methods:
    http://www.hypertrophy-specific.info/

    Although it is not designed so much to increase strength as size, I found that it fits my compromised strength training very well.

    Finally, I should mention that after firing my loser rehab therapists, I hired a private yoga-strength trainer. She was especially helpful in recouping strength in my stabilizing muscles.





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    Aug 06, 2007 4:36 PM GMT
    i take anti-inflammatory drugs. I swim everyday and in the gym i do all my leg exercise with machines. Laying on my stomach for leg curls and i do kick backs using legs straps connected to my feet. It take all the pressure off my knees. I suggest going to a trainer to learn these new ways of exercising to strengthen your legs. Good luck
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    Aug 06, 2007 4:52 PM GMT
    I had a sever knee disslocation one night while dancing which actually ended my ballet career when i was 18.

    Since then the patella has actually managed to twist, I'm sure this is in part because i had no medical coverage when it occurred and therefore things like surgery and rehab where out of the question and never even presented to me as an option.

    NOW i actually went into the gym more after i was "healed" and did a lot of leg machine workouts, i started doing yoga and tai chi, and eventually hard core martial arts.

    The yoga REALLY helped me gain a full range of motion again and it took away a lot of the pain and dull ache.

    I also began swimming a lot more which also helped the pain and kept everything nice and toned. It's an excellet substitute for running or jogging.

    I can do full squats, mind you very slowly so that i am watching my form, now as well.

    In the spring i stepped back into ballet classes and still havent lost it. I have full mobility and though certain movements hurt a little, i am still able to perform them. I actually think that the classes have been very good for my knee because my body was so conditioned to performing the movments that going back to them placed my body into an familiar alignment.

    I dont take any anti-inflamitory meds anymore either.

    Best of luck to you and keep us posted!!!!!! Anything you find out you should share for those of us who "feel your pain" as it were!
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    Aug 06, 2007 5:59 PM GMT
    Lots of good advice here. I have bum knees as well (and OW, I was clutching my knees just reading your story!) due in part to bad genetics and in part due to doing lots of cross country running in college.

    The best thing that others have already said is no weight bearing exercises and you'll be all good. But even then, there are some you can do like doing lunges with an exercise ball between you and a wall that include only your own body weight that'll have you screaming after a few sets.
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    Aug 07, 2007 9:53 AM GMT
    Thanks Guys!!! Lots of great, sensible feedback.

    To be more specific, the straight leg lifts really do work. You can't put much muscle on, but you can keep trim. The work-out in the pool idea works really well. You would be surprised how great it is for the abs!! I'm a Uni student, so don't have much money for pool admission, so I go to the beach and walk a couple of kilometres in water up to my crutch. Well, I do sometimes. It's winter down here at the moment, and bloody cold, so I'm a bit lazy.

    The best tip was the progression idea. I do the isometric exercises, increasing the number of reps steadily, then have a few days off, then start again, at a much lower number and work my way up again (i.e. from dozens to hundreds) It really works!! I get a noticeable improvement from stopping and starting again, ramping it up, than I get from keeping on doing hundreds of reps at a time. I do less, but get much more out of it.

    Thanks guys, for the first time in ages I feel good about my exercise routine. I'm getting results.

    Luvs ya all!!!!
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    Aug 07, 2007 11:38 AM GMT
    The fact that you had athroscopic surgery tells me that you likely had meniscual tears and you probalby had portions of the meniscus shaved off. You also did not speficy if it was the anterior or posterior curiciate ligament that was repaired (your own hamstring or cadever transplant?) It is also likley the anterior cruciate ligament (ACL). Did you have the medial collateral ligament (MCL) damage as well...?

    That being said, ligamentus injureis will heal. However, whatever amount of meniscus they shaved off will not regenerate, leaving you with less cushioning material between the knee joint, andl also with a slightly looser knee.

    So, any closed chained (compressive) exercise, especially with the knee bend to end ranges, will exacerbate the pain. There is just no way around this.

    Like many suggested here, the key is then to monitor the PROGRESSION of the amount of resistance when you do closed chianed leg exercises such as leg presses or squats (shallow, not full squats, and if you can tolerate it).

    Open chained exercises such as straight leg raises (SLR) and knee extensions are OK to do. However, if you have a knee cap (patellar) problem, knee extensions are NOT recommended as this puts a LOT of stress on the whole patellar complex. If you do want to do knee extensions, you can try partial range terminal knee extension, where you do not let your knee bend beyong about 40 deg or so. SLR is not as effective as far as training for the qauds in isolation as you recruit a lot of your hip flexors for the movement, but it is still a very fucntional exercises as you do need this movement to prevent buckling of the knee.

    Knee cap problems is NOT the same as the knee condyle joint problems and they require very different treatments and care. However, many athelets have BOTH problems co-exisiting at the same time....

    One warning about patients with athroscopic meniscus debridement... If you had a lot of cartilage materail shaved off, the laxity of the joint can result in early onset of osteoarthritiis as every weight bearing movment willmake the knee joint clunck slihglty, increasing wear and tear. For PROLONGED weight bearing activties, such as hiking, you may want to ask your PT for a deloader knee brace to wear for such acitivities.

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    Aug 07, 2007 11:42 AM GMT
    And I am not sure who told you that isometric exercises will raise your blood pressure significantly if done correctly...

    The tendency for most when performing isometric exercises is to hold their breath, creating a condition called Valsalva, which the intra-abominal pressures increase, causing pressue against the thoracic cavity to also increase, resulting in systemic blood pressure increase.

    Just breath normally, your BP should not raise that high..
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    Aug 07, 2007 12:58 PM GMT
    "The best tip was the progression idea. I do the isometric exercises, increasing the number of reps steadily, then have a few days off, then start again, at a much lower number and work my way up again (i.e. from dozens to hundreds) It really works!! I get a noticeable improvement from stopping and starting again, ramping it up, than I get from keeping on doing hundreds of reps at a time. I do less, but get much more out of it."

    I'm glad that was helpful. Training that way is completely opposite to what I was taught and did for years, and it's amazing to me that you can get more muscle by working lighter.
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    Jun 27, 2013 10:41 PM GMT
    I'm a tennis player and I'm having an issue with the soft tissue located directly to the left of my left kneecap. I notice it's swollen while the same pocket of soft tissue on the right knee is normal and there's no pain.

    What's going on? Tendonitis? Should I go see a specialist?
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    Jun 28, 2013 6:17 AM GMT
    I dunno. Let us know if you do. My knees have been crap since I was 17 (rheumatoid arthritis.) Would be interesting to know if there are any new solutions.

    My $0.02. If I keep up with the things I can do that don't irritate my knees, (e.g., cycling, deadlifts, and light squats) then I seem to be able to run more. As if building up some muscle takes some pressure off the joint.

    I'll be first in line for the bionic ones.
  • FRE0

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    Jun 28, 2013 7:44 AM GMT
    When I was 22, I took up weight lifting for the first time.
    At that time, it was not known that full squats often cause knee damage. I was doing 265 pound full squats; I weighed about 143 pounds and still do. When I had knee problems, I was advised to continue and that my knees would get used to it. There were times when I had to use the handrail to climb the steps to get out of the gym. Finally, I decided that continuing the squats made no sense and stopped.

    Since then, my knees have been somewhat marginal, although they never kept me from running long distances. However, I will not do squats or leg extensions. Walking and bicycle riding are not a problem.

    If anyone has knee problems, I suggest avoiding anything that causes them to act up. It is sometimes best to accept one's limitations, especially when joints are concerned. You just have to experiment and see what you can do without causing your knees to protest too much.
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    Jun 28, 2013 4:07 PM GMT
    Well thanks for this. Would seeing a specialist be superfluous at this point?
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    Jun 29, 2013 11:24 PM GMT
    darius30 saidI'm a tennis player and I'm having an issue with ...
    ... bumping 6 year old threads. icon_lol.gif
  • MikemikeMike

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    Jan 13, 2015 8:15 PM GMT
    Resetting the knee reflexology. It works. No more than twice a day. Morning and night!

    You need to sit in a chair with your legs at a right angle feet flat on the floor, not dangling and not pressing too hard on the floor. Knees should be relaxed. Place your right hand over the top of your right knee. Your thumb on your left side of the knee your ring finger and pinky finger on the right pointer finger at 2 o clock. Squeeze both sides as hard as you can stand for 21 seconds count slow. Then use you 2 middle fingers and find the soft tendon right below your knee cap press in really hard for 7 seconds. As soon as you finish strike your right heel to the ground hard. You must be wearing a good sneaker while doing this. Repeat on other side. Always do both sides even if one knee is the problem. You will feel a tingle in your knee and shin. Pain will dissapate!