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PostPosted: Wed Mar 21, 2012 5:03 pm 
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robertscott wrote:
lh0628 wrote:
Another with DL, I find that it doesn't activate my hams much, the majority of the lifts are done by my quads and lower back...


sit back more and keep your back arched


Thanks I'll give that a try.

Jungledoc wrote:
lh0628 wrote:
Ih--if you have access to a knee extension machine, do a few sets of terminal extensions after your squats.


I do have access one, I'll try this as well. Is it ok if the knee hurts a little while doing this? The pain mostly happens when I'm within the 60-30 degree angles, but there is still a little bit going past 30 degrees.


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PostPosted: Wed Mar 21, 2012 5:08 pm 
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That sounds like you need to target the Vastus Medialis. That view is supported here: http://emedicine.medscape.com/article/308471-treatment

The Vastus medialis is also preferentially recruited during shallow step ups. You don't need any equipment for this. A step or a thick book will do. This muscle is also recruited in very deep squats. You will notice in Olympic weightlifters, how pronounced the "teardrop" muscle is. That makes your PT's advice about not squatting below parallel even more wrong. In the short term, leg extensions as Doc mentioned, or step ups.

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PostPosted: Wed Mar 21, 2012 5:19 pm 
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Thanks for that link stuward.

I forgot to mention that I had a fibula fracture on the offending leg a few years back, but I believe the pain developed after the event. I'm not sure if it's related, but I thought I'd mention it.

I also noticed that my femur tracks inward as it goes towards the knee, making my legs look like a tall 'X'. I'm sure my legs were more straight when I was younger.


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PostPosted: Wed Mar 21, 2012 5:39 pm 
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If your knees are caving in, that's further evidence that your vastus lateralis is overpowering your vastus medialis. Strengthening that muscle should straighten your legs and improve your knee stability. Notice the article also suggests stretching the iliotibial band. A foam roller does that nicely.

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PostPosted: Wed Mar 21, 2012 5:50 pm 
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My iliotibial band is very tight! Is there any exercises that help with this besides foam rolling?

Also, if my vastus lateralis is stronger, wouldn't it pull my knees/legs outward more?


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PostPosted: Wed Mar 21, 2012 6:36 pm 
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There are lots of ways to stretch the IT band. Here's one: http://www.exrx.net/Stretches/HipAbduct ... ibial.html

"Also, if my vastus lateralis is stronger, wouldn't it pull my knees/legs outward more?"

No, if your feet weren't on the floor, it would pull your feet out, which would, in effect, pull your knees in.

Try this. Hold your hands in front of you so that the palms are facing together. Pretend your hands represent your legs. Tighten the muscles on the back of your hands. That would represent the vastus lateralis. Your fingers will widen but your hands will exhibit the X shape.

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PostPosted: Wed Mar 21, 2012 7:57 pm 
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Thanks, that totally makes sense. I'll start doing the stretch in link from now on.


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PostPosted: Thu Mar 22, 2012 9:47 am 
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Jungledoc wrote:
Dub--PFS is a well-known syndrome. It's not a matter or something on the ligament or head of the muscle, but the patella is not centered properly in it's "groove" at the end of the femur. At least that's the long-accepted theory. One of the other names for this is "patellar tracking defect". The idea is that the medial quads are pulling the patella slightly to the inside, and so it rubs more on that side. The treatment has been terminal knee extensions.

Very good to know that. Thanks!

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PostPosted: Thu Mar 22, 2012 10:43 am 
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So I tried the foam rolling yesterday on the side of my thighs, bod did that hurt!

It felt good though, so I'll keep doing that.

Another thing I noticed though is when I squat, especially towards the end of a set. My left leg starts to take over the weight since the right knee starts to hurt a bit, probably 60-70% of the weight is on my left leg.

I'm wondering if this is OK. Would I get better strength and a better knee or would it hurt it more? Bare in mind I'm no where near the 1 RM, I did 190 lbs yesterday, and I would say my 1 RM should be at 250 lbs.


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PostPosted: Thu Mar 22, 2012 12:12 pm 
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You need to focus on the bad knee and let it determine the volume. Do your extensions or step ups one leg at a time. You squat sets should only be warm up weights until your knee has resolved.

Remember what I said earlier about getting the pain free range of motion sorted first. Why are you squatting 190 when you still have pain in your knees? Spend some time now in rehab and progressively increase the load after you have corrected your problems. The strength will come back quickly but not if you re-injure your knee.

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PostPosted: Fri Mar 23, 2012 4:03 pm 
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Your physiotherapists advice is horrid -- and frighteningly typical -- and should be soundly ignored and filed in the circular bin where it belongs.

As far as squats and PFS, rather than talk about the mechanical forces at play here, I'm going to ask you two simple questions that should demonstrate why artificially restricting your range of motion and ensuring you are weak through knee extension is an incredibly stupid idea:

1. Can you go up or down stairs with a perfectly perpendicular shin? If no;
2. Can you never ever go up or down stairs, go up or down a hill, or get into a vehicle for the rest of your life?

If there is a legitimate issue with the mechanical function of your hip and/or knee structures that prevents correct squat form or results in joint pain, the solution isn't to do something asinine like forcing your body into an unnatural movement pattern, unless you're playing to spend the rest of your life in a Hoverround™.

It'd be fantastic if you could post a video of your squats, loaded and unloaded, from the back and from the side.

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PostPosted: Fri Mar 23, 2012 4:35 pm 
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stuward wrote:
You need to focus on the bad knee and let it determine the volume. Do your extensions or step ups one leg at a time. You squat sets should only be warm up weights until your knee has resolved.

Remember what I said earlier about getting the pain free range of motion sorted first. Why are you squatting 190 when you still have pain in your knees? Spend some time now in rehab and progressively increase the load after you have corrected your problems. The strength will come back quickly but not if you re-injure your knee.


Hi Stuward,

I'm actually ok when I squat with a wider stance. It's only when I tried shoulder width stance that my knees hurt.

I am going to try and do the exercises mentioned in this thread to help with the knee (foam rolling, IT band stretch, leg extensions). I won't ignore the problem.


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PostPosted: Fri Mar 23, 2012 4:39 pm 
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JasonJones wrote:
Your physiotherapists advice is horrid -- and frighteningly typical -- and should be soundly ignored and filed in the circular bin where it belongs.

As far as squats and PFS, rather than talk about the mechanical forces at play here, I'm going to ask you two simple questions that should demonstrate why artificially restricting your range of motion and ensuring you are weak through knee extension is an incredibly stupid idea:

1. Can you go up or down stairs with a perfectly perpendicular shin? If no;
2. Can you never ever go up or down stairs, go up or down a hill, or get into a vehicle for the rest of your life?

If there is a legitimate issue with the mechanical function of your hip and/or knee structures that prevents correct squat form or results in joint pain, the solution isn't to do something asinine like forcing your body into an unnatural movement pattern, unless you're playing to spend the rest of your life in a Hoverround™.

It'd be fantastic if you could post a video of your squats, loaded and unloaded, from the back and from the side.


Thanks.

I'm schedule to see her again on Monday again, I figure I should at least give it a second time. She did diagnose me with PFS after all, which seems to be in line with the responses here.

To answer your question:

1. Yes I can. Except for my right knee hurts when I do it, though I can make the pain go away if I manipulate how the foot steps up.

2. I'm guessing this is a rhetorical question.

I will try to get a video up along with some pictures when I go with my friends next time.


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PostPosted: Fri Mar 23, 2012 9:30 pm 
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lh0628 wrote:
1. Yes I can. Except for my right knee hurts when I do it, though I can make the pain go away if I manipulate how the foot steps up.

This was a rhetorical question too, so I'm pretty sceptical, (or you're a civil servant in the ministry of silly walks.) At any rate, I was trying to make a clever point about the particular range of motion and loading that you've been advised against is necessary to function in day to day life — outside of a wheelchair. Sorry if that wasn't clear, I was on my iPad between clients, and somebody once told me brevity was the soul of wit. At any rate, if you keep your shins perpendicular or artificially restrict the range of motion on the knee, that force doesn't just dissipate into the ether, it goes someplace else in your body. There was a study that mechanically restricted anterior patella displacement, and that small amount of force reduction in the knee joint translated to a massive amount of torque in the hips. The human body evolved to move a certain way, and the goal should always be to move towards that freedom of movement and not away from it.
lh0628 wrote:
I'm schedule to see her again on Monday again, I figure I should at least give it a second time.

By all means, go and see her for an injury. That's what they're for. Just keep in mind that unless she's a sports physiotherapist she's not going to give good sport or exercise related advice. Your GP isn't likely to perform dentistry on you, after all.
lh0628 wrote:
She did diagnose me with PFS after all, which seems to be in line with the responses here.

I urge you to be careful about that too. None of us are physiotherapists (that I'm aware of) and none of us have any kind of imaging of any kind of any part of your body, let alone your knee. I'd say chances are the brilliant minds here are doling out some juicy tidbits of knowledge sweet as icing with zero carbs, but we're really only going off of a tiny sliver of the picture here.

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PostPosted: Sat Mar 24, 2012 8:31 pm 
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You need to post more Jason.

1. Because you give damn good information.
2. Because obviosly you don't know the people on this forum very well. See:

JasonJones wrote:
I'd say chances are the brilliant minds here...


Now there are some brilliant minds here, but most of us are little more than drooling troglodytes.

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