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knee rehab

Posted: Wed Apr 22, 2009 9:08 am
by sks24
Got a question about rehab with a knee strain.

On 3/5/09 I strained my knee a bit squatting 140 lbs. Just a little "burning sensation /tinge" really, and, on 3-10, I did 10 reps with 115 lbs, and that with no pain. So I kept upping the weight, and, by 3/30 - 5 lifts later - I was back up to 135lbs on the squats. But there must have been a problem, because I show 115lbs/16 reps on 4/3. And, on 4/15, lifting 120lbs, I noticed another "tinge," but, this time around, my knee hurts pretty much all day.

When I injured it the first time around, I recall my right knee migrating to the outside just a bit, and I think it was arresting that migration when I noticed the little "burn/tinge" on the inside of my knee, just above my kneecap. Like I said, it hurts all the time now. I lifted again on 4/20, and didn't do any deadlifts or squats. Only bent rows. And, after my post-lift run, my knee all but throbbed, but only in that very specific area.

I have a nice hyperextension chair, so I can hit my erector spinae with that.

I have a machine on which I can do leg extensions, curls, and presses. Should I do anything at all in terms of controlled stress on this right knee while it heals? If so, then what should I do?

How much can I get away with? Seems like I should be able to hit my glutes with leg curls. My guess would be that I should avoid extensions and presses with heavy weight/low reps.

Would very low weight and high - 30 to 50 reps - be helpful?

Thanks in advance for your help.


Posted: Wed Apr 22, 2009 9:28 am
by hoosegow
Talk to your doctor, but...

Is your knee swollen?

How bad is your squat form? It has been my experience most knee problems arrising out of squats is due to terrible form. I'd be willing to bet you are collapsing your knees or favoring one leg.

Posted: Wed Apr 22, 2009 9:31 am
by KPj
You could really do with seeing someone in person, a physical therapist or similar - someone that can check out your hips and ankles aswell as looking at the knee specifically.

Other than that, you should read this article,

18 Tips for Bullet Proof knees ... ining.html

My main tips, which are covered in that article, would be

1. Firstly, forget about the knee. Sounds silly, but seriously, unless you suffer some acute/impact based injury, then you're best to 'think outside the knee'. Your knees are slaves to what happens at your ankles and hips. If something goes wrong at either of those joints, your knee will pick up the slack, and eventually get sore. The hips have direct control over your knee. It's all in the hips (and ankles).

2. From what you said in your post, a couple of things jumped out that could be making things worse than they need to be - Leg Extensions, and 'post lift run' - don't run, it's too hard on the knees. If you want to run, wait until you're pain free. Also, leg curls aren't effective in getting at the glutes. In terms of knee health, they aren't even effective in getting at the hamstrings. Also, just about anything that places emphasis on the quads MIGHT cause pain, but you can only try, sensibly, and see how it goes.

3. Do 'single leg stuff'.

4. Get a 'foam roller'.

5. Stretch the hipflexors and quads

6. Really hammer the glutes, but not via machines.

7. Train the glutes. (it warrants a mention again - it's that important)


Posted: Wed Apr 22, 2009 10:13 am
by KPj
One last point...

If it hurts, don't do it.


Posted: Wed Apr 22, 2009 11:28 am
by caangelxox
you may have not used good form or maybe your glutes were not firing enough and your knees were doing a lot of the work.

Do a lot of glute activation work and get those glutes burning before you squat to keep pressure off the areas that should not be doing the work. A lot of knee and hamstring problems happen from glutes not firing and not strong enough.

Wait until your knee heals before you go back to squatting though. What you can focus on right now instead of squatting is a lot of glute activation like glute bridges, fire hydrants, kick backs, bir dogs, etc.


Posted: Wed Apr 22, 2009 12:34 pm
by sks24
Thank you all so much for your prompt and comprehensive replies to my questions. I'm going carefully to read over everything you said and sent (the linked-to article, KPj, looks very good).

I can't afford a doctor right now, but I don't think this strain is very serious. I have noticed, now that I'm 46, that things take much longer to heal. It was very foolish of me not to ask after do's and dont's on 3/5, when I first noticed this problem. So what I would like to do is carefully consider all the information you've provided me, and then I'll come up with my best guess as to a safe and effective program to get me back on track.

I would be greatly appreciative if, upon my presenting that proposed program here, I could get some comments if you notice anything that might cause problems, or see opportunities I might be missing.

Again, I don't think this is very serious, but it certainly has gotten worse over the past month or so. Clearly I'm doing something wrong. But, earlier today, before I read your replies, I ran for 4 miles and then did 15 minutes of all-out sprints. I wasn't a mile into the session before I wasn't experiencing hardly any pain at all in my knee.

The other thing I've noticed is that my other knee feels "tight" too. So I must be doing something wrong.

I really do study the films of proper technique very carefully. But, since I work alone, I simply don't have any basis for objective evaluation.

Again, thank you very much for your help.

Posted: Wed Apr 22, 2009 10:14 pm
by sks24
My knee is not swollen, btw.

Posted: Thu Apr 23, 2009 4:20 am
by KPj
SKS - Sure, post the programand we'll have a look.

Sometimes, if not all the time, dropping some things that you're already doing is just as important as adding some things that you need to do.

It could be worth posting what you were doing before as well. But, it's up to you - i'm happy to help either way. Joint pain is generally a result of stress that has accumulated over time. lot's of things can effect it, not just stuff that feels sore at the time you're doing it, especially when it's inflammation you're dealing with, when you generally don't find out that you screwed up until later that night or the next morning.


Posted: Thu Apr 23, 2009 9:13 am
by sks24
Thank you very much for being willing to consider my case to the extent you have. The Internet - and the people who populate it - are pretty amazing.

I knew absolutely nothing about the exercises caangelxox mentioned, and I had to go to youtube to see about all those terms, and also what one could do with a "foam roller." I get the general idea now. So maybe this weekend I'll sit down and figure out my routine for the coming weeks. All suggestions appreciated.

I do two full-body lifts a week, and I trade off on cardio between running, elliptical, and, during the summers (I live in South Carolina) water running. But I haven't been in the pool since last summer, and, over the past two/three months, I've probably run about twice for every one elliptical session. (I'll bet that's a problem.)

Here's my strength training, in the order I do the exercises, with 1RMs.

1. Squats 180 (lbs)
2. Deadlifts 227
3. Bent Row 167
4. Bench Press 174
5. Lat Pull-Down 14 (that's on a Body Solid machine, plates weigh maybe 10 lbs)
6. Seated Military Press 87
7. Abs (dumbell on incline bench) 50

I do light, medium and heavy days:

Light days: 10-15 reps, 65% 1RM
Medium days: 7-11 reps, 70% 1RM
Heavy days: 5-9 reps, 80% 1RM

On my heavy days I add a bunch of "little" isolation exercises: shrugs and curls all the way down to wrist pro- and supinations.

Two sets: one warm up @10 reps at 50% 1RM, one strength.

I have a power cage, and I use it for squats, bench, bent rows, and military press. It has a plate stack.

I also have a very nice adjustable Nautilus hyperextension chair.

I've had two other injuries: I either tore or strained my (I think) subscapularis (that's why the power cage is now so important for me on that exercise - not letting the elbows below the shoulder), and tennis elbow, which I got when I did a big landscaping job last year. Occasionally a little sensation in the forearm, but otherwise both have healed.

And I used to have serious mid-back pain. The back pain was the reason I began a fitness program. Took about three years, but I've pretty much gotten on top of that.

Again, thank you very much.

Posted: Thu Apr 23, 2009 9:17 am
by sks24
And I scale between 173 and 177. % body fat on this $50 run-current-through-the-body fat meter is in the 17-19% range. I'm 6'2".