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  1. #1
    Registered User mac520's Avatar
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    Rebuilding atrophied muscle in one leg

    Year and half ago, I broke my right patella. The knee pain is still present, but my doctor said it's because my right quad is still underdeveloped and it's not pulling on my patella properly. He said if I build up my quad, the pain should go away. I've been doing leg extensions and leg presses with one leg, and have seen some results, but my leg is still not quite normal, and it's nowhere as strong as my left leg--the muscle is probably about half as large.

    What exercises should I do to rebuild my right quad?

    Currently I am following Bill Starr's 5x5. I've been adding the one-leg leg press to mondays, one-leg leg extensions to wednesday, and am leaving fridays alone since that's when I do arms. I do 3 sets of 8 reps for each exercises. But I'm wondering if this is the best way to go about adding rehab exercises. What exercises should I do? What is the best number of sets and reps? Should I do a constant weight (i.e. 3x8x60 lbs on leg extension) or ramp it (8x50, 8x55, 8x60)?

    On another note, when doing one-leg leg press, should where should I put my foot: in the normal two-leg position, or in the center of the footplate?

    Edit: I also found it interesting that my right leg has become stronger at leg extensions than my left leg (the one twice as big). I can lock out 60 lbs 8 times in a set without struggling, whereas I can't even do it once with my left leg. I can think of 3 causes of this. Tell me which one is most probable.

    1. I simply don't have the neural adaptation in my left leg for leg extensions yet, since I have never done them before. Only full squats.
    2. My right leg IS as strong as my left leg because it has the same amount myofibrillars, but isn't as large because I'm missing the sarcoplasm that adds size. I don't think this is true because I still have trouble doing one-legged squats and hopping on my right foot, which indicates lack of strength in the right leg.
    3. Leg extensions are not an effective way to add mass to the quads.
    Last edited by mac520; 10-09-2009 at 08:24 AM.
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  2. #2
    Registered User mac520's Avatar
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    Hoping for some feedback.
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  3. #3
    Physiotherapist Fresch's Avatar
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    Patello-femoral problems require specific strengthenng for the medial quads (VMO) not the quads in general.

    You should have been given a specific program for this: did this happen?
    The science is out there!
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  4. #4
    Registered User mac520's Avatar
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    Originally Posted by Fresch View Post
    Patello-femoral problems require specific strengthenng for the medial quads (VMO) not the quads in general.

    You should have been given a specific program for this: did this happen?
    I'm sorry for the delayed reply here. I do care about getting some feedback, through.

    My physical therapy was inadequate. It helped in the beginning when they had me doing leg extensions with a five pound weight wrapped around my ankle and helped me stretch and regain full ROM. It has gotten me to the point I'm at now: where I can use my knee in daily activity, but still hurts slightly and can feel its weakness at certain angles (like when hopping in one foot), and visually it is quite obvious that my right quad is about half the size of my left quad.

    How do I strengthen just the VMO?
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  5. #5
    Registered User braindx's Avatar
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    Terminal knee extensions, quad sets, etc.

    Working the quad at the edge of it's ROM.

    You need work focusing on hypertrophy 6-12 reps with higher volume of sets. Leg press would probably be more effective. Step ups with heavy weight. Lunges, etc.
    No post is professional medical, nutrition or training info!

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    Injury articles:
    http://eatmoveimprove.com/2009/08/on-tendonitis
    http://eatmoveimprove.com/2009/11/shoes-sitting-and-lower-body-dysfunctions
    http://eatmoveimprove.com/2010/01/on-muscle-strains
    http://eatmoveimprove.com/2010/02/so-you-hurt-your-lower-back
    http://eatmoveimprove.com/2010/03/cracking-and-popping-and-clicking-oh-my
    http://eatmoveimprove.com/2010/10/a-firm-foundation-focusing-on-the-feet/
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  6. #6
    Physiotherapist Fresch's Avatar
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    Originally Posted by mac520 View Post
    I'm sorry for the delayed reply here. I do care about getting some feedback, through.

    My physical therapy was inadequate. It helped in the beginning when they had me doing leg extensions with a five pound weight wrapped around my ankle and helped me stretch and regain full ROM. It has gotten me to the point I'm at now: where I can use my knee in daily activity, but still hurts slightly and can feel its weakness at certain angles (like when hopping in one foot), and visually it is quite obvious that my right quad is about half the size of my left quad.

    How do I strengthen just the VMO?
    Exercises that challenge the stability of the knee i.e. step ups/downs, part squats, single leg squats, lunges
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