Quads excercises w/ bad knee?

[01svtL]

I've got some pretty bad knee pain that has developed over the last couple of years. It hurts pretty bad to do even 2/3 the weight I was doing in college on the leg press machine now. What are some other quad excercises that are good for people w/ bad knees?

[WADEAL]

I ruptured a patella tendon a couple of years ago and I have managed to get back to some semblence of fitness after fairly major surgery. So I know all about the frustrations of knee pains.

I'm 175lb and can now leg press 660lb, so I guess the surgery was a success, but I still get soreness after training and it was a long gradual return. If you aren't icing and stretching after sessions, start now. It might not cure, but it definitely will help with any swelling.

As for exercises, I struggle with squats and prefer leg presses. However, your physiology might mean that he opposite applies. I also struggle with leg extensions and lunges are an absolute "no-no" due to the pressure going directly through my (still weak) patella.

The problem is that the knee is a very complex joint and simply to say do exercise x or y might be fine if you have the same injury as me, but a disaster if you have a torn cruciate or even something like a hamstring imbalance, or just tendonitis through overuse. So the answer to your simple question - "my knees are hurting, what exercises are good" won't to produce a simple answer as it depends upon the area of the knee that you have injured and the severity.

The key may be to find out which exercise is causing the most problems and find a work around. However, I'd certainly try to find out first what the reason for the pain is. You may be making things worse by continuing to train and a simple trip to the docs or physio might help to sort things out quickly.

If you have to train, the exercises mentioned above, plus hack squats, are the only real obvious big quad builders. To build big quads you need to straighten and bend the knees, so any variations on exercises are going to be fairly limited. This means that the only option may be to lower the weights you use (yeah I hated the doc for saying that as well) and to try variations on each of these exercises to see which ones cause the pain. Alternatively, if you can pre-exhaust the quads with leg extensions and leg curls before doing lighter squats, or leg presses this may mean less pressure on the knees, but may give equally good results without pain. So that is also an option.

I'd also look at your feet positions - it may improve things if you widen or narrow your stances - particularly in squats and leg presses as the foot position affects the way the pressure goes through the knees. With regard to squats and leg presses, I'd also look at the depth you squat to. You may actually be able to improve things by squating lower and stretching further - or by alternatively going less far down and putting less pressure on the knees. Strapping you knees might also be an option to improve their stability - although there are arguments for and against them. Experimentation might at least find out what is causing the most pain and these variations are useful to stimulate muscle growth by hitting the muscles from slightly different angles.

Are your feet parallel or are your toes pointing outwards on squats and leg presses? Mess about with that. A simple change of angle can work different regions of the quads - and it may be previous bad form which has led to your pain - although in most cases it is usually a case of simply getting old, lifting too much weight - or in my case probably both.

Is your form correct? - I'd get someone to video you or look at you lift and comment - you can't tell if you are doing something wrong when you are under a big lift, so get a third party to look - even if you are an advanced lifter they might see something you miss. After 20 years of training I'm starting to wonder what the inductions are about at gyms these days because strict form and slow, continuous, tension have disappeared or been completely ignored in my local gym. Get your form right and train don't strain.

The final thing (and this probably should have come first), is that if you are in pain (and I don't mean the regular soreness you get from lifting), that is the body's way of telling you to stop. Listen to it and try resting. After a couple of weeks off things might improve. If you feel guilty you can always swim. The typical athlete always tries to comeback too soon after an injury and your injury might be something that is simply being aggravated by overuse and has not been allowed enough time to heal properly - although given that you suggest it has been a 2 year problem it sounds more serious.

Hope this helps

[01svtL]

I ruptured a patella tendon a couple of years ago and I have managed to get back to some semblence of fitness after fairly major surgery. So I know all about the frustrations of knee pains.

I'm 175lb and can now leg press 660lb, so I guess the surgery was a success, but I still get soreness after training and it was a long gradual return. If you aren't icing and stretching after sessions, start now. It might not cure, but it definitely will help with any swelling.

As for exercises, I struggle with squats and prefer leg presses. However, your physiology might mean that he opposite applies. I also struggle with leg extensions and lunges are an absolute "no-no" due to the pressure going directly through my (still weak) patella.

The problem is that the knee is a very complex joint and simply to say do exercise x or y might be fine if you have the same injury as me, but a disaster if you have a torn cruciate or even something like a hamstring imbalance, or just tendonitis through overuse. So the answer to your simple question - "my knees are hurting, what exercises are good" won't to produce a simple answer as it depends upon the area of the knee that you have injured and the severity.

The key may be to find out which exercise is causing the most problems and find a work around. However, I'd certainly try to find out first what the reason for the pain is. You may be making things worse by continuing to train and a simple trip to the docs or physio might help to sort things out quickly.

If you have to train, the exercises mentioned above, plus hack squats, are the only real obvious big quad builders. To build big quads you need to straighten and bend the knees, so any variations on exercises are going to be fairly limited. This means that the only option may be to lower the weights you use (yeah I hated the doc for saying that as well) and to try variations on each of these exercises to see which ones cause the pain. Alternatively, if you can pre-exhaust the quads with leg extensions and leg curls before doing lighter squats, or leg presses this may mean less pressure on the knees, but may give equally good results without pain. So that is also an option.

I'd also look at your feet positions - it may improve things if you widen or narrow your stances - particularly in squats and leg presses as the foot position affects the way the pressure goes through the knees. With regard to squats and leg presses, I'd also look at the depth you squat to. You may actually be able to improve things by squating lower and stretching further - or by alternatively going less far down and putting less pressure on the knees. Strapping you knees might also be an option to improve their stability - although there are arguments for and against them. Experimentation might at least find out what is causing the most pain and these variations are useful to stimulate muscle growth by hitting the muscles from slightly different angles.

Are your feet parallel or are your toes pointing outwards on squats and leg presses? Mess about with that. A simple change of angle can work different regions of the quads - and it may be previous bad form which has led to your pain - although in most cases it is usually a case of simply getting old, lifting too much weight - or in my case probably both.

Is your form correct? - I'd get someone to video you or look at you lift and comment - you can't tell if you are doing something wrong when you are under a big lift, so get a third party to look - even if you are an advanced lifter they might see something you miss. After 20 years of training I'm starting to wonder what the inductions are about at gyms these days because strict form and slow, continuous, tension have disappeared or been completely ignored in my local gym. Get your form right and train don't strain.

The final thing (and this probably should have come first), is that if you are in pain (and I don't mean the regular soreness you get from lifting), that is the body's way of telling you to stop. Listen to it and try resting. After a couple of weeks off things might improve. If you feel guilty you can always swim. The typical athlete always tries to comeback too soon after an injury and your injury might be something that is simply being aggravated by overuse and has not been allowed enough time to heal properly - although given that you suggest it has been a 2 year problem it sounds more serious.

Hope this helps

Thanks man.

My g/f is in PT and has learned that extensions are terrible for the knees, particularly the patella area.

My Mom just had her second partial knee replacement surgery, so I fear it may be in my genes to have bad knees. I don't think I'm built to put on a **** ton of muscle/weight, but I'm trying anyway. I continue to do chest/shoulder exercises after tearing my labrum off the bone almost a year ago. I think swimming every day for about 3 weeks after my injury helped a lot. My strength is almost back to where it was, and I never even scheduled the surgery that the Doc said I needed to reattach it, haha.

[BigPapiPierre]

Thanks man.

My g/f is in PT and has learned that extensions are terrible for the knees, particularly the patella area.

my thoughts exactly... my wife is a PT also and i tore my ACL 100%, MCL 70%, light PCL and LCL damage and also injured my miniscus in a basketball fall last year and i have stayed away completely from leg extensions and stairs...

best thing (as told by my wife and other PT's) is Hamstring Curls, light leg press and light squats. you need to strengthen the leg again.

i actually started a couple months ago really focussing on my legs and getting back some lost strength and its going well. im lifting as heavy as i can and no more pain then usual...

Try swimming, that is also great!

[WADEAL]

One thing I didn't comment upon in my first post was the importance of balance in the opposing muscles.

The hamstrings are a very important stabiliser and need to be worked as hard as the glutes and thighs to support the legs. This is especially true if you have been involved in any sort of running exercise in the past. Running tends to shorten the hams, focus on and build the thighs.

The easiest way to spot a weak hamstring is to look at the knees. Knock knees are usually a sign of strong quads and hams that are not necessarily weak, but out of balance and not as strong. Injuries can often be caused by simple imbalances. So work on the hams.

Again, I speak from personal experience. After years of pretty serious distance running (which is all quads), I got into martial arts (your kids go along and you get dragged in don't you?). I soon realised how short my hams were and how tight they were when the stetching started and I tried to kick higher. Despite being really fit, I discovered just how much the running had left the legs unbalanced.

I later bought a pair of martial arts shoes to train in. They are light and have virtually no heels. After a week I stopped wearing them. A normal shoe has a heel and a simple 1/2 inch difference in the heel height gave me achilles problems. So injuries are easily picked up and your gait can affect all sorts of other areas.

Having heard your story about refusing labrum surgery, I suspect that you are one of those who is simply unable to hold back and carries on no matter what (join the club brother!!!). A few words from a sage who is wise after the event. When they told me not to train through injury at 25 I didn't listen. At 47 I sure wish I had now! I'm carrying a knee that's shot (marathons, heavy squats in later years and a really bad twist shot that), tendinitis in the elbows (heavy bench presses) and a rotator cuff injury that are all due to wear and tear that probably would have gone away if I hadn't "trained thru" it. So take care.