Lower body exercises for client with bad knees.

[Baadboy11]

Ok got a lady pretty fit, on a weights and cardio program. Problem is she has no cartilage in one knee and the other is on the way out. Anybody got some good leg workouts that wont bug her knees?

Already doing:
Wall sits
Deadlifts
Weighted step-ups (short step)

[nickmanzoni]

facepalm

[Baadboy11]

facepalm

care to expand on that thought?

[Baadboy11]

Bump for knowledge

[Ape escape]

Every leg exercise will involve the knees to some extent. Just use really light weight and high reps (50 reps+)

[SerpentHearted]

care to expand on that thought?

he's implying it's a terrible choice of exercises.

Wall sits in particular i think are bad for knees.

This subject has come up on the forum before and I remember straight legged dead lifts being suggested. That's all that comes to my mind. It's a tough one.

[regl8r]

You need to find out more information.

Someone telling you that they have no cartilage can mean a few things. There are two kinds of cartilage; articular and meniscal. Many people get meniscal removed and assume they have "bone on bone" contact when in fact they still have articular cartilage.

Find out as much info as possible and report back. Does she have pain when completing exercises using her knees?

TKEs are GREAT and in my mind a must. Short box (I mean 6" low at first) step downs work well too... keeping one knee bent while other leg is on the ground, then extend leg that is bent on the box to raise up and repeat. These exercises should help strengthen all the ligaments/tendons surrounding the knee joint.

I'd stay away from the wall sits. I see it more as a torture exercise than building strength and the stress it puts on the knee joint is not worth it. Go bodyweight squats instead, use a box to determine how far she goes down. Once she gets comfortable at a certain level, go a little lower and try to get to parrallel eventually but don't be concerned if it never happens.

[Baadboy11]

You need to find out more information.

Someone telling you that they have no cartilage can mean a few things. There are two kinds of cartilage; articular and meniscal. Many people get meniscal removed and assume they have "bone on bone" contact when in fact they still have articular cartilage.

Find out as much info as possible and report back. Does she have pain when completing exercises using her knees?

TKEs are GREAT and in my mind a must. Short box (I mean 6" low at first) step downs work well too... keeping one knee bent while other leg is on the ground, then extend leg that is bent on the box to raise up and repeat. These exercises should help strengthen all the ligaments/tendons surrounding the knee joint.

I'd stay away from the wall sits. I see it more as a torture exercise than building strength and the stress it puts on the knee joint is not worth it. Go bodyweight squats instead, use a box to determine how far she goes down. Once she gets comfortable at a certain level, go a little lower and try to get to parrallel eventually but don't be concerned if it never happens.

Thanks for this response this is what I was looking for. I'll ask her what was removed, but she has pain when completing exercises such as squats, or really anything that puts her knees through a full or almost full range of motion. She is ok with wall sits, as they don't hurt the knees, same with step ups. Also when I said deadlifts I meant straight leg, and she's ok there too. I'll certainly add in some TKEs and ease up on the wall sits, I just have trouble not exercising the largest muscles in her body ya know?

Reppd fur sure

[regl8r]

If she can do 3 quarter squats stick with that for now. Like I said use a high box if its not painful. Box plus four 45 lb plates or whatever for example. After some sessions at that height try and take a plate away and go lower, if no pain AWESOME keep on going hope you get to parrallel eventually. Slow and steady wins the race

[lexinak]

Ok got a lady pretty fit, on a weights and cardio program. Problem is she has no cartilage in one knee and the other is on the way out. Anybody got some good leg workouts that wont bug her knees?

Already doing:
Wall sits
Deadlifts
Weighted step-ups (short step)

I work with a lot of older/not in good shape people with issues like this and honestly, even among those with knee injuries/no cartilage, it's going to be a unique case every time. Try hip abductions (+ weight on a cable machine if possible) and standing knee extensions (stand on one foot, bend other knee up to 90 degrees, bend, straighten, bend, straighten). For hamstrings she might tolerate hamstring curls on a ball, or maybe just do simple hip lifts on the floor and make her focus on digging in her heels to get the backside of the legs.

So basically, experiment. Some things will feel okay, some things will hurt. Go in with a long list of exercises and try them all.

[Kreb]

Does she have a primary physician or is she working with a physical therapist? Start there. It sounds like there is some information she is leaving out or doesn't know about. If it's just the squats causing her pain (assuming BW), there is a good chance its not the squat but how she is executing the squat.

As for suggesting 50+ reps......why?

[KyleAaron]

This is one of those threads on this forum that frighten me.

[ericzimmerman34]

I to believe wall sits are a dangerous choice for a client with bad knees. I actually learned this in a certification course and it makes sense. If you look at the biomechanics of it all of the weight is placed on the knees. If you have cable machines with the foot attactment straight leg extensions and flexion are great choices for them to start out with.

[Baadboy11]

I work with a lot of older/not in good shape people with issues like this and honestly, even among those with knee injuries/no cartilage, it's going to be a unique case every time. Try hip abductions (+ weight on a cable machine if possible) and standing knee extensions (stand on one foot, bend other knee up to 90 degrees, bend, straighten, bend, straighten). For hamstrings she might tolerate hamstring curls on a ball, or maybe just do simple hip lifts on the floor and make her focus on digging in her heels to get the backside of the legs.

So basically, experiment. Some things will feel okay, some things will hurt. Go in with a long list of exercises and try them all.

Thanks I'll add some of those in, good stuff.

Does she have a primary physician or is she working with a physical therapist? Start there. It sounds like there is some information she is leaving out or doesn't know about. If it's just the squats causing her pain (assuming BW), there is a good chance its not the squat but how she is executing the squat.

As for suggesting 50+ reps......why?

I think she worked with a pt before but Its been several years. They basically told her she could use the knee, but I'm trying to make her use it without hurting it and driving her away. And yeah BW squats cause her pain, and her form is actually pretty good when I made her try a couple.

This is one of those threads on this forum that frighten me.

What 50+ squats are a bad idea? lol

I to believe wall sits are a dangerous choice for a client with bad knees. I actually learned this in a certification course and it makes sense. If you look at the biomechanics of it all of the weight is placed on the knees. If you have cable machines with the foot attactment straight leg extensions and flexion are great choices for them to start out with.

Thanks for the suggestions, I'll add some cable work too. I can see how wall sits would put pressure on the knee, but they seem to be ok with her so who knows.

[cthulhupun]

This is one of those threads on this forum that frighten me.

It's what you get with a completely unregulated field.

[nickmanzoni]

care to expand on that thought?

You're an idiot.
"bad knees" is not a diagnosis.
Impact and static stretch holds are the worst things you can do for knees.

Expanded enough?

[Baadboy11]

You're an idiot.
"bad knees" is not a diagnosis.
Impact and static stretch holds are the worst things you can do for knees.

Expanded enough?

Did I say bad knees? I said "no cartilage" in my first post I see reading is not your strong suit..... however this is still a much more helpful post then your first one. Thank you

[Baadboy11]

facepalm

This is one of those threads on this forum that frighten me.

It's what you get with a completely unregulated field.

You're an idiot.
"bad knees" is not a diagnosis.
Impact and static stretch holds are the worst things you can do for knees.

Expanded enough?

And instead of helping with an honest question we get responses like this. How do you expect a new comer in the industry to gain knowledge when this is the response to their questions?

[regl8r]

Baadboy take the haters with a grain of salt.

There are alot of people who like to preach from their high horse on this board. At some point in time every trainer was inexperienced and at some times stupid.

At least you are seeking knowledge and ways to better yourself, best of luck.

[KyleAaron]

And instead of helping with an honest question we get responses like this. How do you expect a new comer in the industry to gain knowledge when this is the response to their questions?

That's what we have an education system for, and experienced trainers in the gym the new trainer works at.

If you rely on message boards for your professional education, your career isn't going to be exactly a sterling one.

Fair enough to be asking about obscure stuff. But "bad knees"? As Nick said, that's not a diagnosis, it's meaningless by itself. If a client complains of any pain, it goes like this,

1. Have you had this diagnosed by a medical professional?
2. If yes, what were the recommendations? Okay, let's follow them.
3. If no, let's try an exercise.
4. If exercise hurts, check technique.
5. If technique is bad, correct. Return to #3.
6. If technique is good and pain is still there, try another exercise. Return to #3.
7. If every appropriate exercise leads to pain, tell client to go to doctor. Return to #1.

This is basic stuff, covered by most PT courses and common sense. The only difficult part will be choosing exercises. Exercise technique is a big weakness of most PT courses. This is why we have experienced trainers in gyms you can talk to; any new trainer should seek to be employed by others before being self-employed. When you're self-employed you're on your own.

[buhtail]

nice to know we have such good trainers.......... sarcasm loooooook static holds like wall sits are not bad on the cartilage maby if its the miniscus and leg extensions put alot of pressure under the petalla so find out what area is wrong with here cartilage and ajust to it . all wall sits are is just cartilage on cartlage pressure nothings gona happen from that unless u add impact witch that impact will crack it and the movement with the impact grinds it away at the same time. also let me know and explain if u disagree

[benikin73]

Thanks for this response this is what I was looking for. I'll ask her what was removed, but she has pain when completing exercises such as squats, or really anything that puts her knees through a full or almost full range of motion. She is ok with wall sits, as they don't hurt the knees, same with step ups. Also when I said deadlifts I meant straight leg, and she's ok there too. I'll certainly add in some TKEs and ease up on the wall sits, I just have trouble not exercising the largest muscles in her body ya know?

Reppd fur sure

Hi, thanks for the read... I too have a client with the same issues and am struggling to work the lower body.. any sort of flexion and or extension exercise is an issue, Squats - Step Ups - Lunges - split Squats, even Spin is a problem..

Thanks for the idea of the TKE exercise, but if any one has any more ideas it would be appreciated.. Thanks to the original poster and I do apologise for jumping your post.

Cheers

[SaviorFair]

Ballet dancers do plie's and demi-plie's to strengthen their knees as well as releve's.

I know these work because in the late 90s I was taking a lot of ballet and jazz classes at high powered studios in NYC to help my competition dancing. I had a really bad knee that was bothering me. After three weeks of three classes a week, my knee was not hurting.

We did all sorts of balancing exercises at the barre.

Just a thought.

[aflo1994]

Cable kickbacks
Side leg raise with cable
Isometric hold on the leg extension, fully extended, light weight of course

[Ronin4help]

Ok got a lady pretty fit, on a weights and cardio program. Problem is she has no cartilage in one knee and the other is on the way out. Anybody got some good leg workouts that wont bug her knees?

Already doing:
Wall sits
Deadlifts
Weighted step-ups (short step)

Go through all the exercises uou know and keep very detailed notes on her feedback. This will protect you from liability. When you get a few exercises that work, play with the programs to keep the routine fresh.