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Old 01-27-2009, 07:50 AM   #1
Brendon Mahoney
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Squat alternatives for clients with bad knees

Hi guys,

I was wondering what alternative exercises you recommend for clients with knee problems, esp. older clients. Ideally, I would like to get them to squat properly to strengthen their quads, hips, glutes, etc.

Any suggestions?
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Old 01-27-2009, 08:49 AM   #2
Jared Ashley
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Re: Squat alternatives for clients with bad knees

I found that I could get most clients with "bad knees" up to the point where they could squat with a combination of partial ROM squats, leg press, lunges, step-ups, and deadlifts. I would start unweighted and slowly add weight; step-ups would start sometimes with a VERY small step (4" or so)... I would add weight until they were holding maybe 20 lbs and then drop back to zero weight while raising the step, repeating the cycle.

After a couple of months, I would have them re-attempt a full-ROM air squat, and many were shocked that they could do it without problems... I truly think more of it was fear and lack of balance than actual weakness or bad knees.

For those who truly could not get full ROM due to knee pain, and there were a few, I would just continue progressing with the above. Most of the time their partial ROM squats were around 1/2 to 2/3 of the way to parallel... in those cases I figured it's better to start slowly adding weight to a partial ROM than to simply not squat. The clients understood they weren't doing "true" squats, but it seemed they worked all the harder for it.
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Old 01-27-2009, 09:16 AM   #3
Ned Ferguson
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Re: Squat alternatives for clients with bad knees

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Originally Posted by Jared Ashley View Post
For those who truly could not get full ROM due to knee pain, and there were a few, I would just continue progressing with the above. Most of the time their partial ROM squats were around 1/2 to 2/3 of the way to parallel... in those cases I figured it's better to start slowly adding weight to a partial ROM than to simply not squat.
They have to be getting full ROM sometime if they ever sit in a chair or on the toilet. I wonder if you could have them do reps from a chair with armrests so they can help themselves get up, gradually reducing the amount of push until they are finally able to get up without using their arms. This way they can experience full ROM. Just a thought.
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Old 01-27-2009, 09:43 AM   #4
Stan Wildes
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Re: Squat alternatives for clients with bad knees

What I have tried with these types of clients is a type of squat where the clients hold onto the rings or a suspension training system and let them lean back slightly while still holding onto the rings and then perform squats. It will take some pressure off of the knees while still building some strength in their quads.
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Old 01-27-2009, 11:54 AM   #5
Brendon Mahoney
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Re: Squat alternatives for clients with bad knees

Good advice guys. I guess the answer is scaling. Starting small to build strength and then working up. Thanks for the suggestions!
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Old 01-27-2009, 02:21 PM   #6
George Noble
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Re: Squat alternatives for clients with bad knees

I'm well above parallel on my chair Ned. Not sure about my toilet.
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Old 01-27-2009, 03:01 PM   #7
Scott Dyck
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Re: Squat alternatives for clients with bad knees

I'm working with a woman now with VERY bad knees, and she's progressing well holding onto a heavy green jump-stretch band wrapped around a support for partial ROM squats, and short step ups, about 6" right now.
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Old 01-28-2009, 04:02 AM   #8
Shane Yost
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Re: Squat alternatives for clients with bad knees

What I usually do is start them on quarter ball squats and Like Jared suggested give them exercises that stimulate mobility like small step ups. Machine wise you can set them up on a leg ext so that they're only moving their legs about 30 to 45 degrees. Leg curls tend to be a little more difficult. For hams I usually implement basic pilates, I try to stay away from machines as much as possible but sometimes its inevitable
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Old 01-31-2009, 01:20 AM   #9
Blair Robert Lowe
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Re: Squat alternatives for clients with bad knees

Currently I have my mom doing stiff leg DL with small DB or stick and squats above parallel with your hands on the table so she can assist pushing back up and lower down safely. She also does squats on her Total Gym ( hahah ). She has a weak patella probably brought on by carrying too much weight and not enough leg exercise. She thinks she needs to strengthen up to prepare it for surgery but I'm of the opinion if she strengthened it up and lost weight she would be golden.
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Old 01-31-2009, 08:57 AM   #10
Joey Powell
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Re: Squat alternatives for clients with bad knees

I will bet dollars to donuts that we have more hip and knee replacement, osteo-arthritis and other issue than just about any affiliate.

They all squat... day one. No Kidding. even one vet who is missing most of both legs.

Learn to squat with the hips, not knees.
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