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Old 07-11-2008, 04:42 AM   #1
C James Barton
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Unhappy Slightly knackered knees

I've been doing SS for a couple of weeks, and had growing problems with my knees. The physio I saw last week couldn't see anything majorly wrong (no weakness, no assymetry, no limited movement), although she mentioned that the clicking in my knees was due to irritated plicae. Anyway, it got worse, I saw a doctor yesterday, and he's referred me to an orthapaedic physio, who can hopefully give a proper diagnosis and treatment. In the mean time, the doctor said:

- no weight-bearing leg exercises (so no barbell squats, or squats of any kind), and "no running, no cross trainer"

- strengthening the quads is good for most knee injuries, so he suggested I use leg extension machines.

Despite my disappointment, I'll take the first piece of advice. I'll take the second as well, unless anyone has a good alternative to the leg extension machines. The doctor is happy for me to swim - I'll do that if there are no better alternatives, but I find it pretty dull.

My questions are:

- is Starting Strength worthwhile by itself without the squats? Doesn't it depend on squats to stuimulate hormonal and neural changes? Should I stick with it and substitute quad and ham machines or maybe good mornings?

- how worthwhile is CF without any squats or running in it? Squats are such a fundamental movement, I'd probably be altering half or more of the WODs (although I would be taking the scaled versions anyway).

My current goals are to build some strength prior to moving over to an all CF / CFE regime. What can I usefully do in the mean time?

thanks for any help or suggestions
James
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Old 07-11-2008, 07:31 PM   #2
Richard Hancock
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Re: Slightly knackered knees

I am no PT, but have experienced more than my share of knee pain. I found that some clicking without pain is tolerable. I am shocked that leg extensions was prescribed. I was always told to avoid that, specifically. Diff strokes, I guess. Straight leg raises is good for quads, and hamstring curls is usually safe for most common knee ailments. Stick to light loads, I imagine.

I wish you luck and confidence in your ortho dr. Make sure you CAN trust his judgement, and stick to his advice. Soft, strengthening exercises, i.e. swimming, eliptical, therapist prescribed exercises, will promote blood flow and thus healing.
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Old 07-12-2008, 10:24 AM   #3
C James Barton
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Re: Slightly knackered knees

Hi Richard, thanks for the reply

I might be using the wrong description of the exercise my doctor told me to do - I said leg extensions, but that's not really right, it's a seated knee extension. Is this the exercise you meant: http://www.kneeguru.co.uk/KNEEnotes/node/1198 ?

My GP banned me from running and ellipticals. I gave both rowing and cycling a try, and saw that my knees bent to much under load to be sensible now. So swimming it is. Haven't been in the pool for a couple of months, I think.
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Old 07-12-2008, 11:28 AM   #4
Richard Hancock
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Re: Slightly knackered knees

yes, that exercise, the straight leg raise, has been prescribed to me so many times I am starting to believe it works. I actually worked very hard, after my most recent knee surgery, to rehab, that I used those raises faithfully, and you can get quite a burn out of them. They are very isolating, but keep the atrophy away, while you heal.

The beausty of swimming is its light resistance. Be safe, good luck.
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Old 07-12-2008, 04:35 PM   #5
Robert Callahan
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Re: Slightly knackered knees

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Originally Posted by C James Barton View Post
I said leg extensions, but that's not really right, it's a seated knee extension. Is this the exercise you meant: http://www.kneeguru.co.uk/KNEEnotes/node/1198 ?
Leg extensions may keep atrophy away but they will do very little for stabalizing your knee. There is never a single moment during the day in which both the hamstring AND the quad are not working in concert to stabalize the forces on BOTH sides of your knee. So why would you ever do an excercise that isolates one? It will have no carry over to actual functoinal stability. I would surmize that something in your form is messing up your knees and instead of scratching squats off your list of "ok" excercises I would find someone (an affiliate?) that can teach you how to do them properly. You could even post a video on here and get it looked at if you do not want to pay for a coach to do it in person. Just my thoughts though...

-Robert
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Old 07-12-2008, 07:09 PM   #6
Aileen Reid
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Re: Slightly knackered knees

I'm no doc but have also had my share of knee woes so I'm an armchair expert for whatever that's worth. I have been through the plica thing. I don't know how he can tell, I think its a stab in the dark because he can't pin it on anything obvious. Just my $0.02.

After 2-3 years of knee and back problems my own conclusion is my back causes my knee problems which where maltracking to the extent I stuff my knee. So my advice is to at least get your back checked out, leg lengths etc etc. If you're all balanced and even fine, forget I mentioned it.

Good luck anyway.

Last edited by Aileen Reid : 07-12-2008 at 07:09 PM. Reason: Sp
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Old 07-12-2008, 08:15 PM   #7
Sara Stamm
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Re: Slightly knackered knees

I've know many, many people with knee problems (although my own pains have been in hip, shoulder and ankles) and the majority of them had muscle imbalances that cause the patella to track improperly and cause pain. Often the outer quadricep (vastus lateralis) is stronger than the inner (vastus medialis) which pulls the patella outwards and can even cause clicking.
Turning your feet outwards while you do your leg extensions will target the inner quad. Another exercise which has seemed to help numerous people is lateral straight leg raises. You lie on your side and lift your upper leg straight up to the side (like scissors). This will strengthen your glut med, which also ensures proper tracking of the knee cap.
Hope this helps, Sara
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Old 07-14-2008, 05:26 AM   #8
C James Barton
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Re: Slightly knackered knees

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Originally Posted by Robert Callahan View Post
Leg extensions may keep atrophy away but they will do very little for stabalizing your knee. There is never a single moment during the day in which both the hamstring AND the quad are not working in concert to stabalize the forces on BOTH sides of your knee. So why would you ever do an excercise that isolates one? It will have no carry over to actual functoinal stability. I would surmize that something in your form is messing up your knees and instead of scratching squats off your list of "ok" excercises I would find someone (an affiliate?) that can teach you how to do them properly. You could even post a video on here and get it looked at if you do not want to pay for a coach to do it in person. Just my thoughts though...

-Robert
I'm off to see an affiliate next week. I might not be doing squats right now, but I'm not writing them off, not nearly.
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Old 07-14-2008, 05:30 AM   #9
C James Barton
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Re: Slightly knackered knees

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Originally Posted by Sara Stamm View Post
I've know many, many people with knee problems (although my own pains have been in hip, shoulder and ankles) and the majority of them had muscle imbalances that cause the patella to track improperly and cause pain. Often the outer quadricep (vastus lateralis) is stronger than the inner (vastus medialis) which pulls the patella outwards and can even cause clicking.
Turning your feet outwards while you do your leg extensions will target the inner quad. Another exercise which has seemed to help numerous people is lateral straight leg raises. You lie on your side and lift your upper leg straight up to the side (like scissors). This will strengthen your glut med, which also ensures proper tracking of the knee cap.
Hope this helps, Sara
I had a problem like this about five years ago - my physio put it down to too much cycling with the saddle too low. She gave me a few exercises to do, and the problem had vanished within a month - one of them sounds very much like the leg raise you describe. I will add that one back into my regular schedule.
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Old 07-14-2008, 05:32 AM   #10
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Re: Slightly knackered knees

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Originally Posted by Aileen Reid View Post
I'm no doc but have also had my share of knee woes so I'm an armchair expert for whatever that's worth. I have been through the plica thing. I don't know how he can tell, I think its a stab in the dark because he can't pin it on anything obvious. Just my $0.02.

After 2-3 years of knee and back problems my own conclusion is my back causes my knee problems which where maltracking to the extent I stuff my knee. So my advice is to at least get your back checked out, leg lengths etc etc. If you're all balanced and even fine, forget I mentioned it.

Good luck anyway.
I ran four or five times a week for a couple of years without having knee problems, so I think I'm probably alright from an anthropometry point of view. If I did want to get this checked out, who would I see? Is the kind of thing a physio could normally do, or does it take a doctor?
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