Left Knee Update

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On my list of topics to revisit, I included a left knee update. This story took a lot longer than I expected. I think it is boring, but maybe someone can learn something from my experience. Here goes.

In 2013, I began to experience knee pain, which I described in the post My Left Knee is Bumming Me Out. Being a stubborn person that will do anything to avoid going to a doctor, I tried a few things to help my knee – including more rest – but I wasn’t getting any results.

Then in 2014, I left Seattle for the San Francisco area for 6 months. I decided to worry about my knee later. I had a city with hills to explore. Well 6 months turned into 13 months. I urban hiked hundred of miles.

On steeper streets I walked slower, because I only had pain when the knee was more bent. I favored my right leg more and more. And because I couldn’t do any leg exercises in the gym, my left leg lost muscle. My right leg lost some too, because I didn’t see the point in further building up the strong leg. I’m aware there is research that exercising the good leg can benefit the weak one, but I wasn’t inspired.

In 2015 I decided to finally see a doctor. To my surprise X-Rays showed nothing, so he sent me to a physical therapist. If the physical therapist said my problem was worse, I would get an MRI. I needed that sign off first though. OK, I’ll play the game.

At my first visit, the physical therapist took me through a few movements and told me I didn’t need surgery and that we would be able to strengthen my knee. At first I was skeptical, but she explained to me what she was seeing in my movement and how she would go about fixing my knee.

I did custom leg exercises to strengthen all the muscles supporting the knee. Because they had atrophied so much, the knee didn’t have a chance to heal. Making them stronger would take the pressure off the knee, which they did. She also used tape to hold my knee into place, because it was floating to the left, which made it not only inefficient but painful.

After about 2 months, my knee was strong enough to do body weight squats to parallel with no pain. I was back!

In 2016, I used the leg press to regain strength. My strength tripled in 6 months. Then I got over confident and pushed the weight too much and it set me back a few months. But I’m fine now. I don’t know if my knee will ever be 100%, but I’m gaining a little bit more strength each month. On steep hills, I occasionally will lose some stability. Nothing serious though.

I got tremendous benefit from the knee exercises and using a stiff foam roller on my IT Band. Some people discount the foam roller, but all I know is it was one part of my recovery plan that worked.

This page has a video with some of the knee exercises I used. They don’t look like much, but they work when you do them twice a day.

Use Ghost Reps To Reduce Injury Rate

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Today in the gym I watched a lady doing “squats”. I use quotes because her form was atrocious. It wasn’t really a squat, but more like a good morning where the knees give out at the last minute. Her torso was so far extended early in the movement that she had to crane her neck up lest the weight might roll forward.

Meanwhile her trainer kept chatting about her weekend. She didn’t get injured, but she easily could have.

One of the tricks I learned a long time ago is that it is often not enough to do a warm up set with a lighter weight. What we often need in movements with a high skill component is a mental warm-up. We need to execute a few reps using perfect form with no weight. Sometimes just the bar. Years ago I started calling these ghost reps.

Ghost reps have saved me from many injuries. I can always tell when I’m too stuff, too tired or lacking focus when I can’t execute a perfect rep without weight. It tells me I need to fix something before I load on weights or I better postpone that exercise to a future workout.

The absolute worst injury I ever got in the gym was throwing out my back doing a deadlift one morning with just 115 pounds. I couldn’t move for days. Had I done a few ghost reps, I think I would have detected something was off and not to proceed.

Ghost reps will have the most value with higher skilled movements, but I also use them after a long hiatus or when I need to gather focus for less skilled movements.

Even though I am older now, I never get injured. Although most of the credit goes to using machines in a slow controlled manner, I also credit a warm-up routine that accentuates positive body language and ghost reps.

Broad Squat

Photo by Ulf Liljankoski

This is what I call a ghost rep for a broad squat. Do this for a few reps before adding weight. As a side note, I don’t think it is smart to wear running shoes while squatting. See the article What Are The Best Weight Lifting Shoes for Squats & Deadlifts? for an explanation.

 

SilverSneakers – Young Trainers Teaching Old Timers Bad Lifting Form

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The gym I go to has a lot of older adults, because they participate in the SilverSneakers program. The program connects those over 65 years old to a gym and it works with their health insurance. It is an excellent idea for older adults to build strength and general preventive health. It would be perfect except for one thing. Young 20 year old trainers are teaching fast lifting forms. 1 second up, 1 second down.

It is one thing to see some 25 year old male hopped up on Mountain Dew Extreme performing ballistic movements, but it is almost criminal to see the same nonsense taught to older lifters. The young punk has far greater recoverability potential and can afford to make and recover from those mistakes.

SilverSneakers

Photo by Diane Cordell 

Fast lifting is exactly what I see with all but one older lady in my gym do. More on her later. They push the weight on the machine quickly. The weight now has momentum as it passes over the area where the muscles should have been targeted. The weight reaches the end where it is held. Zero tension is now on the muscle. Now they control gravity and let the weight fall back to the start where they repeat the process until a certain number of reps and sets are completed. The majority of the set is spent with the muscles not under load. 

Arthur Jones, the brilliant inventor of Nautilus, used the term “throwing weights” to describe this.

When personal trainers teach people to use speeds for machines that are used in Olympic lifting they make the exercise less effective. When you lift with machines: Lower the weight and slow the movement. You will gain greater strength and reduce the risk of injury.

The one older lady I mentioned that lifts slowly and with control retired from a career in physical therapy. She understands what causes injury and how the muscles work a lot more than the young trainers do with their certifications.

If you are a SilverSneakers member or know someone who does, keep using the machines, but slow down the lift. Try to take 3-4 seconds in each direction. Never lock out or pause at the top or bottom of the movement. That will mean you will need to reduce the reps, sets or both. That is fine. You’ve increased the intensity. Your muscles are working harder. Your joints will thank you.  

I haven’t confronted any of the trainers in my gym with these thoughts. I doubt they would be receptive. But I want to get the word out to older lifters that might be enrolled or thinking about enrolling in the SilverSneakers program. Maybe they will find this post and find it helpful.

Returning to Glitter…Already!

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It has only been one month since I stopped going to the gym, but I signed back up today. In the post Stepping Away From the Glitter…Again! I ranted about how hot my glitter gym was and how I couldn’t take it anymore. I would go outside and do Hillfit instead. That was the plan and it would have worked except for one thing.

My knee isn’t getting better. Since spring it has been bumming me out. Rest isn’t working. It isn’t even that bad. I can walk for 7 miles with no pain, but driving an hour or more with my stick shift car causes minor soreness. I have stability issues trying to do a wall sit or bodyweight squat in the bent position, so I avoid those movements.

I’ve done foam rolling, braces, topical magnesium, rest, ice, heat and taken copious amounts of MSM, gelatin and Zyflamend. It hasn’t gotten much better. A few days ago I was reading a post on the Congruent Exercise Facebook page about the leg extension exercise, when I asked Bill about what he’d do for my type of knee pain.

Here was his response.

knee-help

Later in the thread, the Framework for the Knee book was recommended, so I picked up a copy. I went through it quickly and realized that sitting on my ass waiting for my knee to heal wasn’t going to work. Like Bill suggested, the book was clear that I needed access to a stationary bike. Dr. DiNubile writes the about cycling:

It is the cornerstone of knee rehabilitation because, from an exercise specificity standpoint, it targets the ever important quadriceps muscle better than any other aerobic-type exercise, building both strength and endurance.

After reading this, I closed the book and returned to my old gym. With hat in hand, I resigned up. The gym is still too hot, but the focus now is on knee rehab. My gym is only $16.43 a month, so it is a small investment to see if stationary cycling does the trick.

 

FrameWork for the Knee: A 6-Step Plan for Preventing Injury and Ending Pain (FrameWork Active for Life)
FrameWork for the Knee: A 6-Step Plan for Preventing Injury and Ending Pain (FrameWork Active for Life) by Nicholas A. DiNubile

My Left Knee is Bumming Me Out

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My left knee hasn’t been 100% since spring. I don’t know what happened to make it sore, but it has been bumming me out for months now. It gets better and then it gets worse. Just when I think it is healed, the soreness comes back.

I suspect that the reason my knee hasn’t fully healed and perhaps what has caused the pain in the first place is the fact I drive a stick shift on the hilly city streets of Seattle. Constantly depressing the clutch is probably the culprit.

I was really hoping to start uphill sprinting again this fall, but that isn’t going to happen.

My healing plan so far has been using ice, wearing a wrap, and consuming MSM, gelatin, bone broth and starting yesterday – Zyflamend. I’ve heard lots of good things about Zyflamend, so I have some hope that my knee might get better.

Zyflamend By New Chapter - 120 Softgels
Zyflamend By New Chapter – 120 Softgels

If I could wave a magic wand and convert my car from a manual to automatic I would. I’ve driven only manual cars since college. It has been fun, but a few hundred thousand miles is probably enough for one knee. I do know one retired long haul trucker that needs to have his knee replaced from years of clutching.

I do love my car and my plans were to keep it as long as it held up. Now it is looking like the car might outlast my knee. Maybe this is just my frustration talking? If anyone has any additional ideas on fixing my knee, please leave a comment. I can’t even do a single 25 pound goblet squat repetition without pain.