This is kind of a philosophical question. I’ve been rehabbing a torn meniscus, which is going well. But for a long time, I have not been able to do bodyweight single-leg stepdowns without severe kneecap pain. However, I can do Bulgarian split squats, front squats and box squats with very little knee pain normally. Before the injury I was also doing Poliquin step-ups on a slant board, but using my max available range of motion would also hurt the knees, so I had to limit the range somewhat. In rehab, single-leg presses were very humbling, and I couldn’t use much weight at all. Is it advisable to regress these single-leg step exercises to be able to do them pain-free, or just try to progress the non-painful movements as much as possible? Avoid what is painful, or try to fix what is painful? I’ll ask the PT in my next session, but wondered what others think. I have not tried Spanish squats or terminal knee extensions yet - these look like good options to load the quads and take pressure off the knees, and I’m kind of surprised I haven’t done them in therapy yet.
My son was a running back and took a hit on the right lateral knee and folded it medially. After surgery, some draining of fluid and when site closed, we jumped into a local commercial gyms pool and did every movement we could think of. His right knee actually became stronger and was dunking basketballs shortly thereafter, once he developed the trust in the rehab process we came up with. Just my .02 cents and wish you the best.
If it’s meniscus and getting stuck in the knee hinge, any reason to not just have it trimmed?
No, the meniscus isn’t getting stuck. It’s actually healing pretty well. It’s the patellofemoral pain that I still have on some movements. I think in my case and age (46) that it’s best to work around it, build up strength on movements that don’t hurt, and then see where I am. Flameout and the rehab movements are helping. And sled pushing feels great - just hope the local HS football team doesn’t put it away over the winter!
For sure. CT has talked a lot in the past about using sled work almost exclusively for leg mass for those of us with a few miles in the rearview, even for some of his bodybuilders!
I’m curious what your PT said if you’ve had your next session.
Patellofemoral pain sucks – I’ve been battling mine for years. After lots of trial and error, my approach to the rehab and strength exercises was that if it was no more than 2-3 on the pain scale, I’d proceed. It was tough to find that balance but simply avoiding anything that caused even a low level of pain actually seemed to make things worse.
Do you use knee sleeves? Not having your degree of problem, though experience a great sense of stability and comfortable compression with my 7 mm sleeves. Allowed me to progress further in squats - an excercise I had abandoned…
Why not do both?
I like to think of all training activities as addressing your outputs (max speed, max strength, power), capacity (endurance, hypertrophy, conditioning) or robustness (ROM, injury resilience etc).
Use pain-free exercises to improve your outputs and capacities. Use regressed version of painful exercises to address your robustness.
I’ll never understand intentionally limiting the number of ways you train your body to move. Personally, I want to be a goddamn weapon no matter the position or context
I’ve got some knee sleeves coming for Christmas - excited to see how they can help.
I had the next session today, and her guidance was to do flat step-downs on a small enough step to not hit the pain point. I’d go from 0 to 8-9 on the pain scale at a certain angle. She said it’s still coming down to weak VMO and glutes, and as I increase strength I should start getting more range without pain. I was doubting my ability to do that, as I’ve worked on the slanted Poliquin step-ups for months now without improving the range of motion without pain. She could even tell my left VMO was smaller - through exercise pants no less. The meniscus injury was on the right knee, and that knee has a little lesser pain and more range on the step-downs.