Leg workoutsforThoseWithBadKneesBy Dr. David Ryan (Cecil Award, National Arthritis Foundation) and Rob Pilger

Man with dumbbell weight training equipment on sport gymMODIFY YOUR WORKOUT
Several individuals have problems with their knees, but this doesn’t need to prevent anyone from exercising. Knee injuries can be worked around to provide a great workout to the lower extremities. A few simple principles have to be applied. First we are going to protect the knee by avoiding heavy weights. To accomplish a more intense workout and stimulate more fibers, we must learn to flex the muscle while we are training.

To do this, you must learn to squeeze the muscle in both the “positive and negative” portions of the movements. So for example, let’s take the leg extensions. Extend the leg straight out and push your finger into your thigh muscle. Now squeeze that muscle very tightly and maintain that tension while you lower your shin. Once you have lowered the leg, keep the tension and slowly raise the leg until it is straight again.

As you begin to obtain more control of movement while squeezing your muscle, you can increase the speed. Begin with slow movements that last over 4 seconds in each direction. Then you can speed up the movement, but limit your speed since it can only hurt you to move quickly.

Young handsome muscular manGO WITH THE FLOW
Movements that flow such as those noted in Tia Chi are less likely to cause irritation or pain to your lower extremities. Don’t try to exercise like everyone else in the gym. Remember that resistance and muscle tension provide the stimulus to allow you to improve muscle tone. Consider that the legs of a swimmer or those of a dancer are usually what most people think of when they consider, “great legs.” Those formats for working out do not include heavy weights; rather they exist with controlled movements under constant tension.

The next thing to consider is workable range of motion. Most individuals who have knee pain have some portion of the movement that is less painful and this is the portion we will explore using. Even if you only have a few degrees of mobility, that is what we will start with. Use that movement and maintain tension in the muscle during that whole time.

Strong Athletic Man Fitness Model Torso showing naked muscular bPROPER MUSCLE MOVEMENT
It is also important to understand that most of the muscles in the legs are of the two joint varieties. These muscle cross both the knee and the hip/pelvis. To stimulate the quad you can either flex/extend the knee or hip.

Begin by squeezing the muscles of the quads and then the hamstrings and calves individually for 10, then 20 seconds for 3 sets. Simply tense the muscle and hold, choosing three different positions of the knee (i.e. full extension, full flexion and a mid-range point).

If you own a pool, then you are blessed and should use it whenever you can. Simple treading of water is more labor intense than simple running and about a 100X more effective than walking. A few laps with a kick board using various strokes are the ultimate benefit to provide excellent cardio and protect the knee joint from unnecessary wear and tear.

Handsome man exercising on a cross trainer machineLOW-IMPACT IS KEY
Choose non-impact cardio devices, such as a stationary bikes, gliders, stair climbers, ellipticals and combination machines such as the Precore AMT. On dry land, the exercises are different, but the concepts are the same. You can still perform various swimming kicks while lying in bed or on the floor with a pillow under your pelvis.

Avoid weight impact exercises, avoid excessive resistance. Obtain resistance from the contraction of the muscles.

Some new exercises to try are outlined below, and only indicate a simple structure for expansion in the future. Putting a program together will start with a simple warm up and gradual increase of intensity and then a taper back to flexibility exercises.

On a padded service, begin on your hands and knees, tighten up your buttocks and lower extremities and work on extending the leg and then raise to a full extension. Return the knee to the chest and extend and raise the leg again. This should take approximately 6-10 seconds in each direction.

Leg extension and flexing under full contraction and this should be done for 30 reps, with 10 reps toes in, 10 reps toes out and finally 10 reps toes straight.

Leg scissors with resistance bands. Lying on your back, you can have a single band that is around the knees, to apply resistance as you adduct and abduct your legs.

Single leg and double leg raises. Lying on your back, you begin by raising one leg off the surface and then attempt to do both legs simultaneously.

Inverted bicycle simulations are best when you flex the muscles in the legs prior to beginning the exercise. Also, inverted leg presses can be done with the body up against a couch or a bench. Legs are pointed upwards towards the ceiling. Flex the muscles while the legs are pressed out and pulled in.

ManPlankPlanks are helpful in both the forward, reverse and side positions.

Now don’t forget the lower leg and allow the big toe to follow the ABCs several times. Calf raises both seated and standing are a great way to stimulate tone in the lower legs.

Gym. Handsome man during workoutHere is a simple routine to help get you started:

  • 9 sets of isometric extensions & curls in 3 different positions
  • Leg extensions for 3 sets of 30 reps
  • Leg curls for 3 sets of 30 reps with 3 different toe positions
  • Rear leg kicks for 3 sets of 30 reps
  • Bicycles for 30, 45 and 60; 3 forwards/backwards
  • Front planks for 30, 45 and 60 seconds
  • Inverted leg press for 3 sets of 50 reps, both wide and close
  • Lying flutter kicks for 30, 45 and 60 seconds
  • Scissors with resistance bands for 3 sets of 30 reps
  • Calve raises for 3 sets of 40-60 reps
  • Finish with 5-10 minutes of stretching

About the Author
DrDavidRyanDr. David Ryan has an extensive background in both coaching and playing professional sports, and has been the team physician for several highly ranked teams. Dr. Ryan now serves as the current Co-Chairman of the Arnold Sports Festival (www.arnoldclassic.com) and is a former Medical Director of this internationally acclaimed event.

Dr. Ryans numerous articles have been published in International Medical Journals, Muscle & Fitness Magazine as well as on the popular BodyBuilding.com website. Visit Dr. Ryans home page on here: www.drdavidryan.com and his YouTube page here.