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David

David Builds New Legs

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Yeah I never weighted them but I never used the wall for support 

I might try single leg DLs with a KB once all the tendons and such in the side of my ankles stop hurting

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@matt - useful, yes. Long and painful? That too.

Tried low bar squats for the first time in three months Friday. Ouch. My right knee hurt like hell, but the PT said to keep going through three sets of 10, so I did. This was with a 20 lb bar on my back, not even a real one yet. I did them after the 30 lb goblet squats and after we upped the distance on the step ups to 12 inches from 8 inches, so my knee had already been pushed a bit. She had me roll out my quads/It band after the first set , and the second two felt a little better. The interesting thing is that despite being sore for the rest of the day, the knee actually felt much better Saturday morning. I am encouraged by that.

We also have added in standard RDLs now. I did three sets of 10 at 115lbs and it felt great to do them again. She said I could drop the single legs if I want, but I don't want to do that until I master them.

We are going to try down shifting to one-day-a-week PT sessions starting this week, which means I will be owning these sessions even more now. I told her I want to try conventional deadlifts soon (staying away from sumo style at least for now to ease the load on my knees). She suggests staying with the RDLs only for the moment because my knee still hurts when I flex it to pick up the bar in DL position. Hopefully this will ease soon with the new added exercises.

Also she said to continue avoid running because of the wear and tear factor. I've started adapting to the elliptical more and more. I hate it a little less now. This thing could end up being my go-to for cardio I guess. We will see. Onwards.

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Wow, ok so here's the Sunday morning update. I did my new leg routine and it went surprisingly well.

Goblet box squats 30lbs 3x10

Low bar back squats 45lbs (bar) 3x8

Conventional RDLs 105lbs, 3x8

12" step ups, 3x10 each leg, swing opposing leg at top

Leg press 160 lbs 3x10

Lateral crab walks, band resistance, 5 circuits

One leg balance on mini trampoline 3x:30 each leg

Clamshells, band resistance, 3x12 each side

Discoveries:

It's going to be like learning to squat all over again. I'm working hard to keep from supinating my feet. That is easier with the goblets because I'm parallel, harder with the back squats. The important cue appears to be not shoving my knees out until I absolutely have to near the bottom to get my hips to slightly below parallel. When I do that, the knee cap seems to track correctly - or at least without pain.

Foam rolling my piriformis and glute is a huge key to fixing this kneecap pain. The patella hurts because it's tracking wrong. It is being pulled to the outside rather than tracking over the center of the top of my femur. The pulling is happening due to the tight IT band, but also, apparently, due to a tight piriformis. I know this because yesterday and today I spent extra time rolling it, which I normally haven't been. It was excruciating painful, tight as a knot in there. After rolling that plus my IT bamd, suddenly I'm walking up and down stairs completely pain free.

The squats and leg presses and RDLs appear to be having an immediate effect or something. Maybe they are reactiviting the right muscles now that the rest of leg infrastructure is in a little better shape. Not sure, but my legs appear to like what's happening.

Ultimately I'm going to have to figure out squatting and deadlifitng - what I need to adjust with my form on these moving forward - on my own. The PT is great, and I love that she's open to helping me get back on track with strength training. But she's really not familiar enough with the mechanics of these movements to coach me back to where I was. I'm going to have to put that together myself with her input. I'm fine with that. At least she's not telling me not to do these things anymore.

Thanks for reading. Onwards.

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I managed to strain or pull the adductor on the left side yesterday doing step ups, maybe I shoulda started them on a lower bench

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Maybe. I mean I started with a 6" step and my knees hurt a little even with that. Today, after like 8 weeks, I did 12" with no problem. Biggest thing I'm being told is to push through my heels. That's helped a lot. And Art, your legs are of course totally different than mine. You may benefit from something else entirely.

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I started with a knee high bench, more or less, and noticed I was pushing off a lot with the other leg, so I made a really slow transition of weight to the left leg while keeping the right foot on the ground to prevent that, and ass I started the actual lift from the floor, it popped / hurt in near the adductor / groin attachment area

I know my squat is weak at the very bottom, and I tend to weight the right leg more

that's why last time I did lunges I did them 'dead' off the floor (and walkijg)

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Good to hear about the continuing progress. I noticed recently that getting my knees out too early feels kinda wrong but didn't make any decision on how to deal with that. I like your thinking about getting them out just at the bottom of the movement.

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Thanks men. Well I saw the surgeon again today and now he's suggesting an MRI just to make sure 'we're not missing anything.' I'm getting it tomorrow. Not sure how I'm going to feel if it shows something major that could have been corrected surgically weeks ago....

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Got my MRI. It's going to take them a few days to read it, apparently. My right knee has hurt since Sunday. After the session, I was putting a carpet down at home and kneeled on it the wrong way. Maybe I irritated something.

This is all pretty depressing again. I was kind of grooving on the apparent progress last week, thinking I was moving back to toward normal. Seems like I'm farther away from that again. I can get out of my head the idea that I might be facing some kind of surgical procedure. Part of me wants to blame the surgeon for making me go through 10 weeks of PT before checking this out, but that's bullshit. I agreed to this, I had advice on here and and implied advice from Jim Steel to go to another surgeon and get an MRI right away, but I chose to stick with this one. This is the path I chose, I'm here because I chose this route. So it sucks. Whatever. I just wish I could get through a day without my effing knee hurting.

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Injuries suck

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David, I've been offline here for a long time so I'm late getting to this. 

 

The situation definitely sucks, I guess a positive to take now is at least you will know what the problem, and can start work on fixing it. 

You've beaten all the other shit that you came up against in the time you've been logging here, you'll do the same with this. 

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thanks sir. News from the doc is even worse. No more squatting, no more deadlifting, no more running. Even a surgical fix would only have 80% chance of my being able to do these things normally again. Just came from the docs office. Will update with more detail later.

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well hell

waiting for more info

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Thanks for the concern, men.

So it's patellofemoral osteoarthritis, moderate to severe. Arthritis inside the knee, under the kneecap. There's actually a small arthritis-related cyst with some water in it right in the groove where the kneecap slides. That's why it hurts like hell sometimes. Any kind of stress on the knee - going up and down stairs, squatting down, kneeling - aggravates it. It's been there for a long time. Heavy squats and deadlifts made it worse. It did get worse the heavier I lifted. And that's why over the past year running has been so difficult.

There's not really a simple surgical solution. It's not like torn cartilage, in fact aside from an unrelated small cartilage tear on the outside part of my knee, the rest of the cartilage looks normal, with normal thickness all around. Repairing this thing would apparently require some kind of special cartilage graft from a dead teenager or something. And even then the surgeon said there's only an 80% chance I would regain full use, i.e., be able to squat and deadlift normally. Besides, he said his gauge for surgery is normal functionality, not for enhancing recreational activities. It's not like I can't walk or something.

So the plan is to keep going with the PT - I AM still getting stronger - until I plateau. If I'm still feeling pain going up and down stairs, he'll do an exploratory thing and see if there something else we can try. The cadaver graft is a last resort, sounds like. Meantime, no heavy squatting or deadlifitng or running, and it looks like those are pretty much off the table now, given the the knee really can't handle them anymore.

Time to make a new plan. And get my bench and OHP numbers back to where they were. Onwards.

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i think I've found my new go-to cardio exercise. Rowing machine. Just tried it for the first time at the gym. Totally love it. My knees actually felt better afteward since there's no load on them. And it was a great workout. I did a couple of sets at like 500 meters/2:30 each.

I can easily see expanding this and getting a decent cardio workout. Alex Viada actually suggested that at that seminar of his I attended last fall. Plus my bucket list includes rowing on a crew team anyway. This would get me ready. God shuts one door and opens another. Onwards.

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I had a friend back in Austin with no cartilage in the left knee

if he drove a standard shift car his knee worked fine, if he had an automatic, it gave him hell

weird how different things affect, no?

I am convinced I would love rowing, did I have a rower

hopefully you get better with time

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Thanks, Art. To be honest I'm just eager to whittle down some of this PT and get back to a regular program with cycles I can work on. I mean I can still do rack pulls above the knee and RDLs and good mornings and leg presses. Hopefully I can program a couple of lower body days using those exercises along with some of the PT stuff, a couple of upper body days per week and a couple of cardio days. I liked three days of lifting and 2-3 days of running, that's what seemed to work best. Question is, what's the best way to get everything in now.

Thinking out loud here, maybe something like this. . .

MON Bench / assistance

TUES off (day after late nite)

WED Rack pulls / good mornings / PT stuff

THURS Rowing

FRI OHP / assistance

SAT. Rowing

SUN Leg press / RDLs / PT stuff

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It's just good to see that you're still moving forward despite the setbacks and the news. Any forward motion is good motion.

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Indeed. Thanks, Mathiah. I'm down to one day a week with the physical therapist. I think the next step is to come up with a new program that looks the way I want it to look and see if she is okay with it.

I emailed Jim Steel about all this and his only question was whether I can still do leg presses and rack pulls. I replied that I can. His response: "good, your legs will be fine strength and size wise." I'm taking that to mean that building a new program using those two exercises to replace squats and deads makes sense, so that's where I'm headed.

The big question is how many of the PT exercises are essential, and can I get away with doing them twice a week or do I really need to keep hitting them three times a week? My frustration right now is that I'm spending so much time doing those that I don't have enough time left for enough cardio to maintain the level of conditioning I've been used to - and that I'm losing the strength that comes from cycling heavy leg exercises like rack pulls and leg presses.

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I like your approach to the setback - just kick on, find alternatives that will allow you to keep leg strength, upper body lifts can carry on as before, and you can just fit the PT in around the rest. I am sure you will find the right balance. 

I also agree with you - if I did bother with any cardio at all (traditional style) rowing or cycling would be my preferred choices...anything else I just dont enjoy...

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Thanks, Neil.  Much appreciated!

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I'm glad you know exactly what the knee issue is now. I commend your attitude to working with the situation. Keep up the good work.

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Good to see your spirits improving! You'll find ways to do lower body resistance trainig, I'm sure, and you're in good hands with JS, it seems.

And since you like the rowing machine, you should check out what boat clubs are nearby. It's an awesome sport (albeit a little technical, so prepare for some initial frustration... it will pass ;)).

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Thanks, Chris, thanks, Mark!

 

So inserted below is the plan I gave to the PT yesterday. We'll talk about it at my next session on Tuesday.  Hopefully she'll approve.  I've basically split the PT sessions in half and distributed them through the week.  We'll see if it flies or not.  

 

I've already experienced an issue trying to implement it. I was doing rack pulls during yesterday's session for the first time in weeks (Day 4 below).  It felt awesome.  I got interrupted and had to pick up my daughter early from school.  When I got back to the gym an hour later, I stretched a little and went right into the PT assistance.  I got a little carried away with the goblet squats, going to deep too fast, and got this excruciating pain in my right knee.  Rather than stop, I proceeded to the 12" step-downs and almost fell off the platform thing due to the same pain.  Session over.   Went home, iced it, watched TV for the next four hours to let the frustration pass.

 

This is going to be a big psychological adjustment moving forward.  After pushing through varying degrees of pain when I was squatting and deadlifitng, I'm really going to have to learn to just stop stressing this knee whenever I feel anything untoward.  It really can't take much stress, especially right now.  Pushing through muscular pain/soreness is one thing.  Messing with the knee pain is just going to make the inflammation worse.  I know this intellectually, but I'm really going to have to start practicing this - especially as I try to move back into heavier lifting again.  I'm going to have to shift gears mentally when moving from the heavier rack pulls back into those PT exercises.  It has to be a whole different mindset.

 

I'm probably going to start wearing those awesome knee sleeves again, just as protection when I'm not doing PT stuff. And I've got to get myself a good ice pack designed for knees. I've kind of blown off the icing, but from what I'm reading, it's a basic treatment when you're dealing with this.  According to the MRI, I've got some prepatellar bursitis on top of the arthritis - additional inflammation, probably due to the amount I've been working the knee lately.  The main treatment for that is ice and anti-inflammatories.

 

Anyway, enough of the details... make sense why this log fits better in injuries than the regular log section?  Thanks again for the kind words, guys.  Onwards.

 

POSTHAB%2BTEMPLATE.jpg

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