I’m looking for comments and suggestions for my lower body workout. The goal is to increase muscle strength and, to some degree, flexibility. After a poorly-managed ankle injury and subsequent recovery a few years ago, my strength has decreased significantly. I have stability issues with my left ankle, plus Patello-Femoral Syndrome (PFS) in my left knee, so I can’t do lunges safely. While I have tried to get into squats with the Stronglifts program, I have terrible depth (even unweighted), and I find that I get knee pain afterwards, anyway.
What I’m hoping for is suggestions from fellow PFS sufferers other other leg-experts for activities that let you lift HEAVY without over-straining the knee joint.
So here’s my usual leg routine, plus the weights I’m currently at:
FIX YOUR SQUATS. This is the biggest one for me. Widening my stance resolved A LOT of my PFPS pain. Do your pre/rehab work (clamshells with bands, foam rolling, etc.) and hammer the shit out of it with an orbital polisher.
@shairozdewji PFS sufferer here--the magic combination for me is at least one day a week of heavy squatting and dedicated calf/ankle mobility (but sometimes it's quads or hamstrings that are tight and making knees angry, so YMMV...get a lacrosse ball and make friendly with it). Barefoot-style shoes have also helped.
@shairozdewji Personally I would eliminate 1 and 2, absolutely, no question. They are a bit notorious for exacerbating knee pain. The problem being that they are so specific to those muscle groups (hams / quads) that all the load of that weight you're using (70#, etc.) is all on them and being that some of the major attachments points are on or related to your knee is part of why you're experiencing pain IMO (e.g. with a regular squat you are recruiting other muscles, which is a good thing). I also dislike your #5 too for related reasons.
If you've been diagnosed with PFS, have you seen a physical therapist about it? If so, do you have the rehab routine they designed for you? If you haven't, I would consider seeking one out. The other option is to find a really good personal trainer to help you design a routine.
If you don't want to do either of those two options, I would:
Foam roll the hell out of your IT bands, every day, before and after your workout. Before you go to bed...all the livelong day.
Get away from the machines and do things like goblet squats, weighted lunges, bulgarian split squats, step-ups. There is a whole world of leg exercises that lie between the machines and the squat rack (i.e. you mentioned starting strength). Honestly though, I would assume that knee pain would get worse going to the machines rather than just doing some weighted squats in the squat rack.
@dawn16 Thanks for the detailed advice! I'm working on getting a trainer through our Grad Student benefits program, it just takes a while for the approval process.
I had been choosing machines because I thought it was a good thing to isolate the muscles of interest, but you make a good point that free-weight exercises will help me strengthen the muscles that support my knees.
@shairozdewji oh man, if you have some benefits that cover a trainer, that is awesome! esp. if it's one that is also studying at a university in the exercise science department...they would likely be very knowledgable.
@shairozdewji Open chain exercises (where your feet are free to move) are generally terrible for rehabbing knees. Closed chain exercises (where your feet are on the ground) is what you want. So like /@banky2072 said: squats (of varying kind), lunges, deadlifts, etc are what you want to be doing. And don't just focus on your quads. The knee is supported also by the hamstrings, adductors, etc.
Otherwise mobility, mobility, mobility. Check out Kelly Starrett's stuff and Eric Cressey.
