Hi there,
At 57 I’m trying to keep a fit and healthy and will never race. I use TR as a foundation for any club rides or MTB-ing that i do throughout the year.
Recently had some work done on a knee (torn meniscus). Went to see the physio for a follow up as still having some issues and he basically said that I needed to bulk up my quads to strengthen the area around the knee.
So he suggested leg extensions and hamstring curls as I can’t at the moment fully squat. He aldo suggested jumping on a static bike, turning up the resistance and pedalling slowly for around 10 minutes to get to the point where i felt like my legs were made of jelly.
In light of this I have a few questions that I’m hoping some of you could assist with…
If I cannot squat at the moment so all similar exercises are out (lunges, romanian deadlifts etc) is there a way to do seated leg extensions without going to a gym and second part will this build leg bulk?
Are there any other exercises that folks think i could do - need to avoid weight through the knee so leg press also out.
I cant think apart from threshold intervals and using a grinding slow cadence how I can achieve legs like jelly in order to build them up.
Wondering if anyone else had had similar issues around rehab and managed to work through them - if so, how?
And although I can’t squat that deeply I’m wondering if starting to will increase the range of loaded motion.
If I have to hit the gym so be it…but I’m financially tight (born n bred in Yorkshire) and mostly retired…
Bands might help but I’m not sure about getting to full extension without it rolling up your leg. Maybe you could hold a medicine ball or dumbbell between your feet and extend both at the same time?
Just some quick thoughts on exercises- hiking, stairs, assisted squats, step ups, box squats. Slow at first, build strength as you go. Good luck and recovery quickly.
Leg press machine - you can control how deep you go very easily. My other half tore her ACL, MCL and meniscus last year and her surgeon had her on the leg press machine within 3 weeks of the accident doing single leg work to build quad strength back up.
dumbbell leg extensions
reverse nordics
backwards prowler push (this one requires something heavy to push so probably not the easiest option to do at home)
I would definitely work on mobility over trying to get stronger quads for now.
Other exercises you could try are later step ups, regular step ups on a small low bench until you get your ROM back.
I’d go find a hill close to you and start walking up it, then find a steeper one and keep progressing. Maybe go backwards to limit the knee extension at first.
If you have to avoid any force being transmitted through the injured knee than maybe single leg leg presses on the non injured leg? iirc there is a reduced but non zero adaptation response in the un-worked side. It’s not much but it’d be something.
Working the quad without transmitting force through the knee is going to be difficult b/c that’s where the quad (indirectly) attaches. If the issue is ROM than 1/4 or 1/2 (or whatever ROM you can get into and out of safely) squats still work the quads just not to the degree that a full squat does. Or, as mentioned, leg presses.
I know you said not the gym but I’m going to ignore that for the sake of story time:
I tore my meniscus a few years ago. Surgery was kind of successful but still had nagging sharp pains and knee issues. 6 months ago I started going to the gym regularly. I do legs twice a week. My back hates heavy squats so I do leg extensions, hamstring curls, hip thrusts, light RDLs, leg press, and some light Bulgarian split squats. (Obviously not those last two during recovery)
I literally do not have knee issues anymore. 20 years of knee pain. Gone! It’s life changing. I’ll never stop going to the gym now. It’s my biggest fitness priority.
Did he actually measure your quad strength side to side? With a hand held dynamometer or isokinetic dynamometer?
Many of my patients who have had surgery have side go side differences in terms of size but regain full function and no pain
Look up “arthrogenic muscle inhibition”. It is basically the fact that pain of swelling can inhibit the muscles around a joint. Studied mostly at the knee and shoulder. So if you still have pain and swelling that could cause the size difference.
But without objective data and just looking at muscle bulk that is not a good proxy for strength or function.
Hey there. 53 year old male and two meniscus surgeries (each knee). I am not a doctor so take my advice as purely info. YMMV.
I am surprised they are not letting you create exercise progressions - even squats.
For example (and usually, Physical Therapy has this)… do seat sits. Stand in front of a chair and slowly sit down without putting hands on arm rests. Then stand up without rocking your way up. Just press through heels. Repeat 15 times x 3 sets. Progress through those.
Then as you build strength that way, do body weight squats to a box or something lower than the chair.
Then maybe the bar on your back and squat down to a box. Then as range of motion increases go further down. For me the progression for that was six weeks before I loaded the bar.
Other things you could do (not a fan of curls that put pressure on the patella and was told to stay away from that forever) would be glute/hip bridges, single leg glute bridges, glute bridges with a big ball where you roll the ball back to your. Focus on not only quads but glutes and hammies as you said.
I do think lunges were part of my progression as well but a little later after I tolerated dual-legged exercises. You’ll want to ice after to control the inflammation. I had to do that for around 2-3 months until the swelling stopped after exercising.
Stationary bike will help with range of motion and would progress with resistance. Most important thing is to move the joint.
Hope this helps. Others have made good suggestions as well.
@nathan Thanks for this - I may have to follow the same path and in fact have been looking at the local selection of gyms. Am I correct that RDL are Romanian Dead Lifts? And how long into that 6 months did it take you to notice the legs/knees getting better and what age are you, if I may ask?
@jiffylush talked to a co-scout helper and he has a wealth of band experience so I’ve been using those. @Stevie_Dee and @tfelds - thanks and i’m mixing the bands work with slow squats and the like.
I’m 8 weeks so well past the “recovery” phase but struggling with some stuff hence the questions - may have to just bite the bullet.
I feel there is likely something lost in translation, otherwise you need a different physio.
Going on what you’ve shared, I would simply work on the bike and good variety from a plan like sweet spot base will strengthen your legs generally, which is likely what is actually needed.