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  • Dr. Ray,

    Firstly, many thanks for this template. I have had persistent patellofemoral pain for a few months and since starting this template, I have noticed substantial improvements.

    My question is about Phase 2. The crux of the issue is that I can't complete the workouts. To emphasise, this is not because of pain, but because of weakness and lack of recovery. I find the idea of 3 exercises at 6x15 RPE10 a crazy amount of intensity, probably because i'm very weak and it doesn't feel like i'm recovering between workouts; I could barely do the first week of isometric exercises at body weight. N.B. I am running a separate upper-body routine on another 3 days.

    For example, here is what I have done so far. I'm in my second week now.

    Tuesday:
    Squat - 6 x15
    Romanian DL* - 6 x 15, 15, 12, 10, 10, 8
    Bulgarian Split squats (bodyweight) - 6 x 10, 10, 8, 8, 6, 5

    Sunday (I didn't feel ready to work out again until Sunday)
    Wall-sits - 6x45seconds
    Bulgarian Split squats (bodyweight) - 6 x 10

    Tuesday**:
    Squat - 6 x 15
    Bulgarian Split squats (bodyweight) - 4 x 11, 10, 6, 5
    Romanian DL - 2 x 5, 6

    * Romanian DL because using a home gym set-up amidst covid, conventional DL seems difficult to do well
    ** My form was beginning to break down like crazy and so I didn't push any further on the split-squats or the RDLs

    My question is this: What is the best approach to Phase 2 given I can't complete it as is. Pushing too much feels like overtraining. I feel like two options are:
    - Reduce volume of sets, and have 2 exercise for 3 workouts
    - Keep volume and only workout twice a week

    Very interested to hear your thoughts, and thanks again.

    Comment


    • rorywatts thanks for purchasing the template and glad it has been helpful.

      Regarding dosage of activity, no worries here. The template is merely a roadmap that can be altered as needed. I think either reducing frequency from 3 days to 2 days or performing one major squat movement and one hinge movement are both reasonable options to help with symptoms, recovery, and adaptation.

      Comment


      • Originally posted by Michael Ray View Post
        rorywatts thanks for purchasing the template and glad it has been helpful.

        Regarding dosage of activity, no worries here. The template is merely a roadmap that can be altered as needed. I think either reducing frequency from 3 days to 2 days or performing one major squat movement and one hinge movement are both reasonable options to help with symptoms, recovery, and adaptation.
        Thanks very much for the reply, greatly appreciated.

        Comment


        • Hi Dr Ray,

          Thanks for the template. Hopefully it can help with the pain I’m experiencing, but at the least, I’m getting some enjoyment from it now the 3-0-3 x 15s are finally behind me.

          If you have a moment, could I get your thoughts on a couple of things?

          My background:

          Endurance/mountain runner. Roughly 1 year’s experience with strength training using barbells.
          Early in the year, I began to experience a pretty mild pain in the back of my right knee. I believe this is around the insertion of the semitendinosus/semimembranous, but I’m not pretending to be a doctor, so apologies if I’ve got that wrong.

          Obviously, covid-19 is limiting my access to non-essential medical consults, so I thought I’d try the template: Although you haven’t explicitly recommended it for my symptoms, they seem very close to conditions you do recommend for, so it seemed worth a shot.

          I’m towards the end of Week 3, having selected squats, conventional deadlifts and step-ups as my exercises.

          I’ve tolerated everything pretty well, but one observation I’ve made is that where I’ve had severe DOMS, it seems to be local to the biceps fermoris, not the site of my existing pain. I don’t know if this is relevant or not, but it seems worth mentioning.

          Thoughts/questions:

          1) Do you think my exercise selection is sound? I had previously been trying to fix myself with RDLs, but these didn’t show up in the dropdown in the template, so I’m guessing they’re out for a reason?
          2) Step-ups: I’m increasing the RPE of these by wearing a weighted backpack and holding a plate in front of me (to distribute the weight around my torso). This ‘feels’ fine, but as I’ve never done it before, is this correct?
          3) I realise that tendon pain can take up to 12 weeks of rehab to resolve, and many cases don’t even resolve with that, and I also realise that any progress won’t be linear. That said, is there a 'cutoff' you would recommend with this template? For example if I haven’t experienced the slightest improvement after, say, 8 weeks, would trying to see a local physician possibly be a better use of my time?
          4) I realise that phase 3 of the template isn’t suited for my sport. Is there any chance you can give very 'top level' direction on where I should head next? I’m happy doing my own research and planning, but I’d be grateful for any advice you can offer.

          Thanks, Chris.

          Comment

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