Knee Rehab Template

[kevinhail]

Hello!

So I bought the knee rehab template. One big problem: I cannot do the bio test. I tried all different sized weights and I just cannot complete a single rep (even with my good knee).

The only way I can get it done is using my racks uprights to hold onto. Any other ideas? Or any other biometric tests I can do? What about a double leg incline squat?

[Michael Ray]

Hello!

So I bought the knee rehab template. One big problem: I cannot do the bio test. I tried all different sized weights and I just cannot complete a single rep (even with my good knee).

The only way I can get it done is using my racks uprights to hold onto. Any other ideas? Or any other biometric tests I can do? What about a double leg incline squat?

Hey kevinhail - I plan on updating this template this year and will likely remove the biofeedback test. I wouldn't become too over-focused on this test. Rather, you can use your training movements as a test in itself to see how you are feeling that particular day to adjust loading accordingly. Make sense?

[kevinhail]

That makes perfect sense. Thanks!

[kevinhail]

Me again! So after a week of the knee rehab template - my knee pain is basically gone. Would you recommend me stick with the course for 15 more weeks or maybe skip ahead a bit? I was thinking of maybe skipping to the 10 rep week or 8 rep week. TBH - I absolutely hate tempo squats, and I absolutely hate high-rep squats lol. Likely not the first person to say that. I'd ideally like to remove/modify one of those factors.

So either:

1. Skipping to a lower rep week (8 or 10)
2. Changing 3-0-3 to 3-0-0 for example
3. Both ( )

Curious on your thoughts.

[Michael Ray]

Me again! So after a week of the knee rehab template - my knee pain is basically gone. Would you recommend me stick with the course for 15 more weeks or maybe skip ahead a bit? I was thinking of maybe skipping to the 10 rep week or 8 rep week. TBH - I absolutely hate tempo squats, and I absolutely hate high-rep squats lol. Likely not the first person to say that. I'd ideally like to remove/modify one of those factors.

So either:

1. Skipping to a lower rep week (8 or 10)
2. Changing 3-0-3 to 3-0-0 for example
3. Both ( )

Curious on your thoughts.

Hey, it's difficult to state without talking to you further. Based on what we've talked about here, I think those options are reasonable to try. You can even try 2 first and then if that goes well, try 1.

[scoTTTimo]

Hey Michael, I just started day one of the knee rehab template. A few questions/clarifications (if you wouldn't mind).

- In phase 1, are we really supposed to hold each isometric move for 45s at RPE 10? ...as in, I should be falling over at 46seconds? It seems like that's going to wear me out pretty quickly, doing this every day (or 2x/day) in phase 1. Am I misunderstanding?

- Phase 2 says "Frequency: 3x/week", but there's 5 days of exercise slots in each week. Is it 3 or is it 5?

- Is it ok to do cardio while running the template? I'm at 35% bodyfat, and need also lose fat to help my knee. If yes, is there something you'd recommend, that doesn't place too much stress on the knee?

- If you're removing the biofeedback test in future iterations, is there something that will replace it, or will the athlete just jump right into the Isometrics in phase 1? I'm asking because I'm also having difficulty completing the test. I can't get to 90 degrees. I don't think it's because of my bad knee though. I'm just fat, have terrible balance, and am extremely inflexible.

[Michael Ray]

Hey Michael, I just started day one of the knee rehab template. A few questions/clarifications (if you wouldn't mind).

- In phase 1, are we really supposed to hold each isometric move for 45s at RPE 10? ...as in, I should be falling over at 46seconds? It seems like that's going to wear me out pretty quickly, doing this every day (or 2x/day) in phase 1. Am I misunderstanding?

- Phase 2 says "Frequency: 3x/week", but there's 5 days of exercise slots in each week. Is it 3 or is it 5?

- Is it ok to do cardio while running the template? I'm at 35% bodyfat, and need also lose fat to help my knee. If yes, is there something you'd recommend, that doesn't place too much stress on the knee?

- If you're removing the biofeedback test in future iterations, is there something that will replace it, or will the athlete just jump right into the Isometrics in phase 1? I'm asking because I'm also having difficulty completing the test. I can't get to 90 degrees. I don't think it's because of my bad knee though. I'm just fat, have terrible balance, and am extremely inflexible.

Hey scoTTTimo- thanks for purchasing the template.

Isometrics - no, that phase can actually be skipped altogether depending on the individual and their symptoms. If you choose to do isometrics, then the time frame is actually rather arbitrary. Some folks may need to start less than :45 seconds, some may necessitate more, there's no magic here so do what you can. For RPE rating, it's ok to do lower RPE based on your symptoms and tolerance level. I'm just more comfortable with folks pushing RPE rating on isometrics unloaded which is different than RPE 10 of low bar back squat.

Phase 2 - correct, if you need/want to do isometrics to help with symptom regulation between isotonic days then that's fine and pre-programmed should you choose to do that.

Cardio - sure, albeit I usually recommend going with low intensity steady state (RPE 4 or less) in the beginning weeks to gain some ground on your symptomatic experience.

BIofeedback - no plans to replace it at this time. The biofeedback will be how you (inclusive of your knee) feel from session to session. Be sure to check out the video walkthrough that is linked in the template.

[scoTTTimo]

Hey scoTTTimo- thanks for purchasing the template.

Isometrics - no, that phase can actually be skipped altogether depending on the individual and their symptoms. If you choose to do isometrics, then the time frame is actually rather arbitrary. Some folks may need to start less than :45 seconds, some may necessitate more, there's no magic here so do what you can. For RPE rating, it's ok to do lower RPE based on your symptoms and tolerance level. I'm just more comfortable with folks pushing RPE rating on isometrics unloaded which is different than RPE 10 of low bar back squat.

Phase 2 - correct, if you need/want to do isometrics to help with symptom regulation between isotonic days then that's fine and pre-programmed should you choose to do that.

Cardio - sure, albeit I usually recommend going with low intensity steady state (RPE 4 or less) in the beginning weeks to gain some ground on your symptomatic experience.

BIofeedback - no plans to replace it at this time. The biofeedback will be how you (inclusive of your knee) feel from session to session. Be sure to check out the video walkthrough that is linked in the template.

Thanks for your responses Michael. I'd read in an earlier post from you that you were planning to remove the biofeedback test, hence my question. Anyway, your reply leads me to some follow up questions:

- How would I know if I can skip phase 1? I'm thinking I shouldn't, due to the nature of my next question.

- I can't complete the biofeedback test. I can't get to 90 degrees, and when I get close to the bottom of my current ROM in my attempt (which is probably about 65-70 degrees), my knee pain approaches severe, even after a warmup. I don't foresee myself being able to get to 90 degrees after doing 7 days of isometrics. I've done 3 days so far, and have not noticed any improvement in my attempts at the biofeedback test. If I still can't do it after 7 days, would you recommend that I continue phase 1 until I am able to complete the test without a severe increase in symptoms?

If your answer is yes, would you recommend any modifications? So far I'm doing leg ext. for the double leg isometric, and split squat for the single.

[Michael Ray]

Thanks for your responses Michael. I'd read in an earlier post from you that you were planning to remove the biofeedback test, hence my question. Anyway, your reply leads me to some follow up questions:

- How would I know if I can skip phase 1? I'm thinking I shouldn't, due to the nature of my next question.

- I can't complete the biofeedback test. I can't get to 90 degrees, and when I get close to the bottom of my current ROM in my attempt (which is probably about 65-70 degrees), my knee pain approaches severe, even after a warmup. I don't foresee myself being able to get to 90 degrees after doing 7 days of isometrics. I've done 3 days so far, and have not noticed any improvement in my attempts at the biofeedback test. If I still can't do it after 7 days, would you recommend that I continue phase 1 until I am able to complete the test without a severe increase in symptoms?

If your answer is yes, would you recommend any modifications? So far I'm doing leg ext. for the double leg isometric, and split squat for the single.

I would not recommend completing the biofeedback (single leg squat on decline squat board) at this time. I would move past this and try to find tolerable loading for your knee, which sounds like you've done with isometrics. You may also benefit from a consultation with us so we can talk through your experience and can provide more individualized programming/guidance.

[abrunette]

I've been trying to progress from phase 1 for months now, but I can't get any traction. I haven't made any progress on the biofeedback test - can't complete it without extreme pain. Spanish squats don't seem to do anything no matter how much weight I add, so I guess I don't know what I'm doing. I can't hold either leg in the split squat for 45 seconds. I do the template 4 times per week. I'm so confused and frustrated because I'm still at the same level of pain as the months ago when I started, and my body isn't adapting to the exercises at all. It still hurts to walk, sit, stand, lay down, etc. I can't set up for the bench press, hold a strong base for any overhead movement, etc. without a high amount of pain or the possibility of not being able to get up from a sitting position after. I just want to be free from this pain so I can walk normally or even deadlift / squat.

[Michael Ray]

I've been trying to progress from phase 1 for months now, but I can't get any traction. I haven't made any progress on the biofeedback test - can't complete it without extreme pain. Spanish squats don't seem to do anything no matter how much weight I add, so I guess I don't know what I'm doing. I can't hold either leg in the split squat for 45 seconds. I do the template 4 times per week. I'm so confused and frustrated because I'm still at the same level of pain as the months ago when I started, and my body isn't adapting to the exercises at all. It still hurts to walk, sit, stand, lay down, etc. I can't set up for the bench press, hold a strong base for any overhead movement, etc. without a high amount of pain or the possibility of not being able to get up from a sitting position after. I just want to be free from this pain so I can walk normally or even deadlift / squat.

Hey abrunette - really sorry to hear about your situation. Ideally we can get a consultation with you to work through your experience and discussion actionable steps to help with coping. As far as the template goes, I'd disregard the biofeedback test and not worry about having to hold an isometric for :45 seconds. Instead, if you want to do isometrics just hold to tolerance. May be worth moving on to phase two and perform movements you want to do but with tolerable loads at a lower RPE. Hang in there.

[Cstaton5006]

Hi there - is this program compatible with Titan, or are the CrossFit style components a little too aggressive? Would something like the upper body portion of Powerbuilding (or others) be more appropriate? Just trying to figure out how broad I’ll need to change my plans for this program - right now I follow Powerbuilding style templates with CrossFit or conditioning on non-lifting days, but knee pain is becoming an inhibiting factor sometimes. I’m usually fine after warmups but lately lunges (and oblique twists, oddly) have given me stiff knees afterward. Thanks!

[Michael Ray]

Hi there - is this program compatible with Titan, or are the CrossFit style components a little too aggressive? Would something like the upper body portion of Powerbuilding (or others) be more appropriate? Just trying to figure out how broad I’ll need to change my plans for this program - right now I follow Powerbuilding style templates with CrossFit or conditioning on non-lifting days, but knee pain is becoming an inhibiting factor sometimes. I’m usually fine after warmups but lately lunges (and oblique twists, oddly) have given me stiff knees afterward. Thanks!

Hey! Thanks for the questions. The template will provide lower body training but you can sub in upper body of your choosing. I likely wouldn't recommend dynamic movements during this process (such a HIIT, snatch, clean and jerk, sprinting, jumping, etc). Hope that helps.

[williamdubble]

Good afternoon Dr. Ray!

Hey thanks for all the incredible content you put out. I recently purchased your knee template after dealing with tendinopathic symptoms in my quadriceps tendons for a couple years. I am currently on week 4 of the second phase of the template. The program is excellent and certainly humbling! Although I still have to tinker with intensity and subsequent symptoms, I am really enjoying myself and I remain confident in the approach, the program and improvements. So thanks!

One very specific way I notice my symptoms is in full hip extension with knee flexion (at and around 90 degrees). When setting up for a reverse Nordic with even a few degrees of increased knee flexion and contraction of my quads I can reproduce my localized symptoms in the quadriceps tendon. My symptoms present at the exactly location I experience my pain during the day and with certain movements. Would you work isometric holds of this position into the “off days” approaching it like you encourage with the main lifts? Should I use the reverse Nordic as a main lift at some point? Should I stay away from this position or movement until things are less sensitized?

Thanks!

[Michael Ray]

Good afternoon Dr. Ray!

Hey thanks for all the incredible content you put out. I recently purchased your knee template after dealing with tendinopathic symptoms in my quadriceps tendons for a couple years. I am currently on week 4 of the second phase of the template. The program is excellent and certainly humbling! Although I still have to tinker with intensity and subsequent symptoms, I am really enjoying myself and I remain confident in the approach, the program and improvements. So thanks!

One very specific way I notice my symptoms is in full hip extension with knee flexion (at and around 90 degrees). When setting up for a reverse Nordic with even a few degrees of increased knee flexion and contraction of my quads I can reproduce my localized symptoms in the quadriceps tendon. My symptoms present at the exactly location I experience my pain during the day and with certain movements. Would you work isometric holds of this position into the “off days” approaching it like you encourage with the main lifts? Should I use the reverse Nordic as a main lift at some point? Should I stay away from this position or movement until things are less sensitized?

Thanks!

Hey! Thanks for the feedback. Glad to hear the template has been helpful. I often have folks slowly work into tolerable ranges with reverse nordics, just be patient with the process. No need to force range of motion beyond tolerance level. You could do this 2 x / week for a few sets and reps. increasing range as tolerated.