# Leg Workout for Severely Injured Knee?



## ThicknCurvy (Jul 6, 2011)

Need some suggestions for leg workouts to accommodate severely injured knee.  Goal is to rebuild strength not bulk as legs are still pretty muscular from years of dance & gymnastics.  I'm working with a trainer & former fitness competitor but we're running out of ideas to vary my leg workout.

Ortho won't let me do any open chained exercises, climb stairs, use elliptical, hike on incline, do squats or lunges, and can't do any weight bearing position with the weight on the front of the patella. 

My leg workout includes 100 reps on almost every machine.  Usually start on  on incline press (up to 200 reps at weights maxed at 270 lbs, sometimes do down sets for endurance, other days do intervals to stress the muscles), seated hammies, extensions (with legs in turned out position), abduction/adduction machines, seated calves, calves on incline press.   Currently no functional exercises beyond what we do in zumba classes.

Six knee surgeries.  Knee injury included ruptured ACL, MCL & meniscus.  Reconstruction 20 yrs ago with patellar tendon graft.  Fractured patella. Screws still remain in patella.  Ortho removed lower 1/2 of patella appx 10 yrs ago.  ROM lmited.  On healthy knee it's -13 degrees beyond 180 degrees straight... injured knee is 2 degrees from 180 degrees straight.


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## Kenny Croxdale (Jul 6, 2011)

ThicknCurvy said:


> Need some suggestions for leg workouts to accommodate severely injured knee.  Goal is to rebuild strength not bulk as legs are still pretty muscular from years of dance & gymnastics.  I'm working with a trainer & former fitness competitor but we're running out of ideas to vary my leg workout.
> 
> Ortho won't let me do any open chained exercises, climb stairs, use elliptical, hike on incline, do squats or lunges, and can't do any weight bearing position with the weight on the front of the patella.



ThicknCurvy,

*Open Chain Exercises*

None of the exercises you lised are Open Chain Exercises, they are Closed Chain Exercises.  

Open Chain are basically non weight bearing, where you are not in contact with the ground.  Open Chain are usually isolation exercises.  Example: Leg Exetensions, Leg Curl, etc.  

Close Chain are weight bearing, where you are in contact with the ground. Close Chain are compound/multi-joint exercises. Example: Squats

So, my understanding is that your doctor has limited you to Open Chain exercises, correct?  

*Open Chain Leg Exercises*

If these are the only type of leg exercises that you are allowed to perform, you are a bit limited on Open Chain Exercises. 

*Options For Open Chain Exercises*

While you may be limited on the number of Open Chain Exercise, you can impliment some variances in the training method applied to these exercise to elicit an increase in strength.

However, the information in your post indicates that you can perform Close Chain exercises, if performed properly...more on that to come.

*More Information*

Provide more information on your training would be helpful.  (Exercises, reps and sets per exercise, rest period between exercises, what exercise you perform on what days, etc).  More information is better than less.



ThicknCurvy said:


> Currently no functional exercises beyond what we do in zumba classes.



*Contracitory Information*

These exercises are closed chain"climb stairs, use elliptical, hike on incline, do squats or lunges, and can't do any weight bearing position with the weight on the front of the patella" 

*Reading Between The Lines*

What your ortho appears to be telling you is not to perform any exercises in which "Shear Force" occurs. 

*Shear Force On The Knee*

Any movement in which the knee is drive forward toward the toes places shear force on the knees.  In other word, the knee is placed in a vurnerable postion.  

Not only that but the weight/load is magnified due angle of your knee.   

*Knee Postion In Lower Body Movements*

The key to minimizing Shear Force on the knee is to make sure you maintain a 90 degree angle of the shin to the floor.  

That insuress that you knee is NOT driven forward, placing Shear Force on you knees. 

*Shear Force Lung Examples*

In performing a Lung, most individuals step forward.  In doing so, they automatically allow their shin to track forward toward the toe and beyond it.  

Doing so places an enormous amount of Shear Force on the knees. 

*Proper Lunges*

In performing a Lungs, stepping back insures that you shin remains perpendicular/90 Degrees to the floor.  That means it minimizes the Shear Force on you knees.  

*Squats*

It the same with squats.  You want to Sit Back as you squat. Doing so, insures your shins are perpedicular to the floor. 

*Stair Climbers = Knee Wreckers*

The performance of this exercise is notorious for drving the knees forward and magnifing the Shear Force on you knees.  

*Ellipticalls and Incline Hiking...*

Not much Shear Force on the knees is involved in either of these exercises.  So, I find it perplexing for these exercises to be considered bad. 

*Down Hill Hiking*

It not going up that kills you knees, it going down that will kill them.

The knee is driven forward in "braking" as you descend.  Also, the eccentric force magnifies your body weight.  Thus, placeing an even greater load on you knees.  

*Squat and Lunges*

How you perform them determines the Shear Force on the knees.  So, it not the exercise but you technique.  

*Partial Range Squats and Lunges*

Also limiting the depth of your squat and/or lung will minimize the Shear Force on your knees. 

*Effective Leg Exercises*

From the small amount of information you have presented, it appears to me that some partial range squats, lunges...even the elliptical would strengthen you legs and the muscles around you knees. 



ThicknCurvy said:


> My leg workout includes 100 reps on almost every machine.  Usually start on  on incline press (up to 200 reps at weights maxed at 270 lbs,



 *Incline Press*

Might I assume this is a Leg Press.  If so, it no different than squats or lunges.  

*100 Reps*

I am assuming that your 100 reps is the accumulated total for each machine.  

*Killing A Fly With A Sledgehammer*

Performing that many reps to work the muscle/muscles is like killing a fly with a sledgehammer rather than using a fly swatter.  It is overkill.  

It is also not very productive.  

*Sets and Reps*

You're better off performing 6-15 reps per exercise for 3-5 sets.  

There is a indirect corolation, see-saw relationship, between Reps and Sets.  That means when one goes up, the other goes down. 

Thus, if your performing a high number of reps, you do a smaller number of sets.  

*High Rep/Low Set Example*

15 Reps X 3 Sets

When using a low number of reps, you perform a higher number of sets. 

Low Rep/High Set Example

6 Reps X 6 Sets



ThicknCurvy said:


> Six knee surgeries.


 
Sorry to hear you had to go through that. 

Kenny Croxdale


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## ThicknCurvy (Jul 6, 2011)

*Sample Leg Day*

Wow Kenny... very helpful.  Thanks so much for taking the time for such a detailed response.  

And yes, you're reading between the lines was right on point; my descriptions were not!  LOL.  

The prohibition against hiking, elipticals etc is because of the sheer force.  And you're right, when I'm on the incline press, as long as I keep my knee at 90 degrees, it's tolerable.  Oddly, we've tried lunges, squats and plies in 2nd position where I'm at 90 degrees and these have caused swelling & pain in the knee.  But perhaps it's time to try them again now that my strength has increased exponentially over the last nine months????

Note:  the ACL reconstruction is stable & doesn't cause the problems... the pain is across the anterior side of the patella.  I do need a knee replacement but doc wants to forestall that if possible until I'm at least 55.

Here's my leg workout we do twice a week for about 90 minutes:
Because I'm limited on amount of weight because of my knee, the PT suggested we train the muscles to the point of exhaustion with more sets & more reps.  The incline press is the only one that varies much from workout to workout.

*1.  Incline leg press*.  We rotate each workout... one day is downset, one interval, one downset, one consistent weight.  Then we repeat the cycle.  I always work with feet near the top of the platform but sometimes I'm wide parallel, other time narrow parallel.  Can't do turnout because of stress on the knee.  Don't get knee angle beyond 90 degrees.

Leg Day #1 - Down sets. 
270 x 20, 220x20, 200x20, 180x20, 160x20, 140x20, 120x20, 100x20, 100x20, 100x20.   We do this with no break in between except for her to take the weight off the bar.  At the last few reps, I can barely push the 100lbs up... legs are shaking in fatigue.

Leg Day #2 - Intervals. 
I start at 140x20, 190x20, 240x20, 190x20, 240x20 x 190x20, 140x20.  There's sometimes a few minute break in the midst of these sets so I can get the blood flowing back to my legs again.  If I can handle it, sometimes I'll add two more sets... seems to depend upon how much protein & glutamine I've had before the workout.

Leg Day #3 - Downsets again. 

Leg Day #4 - Consistent weight -- either 140 lbs or 180 lbs and we vary between one set of 20 working the full ROM at slow pace,, then the 2nd set is pulsing & only about 1/3 of the full ROM.  We repeat this to 200 reps total... 100 full & 100 pulsing.  Rest of 30 seconds after 2 sets; longer 2-3 minute rest & get off machine in the middle of sets.   

*2.  Seated Hamstring Curls*
60x20 -- five sets.  No more than 30 second rest between sets.  Laying Hamstring curls bother the knee but seated don't???? 

*3.  Seated Leg Extensions*
35x15 slow, 35 x 15 holding in extension for 8-10 seconds, 35x15 slow, 35x 15 holding in extension for 8-10 seconds.  Can't increase weight much more because of stress on patella.  Extensions done in turnout to minimize stress on patella.  Legs are trembling in fatigue about half way thru each set of holds.  Usually about 2-3 minute rest/walk around after first 2 sets. 

*4.  Calves*
Rotate between Donkey(90#), Incline Press in turnout (90#) & Standing Calves (160#).  Always sets of 12-15.  Slow flexion & point, rapid flexion & point, then holds for 5 seconds.  Between 5 & 8 sets.

*5.  Resistance Bands*
Various activities but none with extenstion thru the knee.  10 sets of 10-12.

*6.  Seated Abduction Machine*
200 reps total.  60x20 - five sets slow, 60x20 - five wide pulsing sets.
2-3 min rest after each 2 sets.

*7.  Seated Adduction Machine* 
100-200 reps. 70x25 - five set slow.  Sometimes will add pulsing sets.  These are always the last things in the workout.

We're open to any new ideas you have.  Beside the leg days, I ride bike for 30-60 mins a day (depending if it's a leg day or zumba day) and do zumba appx 3-4 times a week.  Leg days are Tuesday & Friday; upper body on Saturday.  Monday is usually a complete rest day.

Only supplements are L-glutamine, bromelain, L carnitine & CLA... although I'm not convinced the latter two help with fat burning.  The glutamine is a lifesaver.  On leg days, 2000 mg at breakfast, 3000 before workout, 3000 after workout, 2000 before bed.  Eating at least 100 grams protein with a breakdown of 35-50/35-50/10-15 Proteins Carbs Fat.  

Thanks again for the tips!
Michelle


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## Kenny Croxdale (Jul 7, 2011)

ThicknCurvy said:


> Wow Kenny... very helpful.  Thanks so much for taking the time for such a detailed response.



Hi Michelle,

Nice to have a name.  

As you can tell, I am a bit anal about this stuff. It relates to what I do/work. 



ThicknCurvy said:


> And yes, you're reading between the lines was right on point; my descriptions were not!  LOL.



I understand.  This stuff gets confusing at times.



ThicknCurvy said:


> The prohibition against hiking, elipticals etc is because of the sheer force.



*Ellipticals* 

Michelle, there isn't much shear force placed on the knees on quality ellipticals.  That because the shin is pretty perpendicular to the foot plate. 

*Hiking Uphill*

There isn't much shear force in hiking uphill either.  In stepping forward while going up, again the is for the most part perpendicular to the ground.  

So, I don't see much of a problem with either of those.  

*Hiking Downhill*

Hiking downhill places an enormous amout of shear force on the knees.  So, this type of movement is usually determinal to the knees...even good knees. 

*"If It Hurts, Don't Do It."*

That the bottom line. 



ThicknCurvy said:


> And you're right, when I'm on the incline press, as long as I keep my knee at 90 degrees, it's tolerable.  Oddly, we've tried lunges, squats and plies in 2nd position where I'm at 90 degrees and these have caused swelling & pain in the knee.  But perhaps it's time to try them again now that my strength has increased exponentially over the last nine months????



*Tyring Them Again*

I commend you for trying them again.  However, if they give you problems...don't do them. 

*Push Your Butt Back*

Pushing your butt back is one of the a majory key in keeping your shins perpendicular to the floor.  

*Limited Range Of Motion*

Also, instead of performing a deep squat or lung, perform only a quater squat or lung.  This will place less stress on you knees.

I realize your Range of Motion is already somewhat limited.   



ThicknCurvy said:


> Note:  the ACL reconstruction is stable & doesn't cause the problems... the pain is across the anterior side of the patella.  I do need a knee replacement but doc wants to forestall that if possible until I'm at least 55.
> 
> Here's my leg workout we do twice a week for about 90 minutes:
> Because I'm limited on amount of weight because of my knee, the PT suggested we train the muscles to the point of exhaustion with more sets & more reps.  The incline press is the only one that varies much from workout to workout.
> ...



*PT*

Does PT mean Physical Therapist or Personal Trainer. 

*Down Sets*

Your down set program of of 200 reps, doesn't make much sense.  

The down set method is one bodybuilders have employed forever.  The method is effective for building muscle mass.  

However, 200 reps is like my analogy of killing a fly with a sledgehammer instead of a fly swatter.  



ThicknCurvy said:


> Leg Day #2 - Intervals.
> I start at 140x20, 190x20, 240x20, 190x20, 240x20 x 190x20, 140x20.  There's sometimes a few minute break in the midst of these sets so I can get the blood flowing back to my legs again.  If I can handle it, sometimes I'll add two more sets... seems to depend upon how much protein & glutamine I've had before the workout.



*Interval Sets*

Interval sets are another effective method of training.  

*Too Many Reps*

However, one again 140 reps are overkill. 

*Distance Runners*

This weight training program is a "strength endurance program", as you know.  While it will increase some strength, the emphasis of a program like this is more on endurace than strength. 

*Strength and Size*

The use of mega reps is akin to distance runners.  They don't have very little strength.  

*Sprinters*

Sprinters limit the number of "reps" they perform in a set compared to distance runners.  

Sprinters possess a great deal of strength, as well as strength and power.

*Interval Sprints*

Sprinters perform short intervals sprints during their training. 

*Growth Hormone*

Growth hormore production is a by product of these short interval sprints.  This increases muscle mass.   

*Limit Strength*

Limit strength is that amount of force you can produce for one all out effort.  Thus, the most weight you could push up in the leg press one time would be a measure of your limit strength. 

*Training To Increase Limit Strengh*

Training to increase strength is completely different than for strength endurance.  Reps are low while sets are high.  

Thus, some type of Limit Strength Training need to be employed in every program.  

*Energy*

I don't see the addition of protein really helping increase you stamina.  

*Caffeine*

Caffeine has been shown to increase you abiltiy to work, stamina.  Usually, a cup of coffee (about 200 mg of caffeine) will give you a boost...minus sugar and/or cream.   

I see coffee as a legal way to "main line" caffeine. 

However...

*Creatine, Caffeine, Whey Protein*

This coctail appears to enhance stamina.  The 2010 issue of the journal Nutrition Research showed a 10% increase in stamina. 



ThicknCurvy said:


> Leg Day #3 - Downsets again.
> 
> Leg Day #4 - Consistent weight -- either 140 lbs or 180 lbs and we vary between one set of 20 working the full ROM at slow pace,, then the 2nd set is pulsing & only about 1/3 of the full ROM.  We repeat this to 200 reps total... 100 full & 100 pulsing.  Rest of 30 seconds after 2 sets; longer 2-3 minute rest & get off machine in the middle of sets.



*Slow Pace* 

This is an effective tool.  Placing the muscles under a longer "Time Under Tension" increases muscle mass and strength to some degree.  

*Pulsing???*

What does that mean? 

*Mega Reps*

Again, the mega reps just don't make sense.  



ThicknCurvy said:


> *2.  Seated Hamstring Curls*
> 60x20 -- five sets.  No more than 30 second rest between sets.  Laying Hamstring curls bother the knee but seated don't????



*Hamstring Muscle Fiber*

The hamstrings are composed of fast twich muscle fiber.  

Fast twitch muscle fiber respond best to low to moderate repetitions...not higher reps.  

So, what you want to do is provide them with the right stimulus (reps).  That is best accomplished with repetitions that are no more than 10 per set.  

*The Right Tool For The Right Job*

You can use a crescent wrench to drive a nail in but a hammer works much better.  The take home message is that, you will get better results if you use the right tool for the right job. 

The most effetive stimulus (right tool) for training fast twitch muscle fiber is low to moderate repeitions.

Training fast twich muscle fiber with high reps is like using a crescent wrench to drive nails.  It works but not as well as the hammer. 



ThicknCurvy said:


> *3.  Seated Leg Extensions*
> 35x15 slow, 35 x 15 holding in extension for 8-10 seconds, 35x15 slow, 35x 15 holding in extension for 8-10 seconds.  Can't increase weight much more because of stress on patella.  Extensions done in turnout to minimize stress on patella.  Legs are trembling in fatigue about half way thru each set of holds.  Usually about 2-3 minute rest/walk around after first 2 sets.



*Holding = Isometrics*

Isometrics are another effective training method. 

*Leg Extensions*

However, I don't see much value in leg extensions...with the exceptions of Quad Sets that are presecribed by Physical Therapist.



ThicknCurvy said:


> [*4.  Calves*
> Rotate between Donkey(90#), Incline Press in turnout (90#) & Standing Calves (160#).  Always sets of 12-15.  Slow flexion & point, rapid flexion & point, then holds for 5 seconds.  Between 5 & 8 sets.



*Gastrocnemius*

This muscle in the calf is a fast twitch muscle fiber. Standing movement work this muscle.  It responds best to 12 reps per set or less.

*Soleus*

This calf muscle is worked with steated calf raises.  It is a slow twitch muscle fiber.  It responds best to mega reps, 20 reps plus.  



ThicknCurvy said:


> [*5.  Resistance Bands*
> Various activities but none with extenstion thru the knee.  10 sets of 10-12.



*Resistance Bands*

They are a great training tool and also one of the most misunderstood...especially with men.



ThicknCurvy said:


> *6.  Seated Abduction Machine*
> 200 reps total.  60x20 - five sets slow, 60x20 - five wide pulsing sets.
> 2-3 min rest after each 2 sets.
> 
> ...



*Abduction/Adduction Machines*

I am not a fan of these machines.  The Leg Press, Squat, Lung, and similar exercise work it well.  

However, if it makes you feel good...do it.  I am all about doing thing that make me feel good. 

Again, the rep range for the number of sets doen't make sense. 



ThicknCurvy said:


> [[We're open to any new ideas you have.  Beside the leg days, I ride bike for 30-60 mins a day (depending if it's a leg day or zumba day) and do zumba appx 3-4 times a week.  Leg days are Tuesday & Friday; upper body on Saturday.  Monday is usually a complete rest day.



*Cafateria Training Ideas*

I will provide you with some ideas in another post.  You can pick and choose what you like might like to try...like going through a cafeteria line.

*Overtraining*

I suspect you may be overtraining you legs.  The point is to stiumlate them, not annihilate them.  

*"Wound Healing"*

Training is somewhat like making yourself sick.  You then need to rest so you can heal.  

Rest allows your body to grow and become stonger.  



ThicknCurvy said:


> [Only supplements are L-glutamine, bromelain, L carnitine & CLA... although I'm not convinced the latter two help with fat burning.  The glutamine is a lifesaver.  On leg days, 2000 mg at breakfast, 3000 before workout, 3000 after workout, 2000 before bed.  Eating at least 100 grams protein with a breakdown of 35-50/35-50/10-15 Proteins Carbs Fat.



There is some good evidence on glutamine.  However, I like you, I dont see any value in the others. 



ThicknCurvy said:


> [Thanks again for the tips!
> Michelle



Michelle, you are welcome.  

*"Research is what I am doing when I don't know what I am doing." Einstein*

One of my areas of expertise from all my experimentation is, "Here's what NOT to do."...  It part of my research.

*Investigate*

The main thing is don't take my word nor anyone elses word on this.  

Investigate information for yourself.  

Kenny Croxdale


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## ThicknCurvy (Jul 31, 2011)

Hi Kenny:

Thanks so much for the tips.  I've given them to my trainer so we can incorporate your ideas into my workouts.  She's also working on her Physical Therapy degree right now so I know she's intrigued by your comments.

A couple of follow-up questions...
I liked you analogy re distance runners vs sprinters.  While I definitely have seen a huge increase in my strength & endurance over the 9 months, I can't up my weight much more on many of the machines, especially the Leg Extension & Incline Leg Press because of the pressure on my knee.  On the Incline, I've maxed out at 270 lbs.  Given that I can't seem to increase the weight much more, it seems I don't have an alternative but to do different workout or do more reps.  Given this, would you suggest less reps but at a higher weight like 220 lb?  What is the max sets/reps you'd recommend?

Re closed vs open chained. Ortho has prohibited open chained but also some closed chain if it puts too much pressure on the anterior of the patella... I think that's why squats, lunges & plies' have been forbidden.  Hoping as my strength increases, I can incorporate these back into my workout.  Eventually would love to be able to take a ballet class again as it's been over 20 years.

Re cardio, the rotation of the elliptical -- while weightbearing -- seems to cause the problem.   Ortho cautioned me that every pound of weight puts 7 lbs of pressure on the knee.  Recumbent biking & rowers seem to be much less painful on the knee.  Even with daily celebrex, the knee couldn't tolerate the elliptical.

Re supplements, for what it's worth, bromelain has made a huge difference in my inflammation & recovery post-workout.  Just had some plastic surgery done and my surgeons advised me to take it post surgery too.  Said there was a recent article in one of their medical journals speaking to the beneficial effects of glutamine & bromelain in post surgery recovery. You seem to be a man who researches a lot... thought you might want to know their thoughts.  

Thanks again,
Michelle


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## Kenny Croxdale (Jul 31, 2011)

*Super Slow Protocol*



ThicknCurvy said:


> Hi Kenny:
> 
> Thanks so much for the tips.  I've given them to my trainer so we can incorporate your ideas into my workouts.  She's also working on her Physical Therapy degree right now so I know she's intrigued by your comments.



Hi Michelle,

It's been awhile.  

Physical Therapist are one group that I have a lot of respect for.  

Hopefully, "intrigued" falls into the catagory of a positive connotation.  



ThicknCurvy said:


> A couple of follow-up questions...
> I liked you analogy re distance runners vs sprinters.



I find a relatable analogy tends to clairy thing.  



ThicknCurvy said:


> While I definitely have seen a huge increase in my strength & endurance over the 9 months, I can't up my weight much more on many of the machines, especially the Leg Extension & Incline Leg Press because of the pressure on my knee.  On the Incline, I've maxed out at 270 lbs.  Given that I can't seem to increase the weight much more, it seems I don't have an alternative but to do different workout or do more reps.  Given this, would you suggest less reps but at a higher weight like 220 lb?  What is the max sets/reps you'd recommend?



*Pressure On The Knee*

Yea, you don't want to overstress your knees.  However, I am still don't see the point of performing mega reps.  

*Super Slow Protocol/Time Under Tension*

This involves performing each repetition of a set, extremely slow.  

*Repetition Speed*

The concentric/positive contraction (pushing or pulling the weight up) takes 10 seconds.  

The eccentric/negative (lowering the weight) take 5-10 seconds.  Depending on which school of thought you subscribe to. 

*NO Lockout At The Top of The Repetition*

This means you do not lock the weight out at the top of the movement.  

Leg Press Example: Before reaching the top, you stop the movement.  Then begin the slow descent back down. 

*NO Resting At The Bottom*

This means, just prior to reaching the bottom of a leg press (any movement and resting), you stop.  You then begin the slow ascent back up. 

*Repetitions Per Set*

4-6 Repetitions Per Set are performed.  

*Time Under Tension*

Performing 4-6 repetitions per set means you are placing the muscle/muscles in the exercise under 40 to 60 seconds of constant tension.  

*Harder Than It Sounds*

4-6 repetitions doesn't sound that hard.  What makes it hard maintaining constant tension on the muscle/muscles for 40-60 seconds.  

*Increasing Muscle Mass*

Exercise physiology has demonstrated that muscle/muscles need to be stressed during an exercise for 20-40 seconds.  Doing so, produces an anabolic (muscle building) hormonal effect.  

Traditional bodybuilders employ set of repetitions of 8-16 repetitions.  If you clock it out, you'll note the time you've placed the muscle under tension is 20-40 plus seconds.

Thus, Super Slow is just a slightly different method of elicting the same effet.

*Super Slow Weight*

Due to the fact that you are placing the muscle/muscles under non-stop constant tension for 40-60 seconds, the weight you use in an exercise need to be dramatically lower than what you are currently using.  

*Leg Press Weight*

That means if your using 270 lbs in the leg press, you probably need to drop it down to about 150 lbs when using Super Slow and working your way up. 

*Lower Weight = Less Stress On Your Knees*

Super Slow allows you to maximally stress your legs while decreasing the pressure on your knees.  

From your pevious post on slow repetitions, it appears your are utilzing a version of Super Slow.



ThicknCurvy said:


> Re closed vs open chained. Ortho has prohibited open chained but also some closed chain if it puts too much pressure on the anterior of the patella... I think that's why squats, lunges & plies' have been forbidden.  Hoping as my strength increases, I can incorporate these back into my workout.



I understand. I am a big proponent of, "If it hurts, don't do it."  



ThicknCurvy said:


> Eventually would love to be able to take a ballet class again as it's been over 20 years..



*Ballet Dancers*

Ballet dancers are very powerful, flexible, aerobcal athletes.  I don't think most people understand the athletic qualities they possess. 

My son competes in Swing Dancing.  He did some ballet along the way. 



ThicknCurvy said:


> Re cardio, the rotation of the elliptical -- while weightbearing -- seems to cause the problem.   Ortho cautioned me that every pound of weight puts 7 lbs of pressure on the knee.  Recumbent biking & rowers seem to be much less painful on the knee.  Even with daily celebrex, the knee couldn't tolerate the elliptical.



Anything that cause you problems (as you know) should be avoided.

Bikes are always a good choice.  



ThicknCurvy said:


> Re supplements, for what it's worth, bromelain has made a huge difference in my inflammation & recovery post-workout.  Just had some plastic surgery done and my surgeons advised me to take it post surgery too.  Said there was a recent article in one of their medical journals speaking to the beneficial effects of glutamine & bromelain in post surgery recovery. You seem to be a man who researches a lot... thought you might want to know their thoughts.



*Bromalain* 

I am not familiar with bromelain.  I appreciate you passing the information along. 

*Research*

Research certainly does provide clues to what might work.  

* Research That I Value*

However, what I really value is the personal experiences of others.

I will definitely look up information on bromelain..  



ThicknCurvy said:


> Thanks again,
> Michelle



You're quite welcome.   

Kenny


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