Anyone......Quadricep Shrunk

[likewoa2007]

I have had a major case of quadrciep atrophy. Anyone who has had it, has anyone not been able to bend there knee to squat down on the surgical leg???

I had surgery almost 8 months ago (ACL with Meniscus)
I also had a clean out almost 3 months back

My quadricep still looks like a pile of musch
Anyone who has had quadrciep atrophy, have you experienced major knee pain when trying to bend on the bad leg.  And then has anyone not been successful at bending the knee to go dwon into a squat form?

Im still doing my pT.  Some say that this could take years?  My Surgeon is recommending a Cortizone shot but I'm only 28 years old.  There is arthritis in  the knee so maybe that might help with bending my knee.

Thanks

[Snowy]

I'm afraid that you're not going to get any answers that differ from those you've been given when you posted this question before. Yes, it's not uncommon to have major quad atrophy after ACL surgery, especially if it's followed by a second scope. Yes, if your muscle is atrophied than you will have great difficulty performing exercises like squats which put major force through the knee joint. Yes, PT is a significant part of the solution and yes, it can potentially take a very long time. Rebuilding muscle is a long, slow process, and you're not going to be able to run before you can walk - in other words, you won't be able to do a squat comfortably until you've worked through the basic muscle building exercises and rebuilt some strength and definition. A cortisone shot may help with discomfort coming from the arthritis, but it won't magically recreate the muscle that you need to support the knee joint while performing exercises like squats. Only a graduated program of appropriate exercises is going to achieve the results that you want.

[likewoa2007]

I completely agree with you.  Its also kind of hard to hold down a job when you cant do the essential funtions of really any job.  The quality of life just sucks and its like your incapacitated

[Clarkey]

Hi There,

Can anyone give me tips on how to get my right quads the same size as my left quads that was not operated on. I go to the gym 3 times a week and use the bike, cross trainer and treadmill for 20 minutes on each machine and my right quads are nice and firm but are a few inches smaller in size then my left quads. Would it be a benefit to use the rowing machine and use the leg press machine to try and get my right quads to a larger size again as it was pe op.

Nick  {2011}

[kscope09]

My physio told me that the size of the musle is not important as long as it is solid, lean musle and your leg is stronger and tracking well and it functions well enough then bulk doesn't matter.

I've got the same thing  too with my claves; on my left leg the calf muslce is as good as ever and has some roundness to it, though because I'm not doing my karate it isn't as sold as it used to be but with my right leg which had the scope the claf musle has come back nice and toned and the pt say's it looks fine but it isn't the shape it used to be and though it is good it isn't like the other one.

[Snowy]

The best way to build muscle is by doing directly targeted exercises with increasingly heavy weights. To trigger the muscle building process, you need to work out to the point where the muscle develops microtears. Muscle growth happens as these heal between workouts. You should be working out to the point of muscle fatigue, and building rest days into your program to give the muscles time to recover (this is really important.)

There are some good tips on this site: http://www.wikihow.com/Build-Muscle

Obviously anyone in active rehab from surgery or with ongoing knee problems should check with their physiotherapist before starting a muscle-building program, or doing specific exercises.

[kscope09]

Most of us here just can't do anything like that because of the potential of making ourselves worse.

When I was able to walk OK againa nd wanted to have a more aggressive workout I wasked my pt if he thought I should do squatts with weights and do leg extensions and his anser was, "under no circumstances" because of the strain they put on the patella.

Some of the old scholl pts will be more liekly to advise this kind of muslce building, but the more odern ones will say that if your joint is weakened already then avoid it like the plague.

[Snowy]

As I said:

Obviously anyone in active rehab from surgery or with ongoing knee problems should check with their physiotherapist before starting a muscle-building program, or doing specific exercises.

I do have to take issue with your suggestion that muscle building with weights is in some way old fashioned or not progressive, however. This is the most effective way to trigger muscle growth, and any restrictions on such a program would be based only on the individual patient's condition. A good physiotherapist will evaluate your condition and your goals and give you appropriate advice for achieving the latter without causing deterioration in the former. It has absolutely nothing to do with an old fashioned vs. modern approach to physiotherapy.

I'm curious as to what you would advise as an alternative to "this kind of muscle building" for someone who is actively looking to increase the strength of their muscles. It's true that a small muscle can be perfectly functional if it's in good condition, but its potential strength is finite unless you increase its size. There are also many, many different exercises that can be used to build muscle without straining other areas. There are plenty of things I can't do because of my patellar problems (like squats with weights) but my PT has found alternatives that are enabling me to gradually rebuild my quad and calf muscles, albeit more slowly than if I could do a full range of exercises.

[kscope09]

Weights are great for building muscle, no problem with that at all and they are great for people with ehalthy joints.  Leg extensions will just wreck the cartliage under your kneecap and you'll be worse than ever.  Mine is thin enough and I'd like to last another 20 eyars befroe I get a TKR if that is possilbe.

OK this is just my experience, some peo0le can probably manage a muslce building program on the legs but it seems risky.

[Snowy]

I understand completely that you have concerns about muscle-building exercise based on your own knee issues, but I'm going to continue to argue the point because I think it could be very damaging for someone with entirely different knee problems to read your posts and assume this is applicable to their own situation.

Leg extensions will just wreck the cartliage under your kneecap and you'll be worse than ever

Not true. For someone who doesn't have existing cartilage damage (or a new ACL graft, or other quite specific issues), leg extensions are a perfectly safe exercise.

some peo0le can probably manage a muslce building program on the legs but it seems risky

Not true. Most people can manage a muscle building program just fine. There are specific knee problems that mean certain exercises should be avoided, but very few people are incapable of participating in any kind of muscle building program. In fact it's a lot riskier to avoid building muscle around your knee, because weak muscles don't provide sufficient support for the joint and leave you at high risk of further damage.

OK this is just my experience

Bingo. This is your experience based on your own knee issues. It may be applicable for someone else who shares those specific problems, but it's certainly not applicable to everyone. If someone with knee problems is looking to build muscle, they should be talking to a physiotherapist to design a muscle building program that takes whatever issue or injury they have into account. They should absolutely not be assuming that any kind of muscle building is a high risk endeavour that could potentially destroy their knees.

[Clarkey]

I can use the leg press no problems but can not do leg extensions as the whole of my right kneecap hurts. I am going to the gym shortly and will increase the crosstrainer resistant from 60 to 80 and increase the speed on the treadmill from 4mph to 5mph. I have not used the rowing machine since I had my knee injury in October 2007 and would it be ok to go ahead and use the rowing machine as well as using the crosstrainer, bike and treadmill and maybe do a few leg weights.

I go to the gym 3 times a week on Mondays, Wednesdays and Friday so would give my leg muscles a rest. I will print off the webpage Snowy has pasted as it looks like it could be a good way to increase the quads in size.

Nick {2011}

[kscope09]

Leg extensions are great if your knees are healthy.  They don't wreck healthy kneecaps but they would wreck ones that are wearing out and full of holes.

The physios I've met all say different things.  Some tell me kneeling does no damage and otehrs tell me how much weight is goign through the knee and scare me from ever trying to kneel again.  Of course I will but I don't liek doing it.

Ok fair enough we're all differnt and you've had knee problems longer than I have.

Look at my signiture, could I do leg extensions with wirghts and squatts with weights?  Because I would like to.

[Snowy]

I can't answer that; I'm not a medical professional. If you're getting different answers from physiotherapists, you need to go back to the surgeon who worked on your knees and ask what a realistic expectation for weight-bearing exercise is given your knee issues. My guess is you'll find that some exercises are fine, but others will need to be avoided; once you have knee injuries you inevitably have to make some compromises. You may also find that you can do exercises with one leg that you can't with the other, depending on the exact nature of the injuries.

It just concerns me that you're very quick to generalize based on your own experience, and make blanket statements like leg extensions destroying knee cartilage or all weight-bearing exercise being a high risk activity. Each of us has a unique set of knee issues, and part of managing that is understanding our individual limitations and, with appropriate professional support, making any necessary adjustments in our routines. We all have unique requirements both in terms of what we're capable of, and what we need to be doing to support our damaged knees. That's why it's so important to work with someone who understands the injury and can make appropriate recommendations for exercise.

Nick - you should ask Dr. Brown about the rowing machine. If he's fine with you using it, start off gradually - maybe with a 5-minute session to begin with - and see how your knee handles it before working up to longer sessions. If it causes any problems, check in with Dr. Brown at your next session before trying again. The rower is great exercise but can cause discomfort if you have tracking problems, so it's worth starting off carefully.

[Clarkey]

This is a good topic to discuss and was wondering if scar tissue in the knee can stop me from using the leg extension machines at the gym. I can use the leg press no problem and can even press using only my right leg which is the knee that had the surgery. 

People on KG and some of my family say you can not be certain it is scar tissue causing the knee pain. Then why would my PT do friction massage to break up the scar tissue and when I had a ultrasound scan the Doctor that looked at the screen said it was scar tissue only to say in my report a thickening of the collateral ligament but 110% was certain he told me it was scar tissue! Its normal after a scope to get some scar tissue just some get it more then others and seem to be more prone to scarring then others as my PT pointed out.

Would the leg press be the best machine to use at the gym to get my right quads larger as I am not too strong on my upper body so could not do normal weights. I would really like to get my rights quads the same size as my left and is this possible or not. Will the right quads always be a bit smaller then my left even if I manage to build up my right quads!

I did try to increase the resistance on the cross trainer yesterday and the bottom of my right knee started to hurt but managed to go a bit quicker on the treadmill without feeling too much pain. Snowy will ask Dr Brown about using the rowing machine and sure he will say it is ok as long as I do not overdo it. If they cannot solve my knee problems would at least like to know what wrong with my knee is it maltracking, PFS or scar tissue that could lead to AF. Surely Dr Brown could work out whats up with my right knee as well as my left knee that also causes me problems.

Nick {2011}

 


 

[Hopesmom]

Nick,

When I had my surgery to remove the scar tissue at Steadman-Hawkins Clinic, my physical therapist told me no more knee extensions, not ever, never.  She said they cause too much compression.  Based on her recommendations, you might consider staying away from extensions, and stick to the leg press.  I will never do extensions again.  As a matter of fact, I think it was all the extensions I was doing in a weight-training program that flared up my existing fat pad problem that had been basically dormant for the most part for 15 years. That has led to two surgeries to remove scar tissue in the fat pad and anterior interval area.

Karen