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I am a big fan of your e-book... I am a 61 year old male, 5’10", 156 lbs, great diet, and am challenged by Chondromalacia^ in one knee and a bad back... I have been to top physical therapists in my area, but they are not as progressive thinking as you...
Riding a bike in general or taking a walk longer than 30 minutes is bothersome [to my knee] the next day. After reading your book, I stopped bike riding, and started walking a little slower and for shorter distances.
I occasionally do standing squats (no weights) at only a 45 degree angle, and if i do leg presses on the machine, I usually pay for it. I live in a two story house and have to go up and down steps several times per day. I go down the steps backwards, which seems to help.
Do you have any suggestions as to how to advance some of your more challenging exercises? Would a mini bike help? How about the Total Gym?
^ “Chondromalacia” refers to a condition that can happen in any joint, but in Andrew’s case, it was occurring in his knee. “Chondro-” means cartilage, the material that covers the end of bones, and “-malacia” means softening. So, Chondromalacia is a softening of the cartilage. Healthy cartilage, on the other hand, is hard, and provides protection for the bones and a smooth surface for motion. Soft cartilage is a problem because it can’t protect the bones and it doesn’t hold up very well during daily activities or sports. What gets most people’s attention is the stiffness, swelling or pain that eventually results. (In Andrew’s case, he noticed pain the next day.)
Doug Kelsey put Andrew in touch with me. Andrew then scheduled a 20-minute Strategy Session to discuss his situation and identify how he could best get rid of his knee pain.
Andrew worked long hours and didn’t have time for knee pain. When we talked, he explained that he’d been having right knee pain for several years, and at this point, he just wanted to be able to ride his bike for 45 minutes and go up and down stairs without knee pain. If it was possible, he also wanted to swim, surf, and use a stand up paddleboard.
Andrew bought a Variable Incline Plane, and we began working together via online video sessions. During his first session, I measured his right leg Squat Load Tolerance. (Squat Load Tolerance is the ability to squat five times without pain using a certain percentage of body weight. For a demonstration, watch this.)
Andrew’s right leg Squat Load Tolerance was initially only 17% of his body weight. Since he weighed 156 pounds, this meant he could comfortably squat on his right leg using about 27 of his 156 pounds of body weight.
This 27 pound limit wasn’t due to leg muscle weakness; instead, it was because his knee joint was weak. Andrew needed a stronger knee joint because limiting his right leg to pressing no more than 27 pounds wasn’t enough to ride a bike or climb stairs without knee pain.
I explained what exercises Andrew needed to do to improve his knee joint, and I sent him a chart with recommendations regarding how often to do them. Andrew did the exercises and completed the chart before we met a week later.
Every week or two, we met via online video to talk about how the exercises were going, how his knee was feeling, and any concerns that he had. During these sessions, I reassessed his knee, and most of the time, I prescribed harder exercises. Sometimes, I adjusted the exercises to make them easier and allow Andrew’s knee to recover more fully before challenging it further.
Within four months of working together, Andrew’s right leg Squat Load Tolerance improved from 17% to 56% body weight. He was cycling for up to 40 minutes without knee pain, and he reported, "I'm happy... I like the progress."
Andrew continued performing the exercises I prescribed for an additional four months. As a result, when we met again via online video, his right leg Squat Load Tolerance had improved to 77% of his body weight. Although, he had not tried to surf or stand up paddleboard because his back had been “acting up,” he was cycling and taking the stairs without any knee pain.
Andrew’s initial problems were knee pain when walking, biking, and taking the stairs. Knee pain from these activities were due to a weak knee joint-- a joint that could comfortably produce only 17% of his body weight. By identifying the proper load for his activities and exercises, Andrew increased his knee strength to 77% of his body weight, and as a result, returned to walking, cycling, and stairs without knee pain. Strengthening his knee joint first-- before challenging his muscles to get stronger-- was critical to Andrew’s success.
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