help me help him

[ebm1224]

in this post i am going to ask you to help me create/modify my boyfriend's workout routine (he says it's ok). a little background:

he's 28 and was always a skinny or in-shape kid and teenager. he never was a gym person but he walked most everywhere and did some drugs back in the day that kept him thin. nowadays he's put on some weight (he's probably 20 lbs above his ideal). his job is very physical so he's pretty strong and actually has a lower body fat percentage than you might assume. he's also in the process of quitting smoking.

back in december we joined a gym and committed to going 3 times per week. at first we went together though we usually did our own thing but these days, due to schdule, we tend to go on our own (though we sometimes run into each other there). at first he was kind of overwhelmed since he hadn't been in a gym more than 5 times since high school. we ended up purchasing some sessions with a trainer which helped him get more comfortable.

the kicker is this: he has knee issues. i'm hoping he will see a doctor about it in a few months when money is not as tight. basically, he has some discomfort in his knees...they also pop alot...just from walking up stairs as a matter of fact. i don't think it's too serious since joint issues run in his family but i don't want him to hurt himself. the trainer encouraged him to use machines to strengthen the muscles around his knees. his current routine is to warm up, use the machines for lower and upper body, and then do 15-20 minutes on an eliptical or bike.

i just started stronglifts 5x5 and i want to show it to him. he says he feels a little aimless in his routine so he could use a "program" to help him out. so the plan is for us to go to the gym together on friday and do the 5x5 routine. the only thing is...what do i do about his knees? i definitely don't think he should be doing squats or deadlifts with a bar. my thought right now is to do the upper body stuff together and have him either do body weight squats or some kind of leg machine while i'm doing the lower body stuff. is that a good idea? or are their other exercises maybe i can switch in?

any ideas of how to help him get more excited about working out? do you think sl 5x5 is a good basis for him? are there other programs you'd suggest instead? any advice on what to do about his knees until he can get to a doctor and get some actual medical advice?

i'm excited to work out with him again

[bigm141414]

For teh knees: The second one really helps creaky knees mine barely squeak these days although he may cry a bit the first time he tries it. I did.

http://www.mobilitywod.com/2011/09/episode-318365-knee-pain-on-stairs-or-hills.html

http://www.mobilitywod.com/2011/06/episode-267365-mobrx-for-lound-creaky-knees.html

http://www.mobilitywod.com/2011/05/episode-253365-knee-pain-case-study.html

As for squats and deadlifts have him do some body weight versions first to test his knees out. If they hurt then i would stop. Make sure he hits proper depth to work the hammies which helps stabilize the knee. If the knees are just creaky and pop I wouldn't worry all that much about it, just have him stretch out like in the above videos and it'll help a lot.

SL5x5 is a great program and I think once he starts to progress with it he'll be more excited. As for the trainer telling him to use machines to help the knees that's not really all that acurate. The machines will most likely over balance certain aspects of his muscles which will cause issues down the road.

Note: I suffer from creaky loud popping knees and a family history of knee issues (both my dad and brother blew theirs out). I haven't had any issues since I started squating properly and stretching.

[Centurion]

Isn't there an entire section in the Stronglifts PDF devoted to bad knees and how squatting will help (and like bigm said, machines will not)?

[wildross]

Isn't there an entire section in the Stronglifts PDF devoted to bad knees and how squatting will help (and like bigm said, machines will not)?

Yes there is. Mine pop less since I've been squatting. I did strain some ligaments early on because I went too heavy too fast. (amateur diagnosis). Just deloaded, corrected my form and worked back through it.

[Gainsdalf the Whey]

I've had knee popping/cracking and knee pain. I've realized the pain was gone for a few months now, but I had completely forgotten about the popping/cracking when i got up until now. It hasn't happened in awhile. I'm guessing it's because of my squats.

Squats are great at strengthening the muscles around the knees. Just don't go super heavy right away, start 50-100 lb lower than he thinks he can do and build up. Machines are exactly what you don't want to do as they only work those big muscles to get thee weight up and down, not those smaller stabilizing muscles that are responsible for keeping the knee steady, and are probably the cause of the knee issues if they are weak.

Just make sure the squats are done with proper form. Feet ducked out at 20-30 degrees to start out with, the knees always pointing at the toes and being pushed out, don't let them cave in.

[Anivair]

bigm141414 brings the win. Those would have been my suggestions as well. By the way, I just ran through number 2. Test retest on my right side gave me some neat results. I really just need to suck it up and couch stretch (and if I could get my flat arches to stop cramping, that would be great).

[chairohkey]

I've had two surgeries on my right knee (meniscus and ACL), since I've been squatting its never felt better.

[ebm1224]

wow, it's good to hear that people have had so much success in overcoming knee problems! bigm, i appreciate the videos but i have to say i don't know that i understand them. what i did get:

1) he should walk up stairs with a wider stance (is that correct?)

2) he should do the stretches in the second video (how often? before workouts? after?)

3) he should keep the knee pushed out slightly when squatting to prevent collapsing in.

what did i miss? i'll likely be helping him with proper squat form since he's only done them a couple times - i was thinking maybe he should do them with toes turned out to keep the knee pushed out a bit more. not sure if that's just overcompensating though.

[Pat G]

Solid work on leading the way EBM. respect to you.

3) he should keep the knee pushed out slightly when squatting to prevent collapsing in.

what did i miss? i'll likely be helping him with proper squat form since he's only done them a couple times - i was thinking maybe he should do them with toes turned out to keep the knee pushed out a bit more. not sure if that's just overcompensating though.

Yup thats right. toes slightly out on the squat, make sure that barbell is going straight up and down, perhaps also check to make sure his lower back isn't rounding at the bottom of the squat.

My knees crackle like chinese new year, but no more pain after squatting like this.

Stretching: i don't know what is the best but I usually start doing static stretches inbetween sets and to finish off.

[wildross]

Knees out is critical to me, since that's the only thing I've hurt. I like the image from Riptoe. The knees/femur should track parallel to the angle of your feet, so there is no side pressure on your knees. When you look down, your feet and femurs should align as you squat.

[Gainsdalf the Whey]

The knees/femur should track parallel to the angle of your feet, so there is no side pressure on your knees. When you look down, your feet and femurs should align as you squat.

This is the rule I use, so ducking my feet helps be push the knees out more to emphasize this. If my feet are more parallel, my knees are more likely to buckle in on me. I'm slowly working them back toward parallel as I get more hip mobility.

[Katamay]

Wow, I'm amazed at all the people who've said squats helped their bad knees. My physical therapist told me I was never, ever to do squats, because they're too high-stress. But I have a tracking problem (bone scraping on bone) as well as generalized ligament laxity, so maybe that's different from what you guys experience? What kind of diagnoses do you all have?

[Gainsdalf the Whey]

I never got diagnosed with anything because I figured I was just out of shape and when I worked at it it would go away. It did. Bone on bone is no good though, I'd listen to the doctor on that one.

[Waldo]

I had pretty severe knee tendonitis for a few years. Hurt to stand up and I walked with a slight limp. I worked up to squats (hurt too much at first) and then to single leg squats. Its almost gone today ~5 mo later. Squats were the best exercise for it by far until I could do single leg squats, which can eliminate biomechanical issues that arise from long term living with/exercising with pain (you can unknowingly compensate for the issues when 2 legged squatting, I literally had forgotten how to use some of my muscles in the full squatting/walking range of motion).

[Oogiem]

Wow, I'm amazed at all the people who've said squats helped their bad knees. My physical therapist told me I was never, ever to do squats, because they're too high-stress. But I have a tracking problem (bone scraping on bone)

I would say that's why no squats for you but I am not a PT or doctor.

FWIW I also have very weak knees and hips and squats is what my PT wants me to do more of as soon as I get a bit stronger. We're working on body weight squats now.

Also no machines for knees. He is having me use a leg press machine for a bit to get a bit stronger. The machines he has me using are cable machines for triceps and lat pulls. Still allow full motion and saves his office floor from dropped weights ;-)

[Anivair]

the Russian Baby Maker helps with the bottom position of the squat a lot. Big props to Greg Everett.