Quad Muscles wont engage without resistance - why?

[truthseeker]

Thank you very much for your responses, I intend to discuss your suggestions next time I see my physiotherapist (28th Jan).

Recently I have tried to increase weights on lunges (and other exercises) but have found that it causes such an amount of pain and swelling afterwards that it seems to be working against me.

I do ensure that I have some protein and something sugary like a juice after I exercise. Currently I exercise first thing in the morning, midday and early evening, with e-stim later on.

I forgot to mention in my earlier post that my OS says there is some degeneration (grade 2), but that he deemed it something not to worry about at this point in time.

Do you think that I will be able to stabilize this knee with continued hard work?
I dont mind not being able to run as its not something Ive done for so many years but I really would like to be able to walk comfortably - at the moment something so simple as walking into a shop to buy milk is an anxiety and pain filled experience - and has been for a long time now.

[Canuck Physio]

Recently I have tried to increase weights on lunges (and other exercises) but have found that it causes such an amount of pain and swelling afterwards that it seems to be working against me.

I do ensure that I have some protein and something sugary like a juice after I exercise. Currently I exercise first thing in the morning, midday and early evening, with e-stim later on.

I forgot to mention in my earlier post that my OS says there is some degeneration (grade 2), but that he deemed it something not to worry about at this point in time.

Do you think that I will be able to stabilize this knee with continued hard work?
I dont mind not being able to run as its not something Ive done for so many years but I really would like to be able to walk comfortably - at the moment something so simple as walking into a shop to buy milk is an anxiety and pain filled experience - and has been for a long time now.

Thanks for the update, I was wondering about the amount of pain experienced. Can you tell me is it muscular pain, or is it knee pain isolated in and around the knee cap or the joint? Either way you should not aggravate the pain, if you add weight to progress add only slight amounts at a time. If this is not tolerated, attempt the exercise with a smaller range of motion, or for lunges place your forward foot on a platform.

It is important to be smart, and that means staying out of the pain onset range.

I do believe that a positive outcome is possible, however, your current program merely needs fine tuning as well as progression. Having said that, without actually seeing your situation it is impossible to make conclusions. The advice I give is merely impartial based on what your comments are, and should only be used in conjunction with your current physio.

Unfortunately the changes that have occured as you have mentioned have take years to manifest themselves, and it is difficult to ascertain how long it will take to get out of that situation. It is important to make sure you don't 'overdo' it either. You exercise quite a bit each day, and I am worried you may be fatiguing yourself.

Additionally, Results showed that while the VL muscle was recruited similarly between the experienced and inexperienced trainers, the VM muscle was recruited differently. The experienced weight trainers recruited more VM fibers and to a far greater extent than the inexperienced lifters. This is an interesting finding and explains how people do incur knee soreness and injury. An imbalance between the VL and VM muscles is a major cause/contributor of many knee problems. Loading the knee joint, such as in the squat, exposes and compounds the weakness to cause possible future problems. No surprise the experienced lifters were stronger in their 1RMs, however they also performed far more repetitions during their 85% of 1RM squats. In doing so they recruited far more muscle fibers during the process. The researchers concluded that while recruiting more muscles fibers generates more force, the ability to recruit more fibers to exert more force is a learned skill that experienced trainers possess. Also, that recruitment pattern follows a different activation pattern from novice to experienced lifters.

The relationship between training status and intensity on muscle activation and relative submaximal lifting capacity during the back squat. J.Strength & Cond. Res; 14 (2):175-181.

This is important in your case, because it appears you have been training for some time. And careful consideration of your current ability, the pain response to exercise, the quality of movement need to be refined for further improvement

Additionally here is the information on how to perform the VMO exercise:

1. Stop doing squats for the next 12 weeks unless you want severe knee problems. You have some serious rehab work to do. Your rehab objective is to correct the balance in strength between these two muscles (the weak tear drop and the strong lateralis). ·Peripheral stability exercises are based on functional (unfixed) unilateral (single leg) movements, performed in a very controlled, precise manner. This means no machines and no conventional two legged exercises.

2. Incorporate "one leg exercises" such as the one leg squat (a lunge type stance, one foot in front of the other etc), step-ups and step-downs off small (less than 1 foot) blocks. Initially use light dumbbells held by your sides, then as you progress move to holding a barbell on your shoulders. This progression is important as it increases the requirement for stability.

3. For the first 6-7 weeks work only though the first 30 degree of range of motion of the knee joint. That is, not going too deep in any of your movements. The deeper you go (knee flexion) the greater the shearing force on the platello-femoral joint. This will equate to more pain. You have to teach your patella to stay in its grove. So perform very slow, ¼ and ½ range movements with static (held) contraction in the flexed position for 2 to 3 seconds every rep.

4. Now you have to re-learn these movements correctly.

5. As you get stronger in this 30o range of motion venture down to 45o for the next 6 or so weeks

6. Taping the patella correctly may help sensory neural impulses remind those medial fibers to work. See a physiotherapist to show you how to do this.

7. Concentration is required the entire time, every rep, every set - something most people are not used to doing in the weight room. The focus is on making the weak medialis muscle work.

8. Worked in this manner, the vastus medialis will fatigue quickly. Initially, limit your sets and perform only reps of 5-6, until this muscle becomes more conditioned. Let me know how you progress.