Author Topic: Hyper-extended knee, rehab tips?  (Read 10206 times)

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D4

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Hyper-extended knee, rehab tips?
« on: May 18, 2012, 03:17:15 pm »
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Hi Lance,

Have u had experience with athletes who hyper-extended their knees?  I hyper-extended my right knee, and my left one feels prone to that same injury right now.  The injury was minor but still, I can't do shit on it besides walk/very light jog, anything more intense I can feel pain.  It's getting better every day, as I'm resting it, taking ibuprofen.

From my own self-diagnosing, I believe it was caused by 2 things:

1) I got too heavy/fat from eating a LOT lately trying to get my lifting numbers up.  160lbs at 5'8" for an ecto doing intense plyo's and training single leg jump, I thought might be a bit much.  Do you agree?

2) I admit I made a stupid mistake, but past few months, I've basically just been doing full squats.  I think I created an imbalance between my hamstrings and quads.  So lately I've been doing leg curls and dead lifts (no squats cuz I can't squat with the knee like this).

I could be wrong, just my opinion on what caused it.  What do you think, and what do you recommend I do to recover from it?

Thanks.
Goal is to dunk.

Vertical needed to dunk: 40"

Current vertical : 38.5"

LanceSTS

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Re: Hyper-extended knee, rehab tips?
« Reply #1 on: May 19, 2012, 12:39:45 am »
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Hi Lance,

Have u had experience with athletes who hyper-extended their knees?  I hyper-extended my right knee, and my left one feels prone to that same injury right now.  The injury was minor but still, I can't do shit on it besides walk/very light jog, anything more intense I can feel pain.  It's getting better every day, as I'm resting it, taking ibuprofen.

 Dont do any plyos or  jumps until its healed, takes time.



Quote
From my own self-diagnosing, I believe it was caused by 2 things:

1) I got too heavy/fat from eating a LOT lately trying to get my lifting numbers up.  160lbs at 5'8" for an ecto doing intense plyo's and training single leg jump, I thought might be a bit much.  Do you agree?

No, you havent been training your hamstrings, especially as a KNEE FLEXOR, and youve been doing a lot of knee extension exercises, while  jumping repetitively.


Quote
2) I admit I made a stupid mistake, but past few months, I've basically just been doing full squats.  I think I created an imbalance between my hamstrings and quads.  So lately I've been doing leg curls and dead lifts (no squats cuz I can't squat with the knee like this).

 Depending on how youre deadlifting, it can be simply another knee extension exercise. RDL's are a good idea here, and use a 2-1 ratio of knee flexion to extension for a while.


Quote
I could be wrong, just my opinion on what caused it.  What do you think, and what do you recommend I do to recover from it?

Thanks.

  Trying to improve a single leg  jump without training your hamstrings makes as much sense as trying to improve your bench press without training your triceps.
Relax.

D4

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Re: Hyper-extended knee, rehab tips?
« Reply #2 on: May 19, 2012, 12:49:29 am »
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I see, thanks for the advice.  Would you rule against me at least doing single leg bounds with my left leg only?  My left leg is stronger at the hams.

I feel like on my dead lifts which I like doing, I am getting the bulk of the work on my hams and glutes, pretty much no quads, if so can I do reg deadlifts? Or should I fuck it and do rdls anyways?

So a 2:1 ratio of leg curls and deadlifts (or rdl) and squat sound good?
Goal is to dunk.

Vertical needed to dunk: 40"

Current vertical : 38.5"

LanceSTS

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Re: Hyper-extended knee, rehab tips?
« Reply #3 on: May 19, 2012, 01:04:54 am »
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  Yea thats fine  just be really careful with that injured side, it could be a minor deal right now that you can turn into a major deal if you dont let it heal.  Look up the PCL and see if that sounds like the area youre feeling the pain as well.   Id keep the reps high on the leg curls at first, then cycle down into a more intense heavy range.  Keep tension on the muscle the whole time, dont relax throughout the whole set.  That will give you the most blood flow to help healing atm.
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D4

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Re: Hyper-extended knee, rehab tips?
« Reply #4 on: May 19, 2012, 06:40:34 am »
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I looked up the PCL.  The weird thing is, before my injury this past Monday, I was feeling some awkwardness and minor pain in the back side of my knee.  Each day since Monday when I injured it, it got better and the pain was still at the PCL area, the backside.  Today however, when I accidentally shift too much weight onto my right knee, it hurts unlike the days before and I feel it on the outside of the knee.  Not sure, but isn't this the LCL area? 
Goal is to dunk.

Vertical needed to dunk: 40"

Current vertical : 38.5"

LanceSTS

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Re: Hyper-extended knee, rehab tips?
« Reply #5 on: May 20, 2012, 01:11:31 pm »
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  Where you felt the pain at the time of the injury will tell you more, swelling and compensation can show up in other areas.  If it doesnt improve with rest you need to go see the doc.
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D4

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Re: Hyper-extended knee, rehab tips?
« Reply #6 on: May 20, 2012, 06:18:09 pm »
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Yeah the initial injury was definitely the PCL area.  IDK what I did on Friday, but it's going back to getting better by the day so that's good.  I'll rest it, and just do dead lifts and leg curls the way you said to do them, and see how it feels in a week.  If it doesn't improve, I'll check out a doctor.  Thanks for the advice.
Goal is to dunk.

Vertical needed to dunk: 40"

Current vertical : 38.5"

D4

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Re: Hyper-extended knee, rehab tips?
« Reply #7 on: May 29, 2012, 03:33:30 pm »
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Hey Lance, it's been 2 weeks since the injury and since then I've only been doing dead lifts and leg curls.  I had to walk on my toes for my right leg to keep my knee bent so it doesn't extend, until this past Saturday I was finally able to walk normally.  It felt good, and didn't hurt when I extended it and put weight on it.  So today, I tried squatting, followed by dead lifts and leg curls.  First 2 warm up sets of squatting, I felt a little tingling in the back of my knee, but it wasn't pain at all, so I kept going and from the 3rd warm up set, it felt perfectly fine, no tingling, no nothing.  

Last time squatting was 3 weeks ago where I PR'd at 5 reps, 245lbs, today I did a pretty explosive single of 260, but failed a 275 single, so I don't think I lost much strength, if at all.  

Friday I would like to go and shoot around, play a little basketball (no pick up games) to test out my leg to see if I can play my league game on Saturday.  Would you approve of this? (Gonna have 1 more leg curling session during my upper body lifting day on Thursday)

Also, I don't know if this is important at all or whatever, but how come I had so much VMO activation/burn in my squats today?  I NEVER had this before?  Does it have anything to do with the squat break + p-chain only lifting I've been doing?

Anyways, thanks for all the rehab tips, it's been going great.

« Last Edit: May 29, 2012, 08:06:43 pm by D4 »
Goal is to dunk.

Vertical needed to dunk: 40"

Current vertical : 38.5"

LanceSTS

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Re: Hyper-extended knee, rehab tips?
« Reply #8 on: May 30, 2012, 12:59:48 am »
+1

  You will have to use your own Judgement on playing, I would definitely do some light and low volume hops, skips, Jogging, etc. and test it out prior to stepping into a game.

  The vmo activity is very common after hamstring activation/strengthening at the knee end.  You can do it on spot if you contract the hamstrings at the bottom of the squat.  This works with psoas and glutes as well, pull down with the hip flexors actively as you descend into the squat and your glutes will fire much harder as well.   Your femur is likely tracking better now as well in knee dominant lifts.

 The thing to do now is, continue to get stronger in your compound lifts while CONTINUING to strengthen the rear side of your legs, at both ends.   Lots of guys missing the boat on this one, due to all the previous dogma with the "pchain".    Instead of looking at it like "im only training quads since they are most important", a smarter approach is "im going to strengthen the living fuck out of my hamstrings so that I can train my quads even harder, Jump all day long, and not get hurt".   

 
Relax.

Raptor

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Re: Hyper-extended knee, rehab tips?
« Reply #9 on: May 30, 2012, 08:49:27 am »
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Have you ever gotten into someone that is great at hamstring hip extensor activities and yet sucks at hamstring leg curling activities, Lance? I'm not sure if I have... I wonder if such a person exists

LanceSTS

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Re: Hyper-extended knee, rehab tips?
« Reply #10 on: May 30, 2012, 03:16:51 pm »
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Have you ever gotten into someone that is great at hamstring hip extensor activities and yet sucks at hamstring leg curling activities, Lance? I'm not sure if I have... I wonder if such a person exists

 Not likely to see a huge difference as far as strength at either end, if theyre strong theyre strong.  Thats the reason I use the high rep range with the knee flexion, its not that theyre really weak in the area, its what the higher reps and time under tension do for the knee joint and soft tissues. 

  Most people have weak hamstrings, at either end period.  Athletes that already have very strong hamstrings are usually already very good athletically in my experience, whether that comes from genetics or training.   
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Re: Hyper-extended knee, rehab tips?
« Reply #11 on: May 30, 2012, 04:54:51 pm »
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What if a guy only does hamstring hip extensor strength training for a long period of time (say two years) and never does any leg curls or knee flexion hamstring activities. Can then a big gap appear in between these two "hamstring events"? Or the hamstring is just a muscle, it doesn't care how you train it?

LanceSTS

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Re: Hyper-extended knee, rehab tips?
« Reply #12 on: May 30, 2012, 10:33:21 pm »
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What if a guy only does hamstring hip extensor strength training for a long period of time (say two years) and never does any leg curls or knee flexion hamstring activities. Can then a big gap appear in between these two "hamstring events"? Or the hamstring is just a muscle, it doesn't care how you train it?


 I doubt that there would be a huge strength gap, but thats purely speculation since I have never done this with anyone.  I think there would still be potential knee pain issues if this guy was a jumping athlete like a track and field jumper.  Especially since you just described the prototype for a high level triple/long jumper (insanely strong hip extension in the hams), even  though they might not have achieved this through training.

 Train them as hip extensors to get stronger, train them as knee flexors with higher reps/tut for the hypoxic effects/healing/ blood flow, and cycle in some heavier work as well.
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D4

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Re: Hyper-extended knee, rehab tips?
« Reply #13 on: May 30, 2012, 11:21:21 pm »
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Well... while walking around campus today, when I kind of took a small hop down a stair landing with the knee extended, I felt a little pain in my knee again.  It's significantly less severe than last week when it was still hurting, but still, it would be stupid to put this knee in a league game in as little as 3 days.  I'll shoot for next saturday for my return.

You say higher reps is better for healing the joint, but I also need to eventually do heavier weight for strength. 

Is 20 reps what you consider high reps?  Also I can just do both right?  3x8 heavier and then right after do 3x20 light...

Thanks.
Goal is to dunk.

Vertical needed to dunk: 40"

Current vertical : 38.5"

LanceSTS

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Re: Hyper-extended knee, rehab tips?
« Reply #14 on: May 31, 2012, 12:03:33 am »
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Well... while walking around campus today, when I kind of took a small hop down a stair landing with the knee extended, I felt a little pain in my knee again.  It's significantly less severe than last week when it was still hurting, but still, it would be stupid to put this knee in a league game in as little as 3 days.  I'll shoot for next saturday for my return.

You say higher reps is better for healing the joint, but I also need to eventually do heavier weight for strength. 

Is 20 reps what you consider high reps?  Also I can just do both right?  3x8 heavier and then right after do 3x20 light...

Thanks.

2 Sets of 30 reps, 2-3 x a week,  progressing the weight from session to session works great for pre/rehab with pure knee flexion exercises.   You train your hamstrings as HIP EXTENSORS for strength for the majority of the time, and use the knee flexion exercises as I described, MOST of the time.

 Optimal scenario for you would  be to do something like ghr's, on a glute ham  bench, CORRECTLY, for 3-4 sets of 6-10 reps, followed  by high rep leg curls for 2 x 20-30 in one session.   In the next do rdls for 3-4 sets of 6-10 reps, followed  by another leg curling variation, preferably unilaterally for 2 x 20-30.

 Ghr's done correctly are a great exercise, done wrong theyre a waste of time and a good way to screw up recruitment patterns.

   
Relax.