Fit and fine by Kamal Singh: Return To Training After A Knee Injury

In all my years of training people, knee injuries seem to be the most common. This is but natural as the knee is a weight bearing joint and tends to be most affected with changes in body weight, footwear, slips and falls etc. If you play a sport, then chances of all types of knee injuries go up manifold. Since knee issues are so common, most people tend to take them lightly. If you are serious about pursuing any kind of regular physical activity be it working out in the gym, road running or playing a sport, then it is a good idea to see a rehab professional and get the issue sorted.

For the fitness enthusiast and gym goer, once the knee injury has healed and rehabbed properly, a protocol needs to be followed to get back to lifting in the gym. Needless to say, if one knee cannot be loaded, the rest of the body can still be trained. So continue lifting weights in the gym – using this time to focus on the upper body as well as the non injured leg. In this way you would lose minimal strength/muscle mass and regaining strength in the injured leg would be much easier.

The Protocol

While coming back from a knee injury, it is a good idea to focus on those exercises where the knee flexes minimally and the lower leg or the tibia remains vertical.

•We start with a single leg deadlift. You can load it by holding a dumbbell or kettlebell in the same side hand or the opposite side. I personally prefer the contralateral loading, as it also becomes an anti-rotation exercise.

•Kettlebell swings. Either single hand or double hand swings. A great way to load the lower body. Remember, this is a hinging movement, so keep the knees as straight as possible.

•Partial deadlifts. The knee may not be ready for a deadlift from the floor. If your gym has a power cage, then keep the bar knee height. If your gym does not, then raise the height by stacking plates. You can progress the exercise by lowering the bar height.

•Box squats. Box squats are a good way to introduce bi-lateral squats. Start with a high box. Begin the squat with pushing the hips back so that this becomes a hip dominant squat. The box squat can be progressed by changing the height of the box.

•Deadlift from the floor. By this time, the knee should be stable enough to pull from the floor.

•Low bar bar squat or the powerlifting squat. This type of squat is also hip dominant but without the box. Depending on the type of injury, the low bar/hip dominant squat could be the preferred squat for training the lower body.

The above protocol would take at least a couple of months to finish. By the end of it, the trainee should be safely able to squat, whether high bar or low bar. My advice would be to use this time to hone technique and not be in a rush to load the bar.

To summarise:

•After rehabbing a knee injury, do not rush back to doing the barbell squats.

•The joint might have healed and the pain diminished, but the tissues might not be ready to loaded through the entire range of motion.

•The protocol – single leg deadlift, kettlebell swings, partial deadlift, box squats, deadlift from the floor, low bar squat.

•Go slow while moving from one phase to the next.

Try this approach and let me know how it goes.

Kamal Singh is a Certified Strength and Conditioning Specialist who has been coaching for 15 years

From HT Brunch, November 1, 2020