One of the hallmarks of mobility is a comfortable resting squat. You’ve probably seen people in the fitness world emphasizing the importance of this movement. You may have also felt the many limitations keeping us chair sitters from accessing such a position comfortably. As a fitness coach with a liking for mobility training I also try to train myself regularly for a better squat. Even though I hold the squat with much respect, squatting has never been something my spider legs found easy. By the time I reach 90 degrees my torso bends forward. If I go any lower, then my knees are at my chin. I envy those with shorter shins, especially when it comes to lower body mobility.
Despite my training to be a more “grounded” athlete the length of my legs has made my lower back and lower body more susceptible to injuries. These injuries include meniscus tears, one of which happened two weeks ago. How ironic is it that it happened while I was coming out of a squat? This was not a movement I hadn’t done before but not one I’ve done while paying attention to other people. Recklessly, I pushed up from a very stretched position and at a lateral angle which caused my left knee to pop as I was pushing through my left foot which was trapped on top of an exercise mat. Immediately I knew I did something wrong though I bit my lip and pretended that laying on the ground and stretching was the next thing I had planned for the group workout.
I hobbled away from the classroom in order to assess the damage. I could still bend my knee but I couldn’t straighten it. I took an anti-inflammatory and applied ice until my next client arrived. After doing two more bodywork sessions I had to hop into the car and drive to meet up with my wife and her family. By the time I got to the beach house my knee swelled up to the point of not being able to bend it enough to get up and down the steps to the house.
I kept up the regimen of ice and rest until Monday when I had to go back to work. By the end of the following week the swelling reduced substantially and I was able to straighten my knee again. I started doing some minor PT exercises like sitting on the floor and just trying to flex my quad. At first it didn’t look like anything was happening because my thigh was so full of fluid. As the week progressed I was able to see a few more striations in my leg and used that as an additional measure of healing. I also received structural integration and massage therapy as soon as possible in order to help keep things in line as best as possible.
Currently, I’m on the second week of healing yet still feel achy. I still am hesitant to bend the knee past 90 degrees because it begins to feel like it’s moving in ways it shouldn’t. If I had health insurance I’d probably get a CT scan or MRI in order to assess the damage accurately but unfortunately I don’t. Fortunately, I don’t feel the need to at this time given that the pain is lateral, I can still walk with a limp, and I things are slowly returning to normal such as being able to go up and down steps.
The general information out there regarding healing time for meniscus tears varies and that information varies even more considering the many types of ways and degrees the meniscus can be torn. Without a scan it’s hard to say to what degree my meniscus is torn. Pain tolerance varies between person to person and then certain areas can be more sensitive. As a very general recommendation I believe I have a four to eight week recovery period before I feel as though I can do normal daily activities again without hesitancy or complications. If I was on the safer side I’d give myself at least three to six months of light activity before getting back into heavy leg training.
In mid-2020 I tore my right mensicus while doing a pigeon stretch in order to combat sciatic pain I acquired from a 17 hour drive from New Hampshire. In a similar fashion I came out of the stretch and heard a pop in my knee. Suddenly I couldn't balance on my right leg because it felt like it was going to give out from underneath me. I couldn't even hop in place. This instability lasted a couple of months and was exacerbated by an ankle sprain I got on the same leg a week later while going down some stairs. It was a pretty crappy summer to say the least but fortunately, with work being slow, I had a lot of time to rest. It was also a time that reminded me of the body's ability to recover and come back stronger.
For someone in my position, profession, and disposition staying still for longer than a couple of days is maddening. I immediately want to get back to working my legs out even though the risk of re-injuring myself is very high in the initial stages of healing. Even the simplest of physical therapy movements should be done with caution.
That said, as a professional healer I have to get back to work in some capacity soon. I’m in a fortunate enough position to just take it a little easier for the next couple of weeks. Also, as a healer, I respect the body’s ability to heal from injury without much intervention. I’m a staunch advocate of A.T. Still’s philosophy that the trick to health is learning how to get out the body’s way while offering it support in its process. It’s interesting how many people respond to such injuries with surgery while the recovery time from surgery is just about the same as it would be if one were to simply get sufficient rest and engage in gradually progressive physical rehab. There’s not a lot of time or patience for rest in today’s world. I can understand one’s desire to get back to it as soon as possible. I also appreciate the fact that sometimes surgery is warranted given the severity of the tear and if other structures were damaged.
I consider this a life-lesson and reality-check to slow down. Both literally and symbolically the knees are joints of balance and forward movement. I’ve noticed things recently moving very fast and I’ve been feeling as though I’m carrying loads without much ability to regain my footing. Perhaps this pop was necessary for me to get re-grounded and proceed with better balance between taking care of myself and taking care of others.
Even though it’s still pretty early in this journey I’ve started to explore basic movements I can do while laying down in order to encourage my knee to find strength again. This includes a series of exercises which I’m doing daily with some good results in regards to being able to feel stable when standing. They are pretty standard introductory moves for anyone recovering from a knee injury. They are also fairly accessible to all people at any level and one’s that will help you get back on track even while you’re taking it easy.
Daily on the Back Kneehab:
Seated Knee Extension - 3 sets of 10-20 reps of 5-10 second holds
Sit down on your bed or floor with your legs stretched out in front of you. You may prop your injured knee up with a blanket if necessary. Simply pull your toes towards your nose on the injured leg until the quads engage. Keep pulling your toes back and flex your quadriceps to a level where the back of the knee begins to lengthen towards the floor. Flex only to a point that’s tolerable and doesn’t cause pain. Hold the contraction for 5 to 10 seconds, relax, and repeat.
Reclining Leg Raise (Forward/Internally Rotated/Externally Rotated) - 3 sets of 10 reps, option to work with an internal or external rotation of the hip.
From the sitting with legs out position, rest back onto your elbows like you’re at the beach. Repeat the same steps as the seated knee extension and while the contraction is held begin to lift your entire leg up to a 45 degree angle and pause at the top. Feel your thigh muscles working and continue working them as you lower your whole leg slowly back to the ground and repeat.
You may make this exercise more challenging by adding ankle weights for greater resistance. You may also turn your knee in or out by rotating from your hip joint before you lift your leg. An inward turn wil put greater stress ont he outside of your knee. An outward turn will put greater stress on the inside of your knee.
Reclining Leg Curl - 3 sets of 10 reps
From the above position on your elbows simply relax your legs. Begin the exercise by slowly dragging the heel of your injured leg towards your bottom with minimal effort. Stop at the point where the joint begins to tighten and lower you leg back down with control, repeat.
Adductor Squeeze - 3 sets of 20 reps
Lay flat on your back with a pillow or small ball between your knees which are bent. With your feet flat on the floor gently push your knees into one another so you squeeze your object with your inner thighs. Get a sense of your lower back and sacrum flattening into the floor as you squeeze. Hold the tension for 5 to 10 seconds, release, and repeat.
Bridge w/ Squeeze - 3 sets of 20 reps
Perform the same steps as above but this time, while you are gently squeezing the object between your knees, press into your feet so that your hips slowly rise from the the floor. Lift to a point that doesn’t place any painful tension on your knees, hold for a moment, and return to the floor. Repeat for reps.
Side Lying Leg Adduction - 3 sets of 10 - 20 reps
From the side lying position extend the bottom leg so that it is straight and bring the top leg back in a bent position so you can press into the foot for support. Pull your toes in of the extended leg and tighten your quadriceps as with the previous exercises. While the knee is in a semi-locked position engage your inner thigh muscles to lift your leg up towards to ceiling as high as is comfortable. Hold at the top for a moment and lower with control before relaxing the leg. Repeat for reps.
Note that with any of the leg or hip lifting exercises you can also work isometric holds by keeping the leg in the top position of the movement for a period of time such as 10 to 30 seconds. This will help you get even stronger at the harder parts of the movements.
Side Lying Leg Abduction or Clams - 3 sets for 10-20 reps each
Rest on your side and straighten the top leg. Extend your knee and flex your quadriceps in order to support your knee. Start to lift your leg towards the ceiling from your hip until you hit about a 45 degree angle from the floor. Lower down with control and repeat. You may also do a bent knee version of this called a "Clam" where you keep your knees bent. Similarly you use the outside of your hips to rotate your knee upwards towards the ceiling and lift your thigh off of the other.
Leg Raises - 3 sets of 10 - 20 reps
Lay back onto your back and extend both legs so that they are long. You may place both hands underneath the hips or lower back for support. Simply extend both legs by engaging the quadriceps on both knees. Keep that engagement in your thighs as you lift both legs together as one up towards the ceiling in order to get to a 90 degree angle in your hips. Hold for a moment at the top and slowly lower down to the ground before resting, repeat for reps.
You may also perform a seated version of this which I personally enjoy due to its crossover applications to calisthenic/gymnastics training. Simply sit upright and tilt your upper body forward with straight legs. Firm up your quadriceps, squeeze your legs together, and then lift the legs as high as you can off of the floor. Lower down with control and repeat.
For the first week or two as I’m waiting for the swelling to go down I’m sticking with a series of these exercises one to three times daily. The idea is to keep the muscles around the knee strong, especially the vastus medialis oblique (VMO). The VMO is your inner quadriceps muscles giving quads that typical teardrop shape when flexed. Activity in the VMO is conducive to better tracking in the knee joint, especially when the discomfort is felt on the lateral aspect of the knee. Not only is strengthening the your mind-body connection to your VMO supportive of meniscus pain but it also helps treat other ailments around the knee such as Iliotibial Band Syndrome or Bursitis.
So far these reclined exercises have helped me feel less helpless in aiding the recovery and more hopeful in the body’s natural healing process. Other steps I’m taking include frequent icing, elevation, rest, and compression at any time when I’m able to be off of my feet. In the first few days of the initial injury I took 2-4 Advil throughout the day in order to reduce inflammation. After two weeks there is still some swelling present and so I’m continuing to rest, ice, and compress. I’m taking one Advil in the morning and one in the evening as I feel the need.
For the next post I’ll be sharing about the steps I’ve taken after the first weeks of resting and taking my first steps back towards squatting with stronger, healthier, and wiser knees. The main thing I want people to take away from my experience is that you don't need to get bogged down by injury. At first it may feel like you're screwed and all of your hard work has just gone down the drain. However, if you treat injury as an opportunity to learn about yourself, your weak points, and how to pay more atttention you can very possibly come back stronger.
Just to share a little anecdote from myself, when I tore my right knee I lost all ability to squat on that leg and even jog. Right up to then I was able to hit 20 consecutive pistol squats on that leg in under a minute. I thought I lost all of that training and hard work from a silly stretch held too and/or at a weird angle. I completely had to forget about my ability to do pistol squats, lunge, or even walk comfortably. Within three months of taking it easy and working on my week points I was able to pistol squats again and with consecutive reps. Afterwards I started to hit my strongest squats, was running down mountain trails, and eventually started hitting the elusive Dragon Squat.
When you train at this level, accidents happen. It's just part of the game we must be willing to accept. Even if you don't train, accidents still happen. I can't tell how you many times I've heard of people falling down steps or slipping on the ski slope during a much needed vacation and tearing something. It's how you come back from them that matters and what you learn from them.
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