I have a new 47 year old male client with knee trouble. Suggestions for strength training?
He saw his physician 2 years ago, and he told him he would need a knee replacement in the future. This client has also been participating in the Insanity series, and has no trouble with the calisthenics portion. I'm looking for advice on lower body resistance training?
I have a 'go to' exercise when I need to strengthen the quadriceps but the knees have long see their better days. It is called 'Terminal Knee Extension' and I have a link for you at Youtube which shows how it is done http://www.youtube.com/watch?v=ZscBVtoX62U. Some clients even responded with a comment that this makes their knees feel better instantly.
You should also be able to do all hip exercises. I have found that people with knee problems often have hip problems as well, resulting from weight shift because of favoring one leg.
As for this question, do you know exactly what is wrong with his knee? Insanity is intense, and one would think it would bother a person who has knee issues.
I would do wall squats, hamstring curls, isometrically work his inner legs
Has his doctor given him any restrictions?
As Susan mentioned, Insanity is an intense workout and is tough on the knees as it requires a lot of plyo. The fact that he has no pain doing Insanity, but that a physician indicated he will eventually need a knee replacement is surprising and would cause me to ask, What changed in the last 2 years that the pain has subsided.
I love Karin's exercise and its a go to in my arsenal of exercises for clients with knee issues. I also tend to work with in the clients range of motion. In other words, no exercises are necessarily banned, unless specifically mentioned by a physician. We just work within the range that is painfree for that client. With knee issues, I often work on strengthening the quad, glutes, adductors and abductors. Some knee pain for some people is generated from overly tight calfs and hamstrings. An assessment will tell you more, as well as how the person moves when performing a squat or walking.
Dr. Nick DeNubile has a wonderful book called "Framework", that talks a lot about working within a patients pain free range of motion when healing an injury. Its well worth the read!
Once you have a handle on the nature of your client's knee issue, and a 'conversation' with his physician, you will be in a much better place for planning his workouts moving forward.
You might want to collaborate with his physician to see the extent of the damage to his knee, find out the doctors diagnosis and then do research on the condition as it relates to exercise.
If you learn that his condition is outside the scope of your preparation, it might be a good idea to refer.
All the best!
Ironically, knee pain (and most joint pain) comes from weakness somewhere else, usually in the joint above or below the painful one, unless there was trauma to the joint itself. But even then, over time, it can get worse because of overcompensating.
Strengthening the knee will help the symptoms, maybe short-term. Assess and find his weakness and ROM limitations, probably in the hips and more than likely in the HS, if it's OA. You'll do him a greater good in the long run. Would benefit from stretching of the hamstrings and strengthening to the hip external rotators and abductors, in addition to the TKE's.