On Quads Sets and Easy Passive Motion

Okay,  so here’s a comment I received (lightly edited):

I am a little worried right now, as unfortunately, I experience pain when walking. I also experienced it while biking. I am not sure yet what low-rep activities to pursue at this point, and I can't take off work to devote my time to laying with my legs up. Sometimes the pain comes on directly during physical activity, and other times will just appear as I'm resting, even laying down, usually at night. I also have an adorable 20-lb. daughter that I have to carry around quite a bit... unfortunately I think it is causing a toll.

Question: Some studies you mention say isometric quad sets improve, thicken viscosity of the synovial fluid. So I'm thinking about keeping some of those exercises and abandoning the wall sits, one-legged squats my PT had me do. Any thoughts? Also wondering how this works, as it doesn't seem like there is any motion involved with these exercises. 

Another question: it appears that bearing appropriately light load and motion is the best combo. In the study with the rabbits, did it seem that they were bearing load when they were attached to the passive motion machine? It seemed to indicate that motion, no load, allowed regrowth of cartilage only when a hole had reached the cartilage. I am considering whether or not bicycling in the air, while laying on my back, would be a smart way to get more motion without overloading and damaging the cartilage.

First, on this: “I'm thinking about keeping some of those exercises and abandoning the wall sits, one-legged squats my PT had me do.”

This sounds like you have a real muscle-first kind of guy. In other words, a typical physical therapist. As I see it, the trouble with “wall sits” (put your back against the wall and slide down, until it looks like you’re sitting on an invisible chair) and “one-legged squats” (squat down on one leg, then straighten up) is that they’re great for people with good knees (or knees that aren’t too bad) but can be disastrous for people with tender, easily upset joints.

When I had chronic knee pain, both of those activities bothered my knees. Eventually I simply said, “no more.”

Now, as for the isometric quad sets: Right, a study showed subjects who did them had thicker viscosity of their synovial fluid. How does that work, when there’s no motion? You know, that’s a good question. I’ve wondered it myself. How the hell does that work?

In any event, I have to confess: I’m not a huge fan of isometric quad sets. I guess they could be a useful way to build up your quads without irritating the joint (though sometimes they do irritate it, oddly enough). I have wondered if perhaps the thicker synovial fluid that researchers found was due to something else.

Then again, maybe quad sets are a good idea, which is my way of saying, “You might want to try them and see if they’re useful for you.” In any event, the bottom line for me is they didn’t factor in my recovery.

On the rabbits and passive motion: Yeah, no load. That’s my understanding. Like when your physical therapist grabs your leg, and moves it through a range of motion, and you just lie there on your back and watch.

So would lying on your back and pedaling in the air be the equivalent? Uh, I’m not sure about that. I just got on my back and went through some “air pedaling” motions, and it was harder than I expected. It certainly wasn’t easy peasy passive motion. However, you can always try it – I’m usually quick to point out that I don’t have advice or answers necessarily, but just like to share my thoughts on things.

I think it’s easier to replicate near-passive motion on a stationary bike. Set the resistance to zero, for instance. Or try to pedal backwards. Still, if your knees get cranky doing that, maybe this isn’t the best activity for you. One other option, if you really think you need to go back to square one, are what Doug Kelsey calls “sliders.” You basically put your feet on something like a dolly, and move your legs back and forth using its smooth rolling motion (I think).

I would definitely find out how Doug advises the exercises be done.

You might think about starting there, and build up to something harder later: easy cycling, or walking, or whatever.

One last note for everyone out there: I talked to the Washington Post reporter again, and she says that the article that she’s writing got delayed, but it’s planned now for early November. I’ll keep you all posted!