Will Quad Sets Help Your Knees?

This came up recently in the comment section.

I remember doing quad sets during my recovery, and my knees didn't like them much. So I stopped doing them and got better anyway. Because of my personal experience, I never really looked that closely at quad sets.

Doug Kelsey does so here, though, in "The Ultimate Guide to the Most Misunderstood Exercise for Knee Pain." He makes some interesting observations:

(1) That quad sets are sometimes prescribed for a mistracking patella. And he dashes some cold water on doing quad sets for this reason.

(2) That quad sets are sometimes recommended to strengthen the thigh muscles. But, alas, they're not really great at this, because they generally don't stress the muscle enough.

(3) That quad sets are definitely useful for something else: thickening the synovial fluid that helps cushion impacts in the knee joint and just makes movement easier in general.

For this use, he advises 100 repetitions a day, in sets of 10. Patience is helpful too: beneficial effects probably won't appear for two months.

What is the science behind this? I'm always curious about that. It appears that the seminal study, which Kelsey himself cites, goes back to 2003. The sample size was a bit small (20 subjects, with a total of 28 bad knees), which isn't optimal, but what they found was without a doubt impressive.

The subjects did an isometric exercise that involved keeping their leg straight and raising it. Patients were told to do the exercise 90 times a day. Joint fluid was taken from their knees at the beginning of the trial and after 12 weeks.

What researchers discovered:

Joint fluid viscosity increased from 45.8±7.6 to 59.8±8.6 mPas (P<0.05). In contrast, there were no significant changes between at baseline and after 12 weeks in the patients without any treatment.

A roughly 33% improvement is really good. Note that these aren't exactly quad sets that the patients did, but I have to assume the benefits are similar.

Anyone out there who has a story to share about quad sets, good or bad?

'I'm Not Dead Yet,' as Monty Python Once Said

Reading all the comments come in after I announced an easing away from the blog was almost like having a ringside seat at my own funeral. Part of me wanted to shout, "Hold on, hold on! I'm still here!"

Yes, my posting from now on will be more sporadic. The blog might go dark for months at a time, or maybe for good at some point. But we're not at that point yet.

If you want to keep the blog alive in some form, go ahead and post questions you have, and I'll answer them (and invite others to help me do so).

Finally, I did want to post this comment from Knee Pain. I realize to many of you reading this, "Knee Pain" is just another online moniker. But she's been with me almost as long as this blog's been around.

She is one of the original hard-luck cases. Look up her success story and you'll be amazed. Her comeback is much more inspiring than mine.

She left a very kind comment, and a great update on how she's doing.   

Hurrah for 10 year anniversary!! I'm very grateful that I found your book.

I remember I practically read it in one sitting. It was very encouraging and great to find someone who could RELATE to this tricky problem of finding just the right amount of movement BUT not too much that would cause a flare up

I remember stories that you shared that I could relate to like the one where you carried something kinda heavy around Hong Kong (maybe it was a fan?) and that caused a flare up. I carried a computer monitor down several flights of stairs and that caused a flare up and I also remember pulling a suitcase on a leash and somehow even that caused a flare up (I think because the act of pulling something heavy with just arm changed my weight distribution on my legs?) Argh.

I was just reflecting recently that my bad knee now seems totally reliable. I'm doing lots of walking and hiking and biking and even backpacking and.... I've stopped worrying that it is going to have a flare up. It doesn't even send me little grumpy warning signals anymore.

That said, I feel it's important to stay vigilant and keep moving and exercising and not get complacent. I don't want a relapse.

Excellent! That's the kind of comment that brightens my Sunday!

Have a good knee day, everyone.