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Rehab: Exercise machines vs squats, lunges etc

 Poster: A snowHead
Poster: A snowHead
Interesting discussion with my physio this week. After I wrecked my knee last year I have focused on things like squats and lunges (amongst other exercises), getting up to a 20kg bar bell. After skiing in Val d'Isere I got a very hurty knee and had to stop skiing; I know this was because I missed 3 months of training because of a meniscus flare up then a car accident so I wasn't as fit as last year. Physio decided to put me on machines e.g. Leg press (which I had been doing) leg curl and leg extension to focus in the quads and hamstrings. He explained that many people who can do the floor exercises with heavy weights still struggle with rehab because other muscles compensate for the quads, e.g. glutes and hip muscles. The idea now is to really fatigue the quads to build up more strength in time for the next trip on 10th Jan, and I may even get my VMO back!

Anyone else taken a similar approach?
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
@holidayloverxx, yes I do. I find that by using the weights machines I can also do everything one leg at a time and concentrate on using the leg properly and individually to make sure I dont inadvertently favour one leg.
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
Leg machines that have you exercise on non load bearing leg joints are the spawn of satan.

Run (or at least hobble) away
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Prior to my accident, my personal trainer was always clear that the compound movements (squats, lunges, deadlifts...) were the way to go to build fitness and strength. The machines were only useful for very specific rehab exercises. So, I can believe that under careful guidance they are good for your particular needs. But in general I'd usually agree with @Mosha Marc. The machines are often misused by people (and trainers!) who don't really know what they're doing.

@holidayloverxx, I haven't started those sorts of things with my physio yet (not until the new year now) but when I do we can compare notes.

I am so looking forward to getting back into the gym. I'd managed to squat 60kg before I got broken, but it might take a while to get back to that!
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
Yes I have always thought it a bad thing but I can see the argument for targetted rehab. No doubt I'll be squatting before long...
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Interesting topic.

My physio has always said the only machine i should really be using regularly (i.e. not for rehab) is the leg press. However last time I was re-building my VMO & quad she recommended using the leg extension machine as well to specifically target the areas I was struggling to build up.

We've recently moved and are now 15-20 minutes walk from the gym (when hobbling) so I've just invested in a weights bench with leg extension / curl attachment and barbell & weights for squatting at home (won't need a rack to start off with) - not cheap, but 18 months into injury I'm fed up & keen to rehab as quickly as possible this time around.

Actually one of the best exercises I found for building up my quads without engaging glutes was single leg squats on a slant board, so I've asked my sister for one of those for Xmas (which she did think was a bit of an odd request!)
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
@Batman_123, That's interesting and makes it hopeful for my VMO. I hadn't heard of a slant board...stoopid question...which way round do you stand on it? foot slanting up or down?
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
@holidayloverxx, foot facing downwards, so as if you're stood facing down a mountain snowHead

Best priced one I could find was the following
http://www.vivomed.com/en/Therapy-in-Motion-Height-Adjustable-Slant-Board/m-8388.aspx
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You'll get to see more forums and be part of the best ski club on the net.
@Batman_123, I feel yet another injury related purchase coming on!
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 Ski the Net with snowHeads
Ski the Net with snowHeads
Machines are open chain - i.e. the kinetic chain is open at the end (your foot), so almost completely unlike skiing, or any sports for that matter. Closed chain compound movements will not only increase muscle strength more, but will also stress the joints less if performed correctly whilst also remapping your neuromuscular system more efficiently. As @Mosha Marc said, hobble away as soon as you can.
@NickyJ has a point, people do favour sides, which is why a big percentage of ski-specific exercises should be on one leg. If you don't have access to much, there are plenty of variables you can add/change to an exercise to make it more challenging.
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@joe1890, I do a lot on one leg; I'm back to mixing it up open and closed chain now (not ski specific - skiing is a bonus, the exercise is so I can keep walking!). Have access to full gym...just back in fact. Out of interest, what are your fitness qualifications - genuine question as you say "Closed chain compound movements will not only increase muscle strength more, but will also stress the joints less if performed correctly whilst also remapping your neuromuscular system more efficiently."

edit - just seen your qualifications in your signature - so new question - why do you think my very experienced chartered Physio, with MSc and specialising in sports injuries decided we should use machines for a while (first time in 18 months) - still a genuine question
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 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
@joe1890, I didn't think all machines were open chain - I had been told that the leg press was closed chain?
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 So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
Open chain is basically where the foot is in free space, closed chain is where the foot is fixed to the floor, the plate on a machine or a base. So leg extension exercises are open chain. Leg press is closed chain. Leg extension can be used to encourage hypertrophy of the quads. Closed chain leg press is more functional. Closed and open chain exercises are used with different goals in mind..

Physios who are rehabbing someone back to sport and as @joe1890 says strength coaches who are prepping someone for sport are very keen to try and make as much of the program functional ( ie exercise that mimic the actual movements of the athlete) because that means you are gaining strength and control of movement at the same time. This can cut down on rehab time but also improve performance and reduce risk of re-injury.

If there is a deficit in quads strength that is particularly out of synch with the other muscle groups ( hamstrings, calf, gluts etc ) then focussed work on the quads using machines can be helpful. Machines can also be used to condition numerous groups by using the various machines as part of an overall program of conditioning.

Im cautious about the leg extension machine as if used carelessly it can trigger patella pain.

I see huge decrease in quads function after patella ( kneecap surgery) and will often target quads for 3 months.

Jonathan Bell
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 You know it makes sense.
You know it makes sense.
@Jonathan Bell, thanks yet again for your information. Happy
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
@Jonathan Bell, thanks...that makes sense for my "blip". I was not using machines when I had my flare up in the summer.
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 Poster: A snowHead
Poster: A snowHead
@holidayloverxx he or she undoubtedly knows your knee far better than I ever could having treated you for 18 months but I'm always wary of extension/flexion machines. For me, far better options, even if quad strength or size are particuarly lacking. As @Jonathan Bell says leg extensions aren't great for knees. From professional and personal experience, machines force the user to move in a particular way that may be completely unsuited to how that person moves most effectively: it's a one size fits all approach. Has its place in entry level rehab but I feel (not in any way questioning your physio, he knows your knee better) that there are 20 better options to target quad development. Without getting technical, isolation exercises cause that one muscle to work better independently but not in conjunction with others. I am just much more a proponent of a global movement approach, rather than muscles.
I also have several more (probably useless) letters after my name now!
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
As @Joe1890 says leg extensions aren't great for knees.

Certainly use with caution


Last edited by Obviously A snowHead isn't a real person on Thu 1-01-15 19:51; edited 1 time in total
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
@Jonathan Bell, error on my part there. Certainly wouldn't use after any ACL work or meniscus surgery. Would be interested in your thoughts?
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joe1890 wrote:
@Jonathan Bell, error on my part there. Certainly wouldn't use after any ACL work or meniscus surgery. Would be interested in your thoughts?


Not too worried post meniscus surgery but do tend to be cautious with open chain ex post ACL
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