A friend of mine has very bad knee pain, specifically from tendinitis that requires him to wear knee sleeves when just participating in simple sports, much less trying to lift weights in exercises like squats. Now this program is not meant to be a panacea, and all suggestions should be experimented with and if anything suggested here causes more pain or dysfunction should stop that form of training immediately.
So the goal with the programming for his lower body is to strengthen his posterior chain, and to pick exercises that will likely not irritate his knees. Start off with lighter loads and then build up with sets of 10 on all exercises. Control the load on the way down (eccentric) of every exercise and even manipulate this to last 4 seconds on certain exercises.
Trap bar deadlift – this can be done from the floor or can be done from blocks depending on what range of motion in uncomfortable. Also is lowering the weight hurts, just drop the bar at the top of the movement and then bend down and reset for the next repetition.
GHRs – glute ham raises. These are to be done at least twice per week and aim to slowly increase by holding a medicine ball or dumbbell to the chest. Really focus on a full range of motion here and controlling your body on the way down.
Direct calf work – this can be done in seated or standing position. Be sure to control the weight at all time and hold the stretch at the bottom and contraction at the top for a little bit of time on each repetition.
Split squats – these are sometimes referred to as Bulgarian split squats, do these with the rear foot elevated on something that rolls and just start off with bodyweight for sets of 20 reps on each leg. Progress by holding kettlebells or dumbbells while performing this. You can also do lunges while you have your front foot elevated and see if that works for stressing the muscles without hurting the joints.
Pistol squats – these are single leg to a bench a parallel height to start and you can use a lower height bench with time. Keep this for higher repetitions and be sure to not just plop on the box each time.
Peterson step ups – standing on a low box lower yourself down until you can touch the heel of your other leg to the floor and then come back up. Really focus on feeling your hip and quad work while doing this.
For your endurance side of things I would suggest inclined running on a treadmill, bike riding, or hill sprints where you definitely take your time walking back down the hill at the end. Do this as recovery work 2-3 times per week (especially for the bike and the treadmill) where you perform about 20-30 minutes or work when you do them. Be sure to stretch out before and afterwards. You don’t need to do this at high intensity, instead just aim to get a sweat and make the body move some.
The training here will be about doing some other correct exercises which I suggest he does a simple google search for that. Then It is time to do some foam rolling and other SMR (self myofascial release) therapy to help out his knee in a few ways. Aim to roll out your IT band, glutes, hams, quads, calves and groins. Then using either a ball or a hand tool really try to release the quadriceps right near the knee focusing on the VMO. Also spend some time on the ball working on your piriformis and glute medius and see what happens. When in doubt keep track of which muscle groups you release that then cause you to feel better after you do so and then make that part of your warm up and cooldown from training. Also be sure to do some stretching and even thinking about holding some yoga positions to help open up and free up the joint some. You can even try some voodoo band work on the knees for if it will have a positive effect on performance.
First having a good healthy diet where you are eating a solid amount of vegetables, getting enough sleep, and not boozing and eating junk will go a long way here. Once you have that in line I have a few suggestions which might help. Only start off with one supplement and give it a week or two to have an effect and then from there decide whether you want to try another. So with that in mind fish oil is always a good idea for dealing with inflammation. You can also try glucosamine, MSM, or chondroitin which are common and possibly useful supplements for inflammation. You can also try turmeric (curcumin) which can help with inflammation and also beta glycan. Finally, cissus quadrangularis which can possibly cause remodeling of connective tissue. You pay for the quality of supplements and be sure that you are getting it from a safe and healthy source.
So there was some work for my friend to do to hopefully get his knees to start to forgive him. Experiment with the ideas here, if anything makes things worse then stop doing it, if anything makes things better then definitely keep it up. Thanks as always for reading and if you have any questions or comments please as always just let me know.