knees and squats

I had been prep'ing for Snowmass ESA for about a month, to include squats.  Two weeks ago yesterday while jogging my left knee gave out.  (don't know if the two are related.)  MRI = torn meniscus.  A week ago today I was arthro'ed to clean it up.  Dr Ortho says squats are BAD and I shouldn't do them.  I see squats are in the training bag of tricks for many in this forum to include pro trainers.  What are this arguments/sides to this issue?  What is a good and safe alternate for quads?  I have lost a couple or three weeks and need to make up for lost time.  Knee is a little swollen, and some soreness from using my leg in compensating ways, I think, but otherwise pretty good.  Hope to get the go ahead tomorrow to restart training.

Ask your ortho to demonstrate a "squat". I'll but it's incorrect.
Bad squats =bad for your knees
Good squats=Good for your knees
Also squats are a posterior chain exercise not "quad "movement.
If your feeling it only in your quads your knees are probably to far forward(bad).
Or your not going past parallel (also bad)
If your knee is swollen ,relax and let things heal before jumping into things.

It would be good to hear exactly what motion, the complete description, you were using for squats.  You could start with stance.  which way were your knees directed, which way did they track?  What about the way your back was positioned?  How was the weight on your feet?  How low do you go?

I do air squats, front squats, low bar back squats, and overhead squats regularly and have found it to help in a big way.  I have not had knee problems using the wider stance with knees tracking towards the direction of feet - which are pointed out.  I have had problems with wall balls for some reason which is probably an issue with technique.

If you had surgery then don't do it.  When you get back to training, make sure you have the correct technique.  You could look for a personal trainer, but how do you know that they are correct.  If they advise against below parallel, move on.

I would think that the doctor should prescribe physical therapy to rehab the knee. Talk to the PT to learn what exercises are good and how to do them properly.

Karl

He just had his knee cut.  He should listen to his doc and PT about when/if squatting is appropriate.

In terms of going below parallel, or not, there's no need to go below parallel to get benefits from squatting.  Not going below parallel is in no way "bad."  Having only a shoulder-width stance is not bad (nor is a wide stance, they're just two different ways to squat).

Further, lots of very well-respected trainers who are very pro-squat, even pro ass-to-grass squat, find that for most adults there are so many strength and mobility issues that, to get them squatting correctly, they need to spend several months with different bodyweight and similar exercises to start squatting bodyweight with good form, and then go from only bodyweight squats and work up slowly. 

Sprinting and riding a bike are two good substitutes for squatting for general ski prep.  Ask your doc and PT though about what may be appropriate for your knee.

What lobloskis said.  Many doctors make this claim but they also tend to have little to no knowledge about exercise physiology.  

A squat is not entirely posterior chain though - there is definitely a quad element to it, but a properly executed squat is a balance of anterior and posterior chain.

One way to make sure you are doing a squat properly is to squat to a box - don't sit on the box, just touch down to it.  This forces you to squat back as opposed to squatting forward.

I'd also watch the knee alignment when squatting - if you're knees are collapsing in or falling out, that's not good for them.

One other trick with squats is to "grip the floor" with your feet - toes and heels - while squatting, and to focus on "spreading the floor" with your feet.  This helps to engage your glutes which will help correct both knees collapsing in and help put you "in the backseat" when you squat.  

Another thought is that if you're having trouble with your knee from squats, that you may have poor overall core stability.  Have you heard of the Turkish getup?  It's a full body exercise vs a leg exercise - mostly core, but if done properly, it really works all of the core stabilizers.  I would suggest doing a few of these before working back into squats to make sure your body is prepared to squat.  
www.tmuscle.com/free_online_article/sports_body_training_performance/the_best_exercise_youre_not_doing

Another great leg option is sled pulls and pushes.

Elsbeth

TGUs may also not be the most appropriate thing for some who just had their knee cut.

For the o.p., you trusted your doc enough to go in and make a permanent alteration to your knee.  I doubt you thought he was an idiot -- if you didn't think he was a highly skilled professional who knew what he was doing, you probably would have found another doc.

By all means ask your doctor and PT about particular types of squats, etc.  But, you didn't get your knee operated on by strangers on the internet, I wouldn't base your rehab on the internet either.

Edited by CTKook - 11/30/09 at 11:12am

that's a good point.  but also keep in mind that most surgeon's know somewhere around nothing about exercise prescription, so when they make recommendations about squats they are talking outside of their area of expertise.

but it's true - you don't want to override that recommendation based on internet suggestions.  I'd recommend finding yourself a good athletic therapist - and if you can find one who is also a certified strength and conditioning specialist then you will be in very good hands.

Elsbeth

Excellent suggestion.

Re: the meniscus, depending upon exactly what was done any type of deep squat might be not-good for reasons relating specifically to the healing process.  It's not a general "this type squat good/that bad" type of thing.

For squatting in general, people should be realistic about what they're looking to achieve (and for that matter why they're squatting at all).  Wide deep squats, "Olympic" style shoulder-width deep squats, and squats to less than parallel can all be good, if done correctly.  For middle-aged office workers many should also be realistic that they can't squat even a broomstick with good form...there are a lot of building blocks that they'd be better off putting in place first.

In that context Elsbeth's suggestion of TGUs is excellent.  My post up above read more harsh than I meant, and she's clearly both a great trainer and a diplomat.  Elsbeth, do you like single-leg bodyweight exercises and the like for other ways to "work up" to squatting?

Thanks forthe kind words, CTKook, and great points. 

I love single-leg work.  I actually program split squats and rear foot elevated split squats more often than bilateral squats.  I screen all of my clients with the Functional Movement Screen before creating a program for them.  Depending on what I see, their injury history and their goals, I decide what to give them.  More often than not, people I see don't have the hip or ankle mobility to do a bilateral squat with good form, so I give corrective exercises in their first program as well as split squats, which are easier to do properly and has the side benefit of being less stress on the back for the same leg benefit. 

I love single leg squats, but most people aren't strong enough to do them which often leads to poor form, which is why I prefer split squats. At the moment most of my clients workout on their own and come to me for assessment and program creation, so I don't have the luxury of being able to cue them properly each time they are doing their program.

For a skier who doesn't have a bad back, I like to progress them to bilateral squats - front not back - for at least part of the program because I think the force vectors have more carry over to skiing than the single leg ones do. 

Elsbeth

Thanks for all the info.  I was doing squats without weight, feet shoulder width apart, toes feeling naturally pointed out a little, keeping my weight balanced over my feet as I go down to a position where my thigh is horizontal.  This makes my knee bend more than 90 degrees since the knee must move forward to maintain balance.  Can someone recommend a book?  There are so many exercises mentioned in this and other threads.  I am going to the Dr this AM for my second post op, hopefully last.  Will see what he says and probably be back on the forum tonight.