How to modify exercises & prevent joint injuries

 
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CROSSFIT. Insanity. Hammer & Chisel. 

These are intimidating workout programs, am I right? Why is that do you think?

Well, I can tell you why I thought they were!

PISTOL SQUATS. LUNGE SQUATS. Dynamic lifting. Plyometrics. 

Two words. High impact.

High impact workout used to freak me the hell out! Why? Because I have bad knees! If you've read anything about my story or my healthy + fitness background, soccer has not been kind to me! It's my favorite sport by far! But, since knee injuries run in my family, and I can't turn competitive Ellyn off when I play, I kind of suffered soccer's joint-destroying wrath!

I blew out my knee (ACL + meniscus ) in 2004. It took me 8 months to recover, and needless to say I was quite skittish when I got back to playing. I bounced back, but ultimately re-injured my knee during the last month of my Senior season, re-tearing my previous meniscus repair in 2006. That was an easy-ish recovering. But ultimately the lack of meniscus in my knee would prove troublesome over the next few years with bone contusions and other relentless injuries forcing me to finally stop playing in the spring of 2014. It wasn't just my knee though! I messed up my ankle ATFL ligament in 2012 playing soccer as well.

Soccer was my first love, but I ultimately had to give it up and find other ways to stay in shape without putting too much strain on my many injured, and not 100%, joints and ligaments. Needless to say, I was intimidated by some of the crazy plyometric workouts from Beachbody, and workouts like Crossfit! But, when I finally got over the fear and just tried things, I found that there's actually a LOT more that I can do then I thought.

An example move - Plyo squat lunge

To the left below is a move from Insanity Max 30! In the workout, the un-modified move involves a jump out of your lunge, which is a bad plan for me and my knees! Any time there's a twisting move, I know that's probably something I can't do! Fortunately, Max 30 has a modifier! So instead of jumping, I step, as I explain in the video below! 

Another example - the pistol squat (above, middle)

In Hammer & Chisel, there are a LOT of pistol squats! When I tried to do pistol squats, I found that my knees got very aggravated. So I thought about ways to modify them. My favorite is to basically do a 90/10 squat! Both of my feet are still touching the ground in this modification. But, instead of a normal squat where the weight is evenly distributed, 90% of my weight is on the leg that I'm working out. As I say in the video, you should be able to balance on that leg if you were to talk the other foot off the group. Your other foot - the 10% side - is merely there for stability and balance! This is more like a one-legged squat as opposed to a pistol squat.

I will say that you can work on your strength, range of motion, etc. to build up to a pistol squat using something like a TRX system, as shown in this video. But, since I don't have a TRX system, and did have another means of modifying this move at time that I filmed this video, this served as a great option for me!

Ultimately, these are my recommendations:

Be wary of fatigue and sloppy form. 

Oftentimes, when I start a workout or early on in the workout, I can handle damn near anything that is thrown at me. Bad knees be damned! But, when I'm deep into a workout, like Max 30, where I'm REALLY getting fatigued, my muscles are tired, and I'm not as mentally sharp, I modify anything that is questionable. When you're fresh, your body is feeling good, and you're feeling really sharp - I don't think you should let your fear of whether your body can handle an exercise keep you from trying. I have actually found that I'm very capable of doing things like jumping, plyometric lunges even though it took me a while to try (because I was scared). But, what I think can get people into trouble is when they don't consider their level of fatigue. I have tweaked my knee countless times because I get tired, my muscles are fatigued, and my form gets sloppy! It's better to just modify, rather than injure yourself and set yourself back, in my opinion. 

LAND ON YOUR TOES & BEND YOUR KNEES!

Let me say that again - land on your toes and bend your knees! If you land flat-footed with a straight leg, that is a recipe for disaster for anyone that has ever had joint problems - especially knee problems! You have to, no matter what move you're doing, land on your toes and keep your knees bent and soft! One way to judge this is if you're landing loudly! If you make a big, crashing sound when you land, odds are you're not landing right! Focus on landing soft, and you're likely landing with your knees bent, and on your toes! 

Check out this move from 22 minute Hard Corps, one of Beachbody's newer programs. This was one of those moves that I was nervous for (because of that darn twist!). But I gave it a whirl, and found that as long as I'm careful about my take off and my landing, I'm good! Notice that I'm landing on my toes each time! Even on the second one, when I do rock back onto my heels a little bit, I landed on my toes. If you're not up to the twist, that's fine! You can do a little step-skip instead to modify the jumping twist! Ain't nothin' wrong with that!

When in doubt, step it out!

See what I did there? Gotta love a good rhyme! But seriously. Similar to when I say be wary of sloppy form and fatigue...if you question your ability to consistently land soft, knees bent, and take care of your bad joints at ANY time during a workout, just step it out. If the move is complicated. If there's a twist you're not sure you can handle. If you're getting tired and you question your ability to consistently have proper form. Don't risk and just step it out. Injuries happen in that millisecond when you've let your mind wander or that moment when you get sloppy. If you don't think you can do it, just step it out.

Up-AND-Down Vs. Twisting

The biggest thing I always tell people with knee issues to be wary of is the twisting. Twisting is what blew out my ACL in high school. Twisting is what injured my meniscus years later. And twisting is what causes my to tweak my knee every single time. Granted, there are ways that you can do twisting moves without injuring yourself (see next tip!), but if you have a history of joint problems, twisting moves are the ones that are more likely to get your into trouble. These include things like the jump-lunge I talk about in the first video (above), and the burpee twist in the video below. These are the moves to be wary of. Just test the waters, see how it feels, and see if you potentially need to modify by stepping it out. 

That being said, don't think that just because something is plyometric (involves jumping), that you can't do it because of your bad knees. Things like squat or tuck jumps and even plyometric/jumping lunges are likely things you can do! The lack of twisting makes them much easier on your knees! So, I say give them a whirl. But of course, still just be wary and listen to your body! If you feel unstable, continue to modify by stepping it out or just taking out the jumping part. 

Build up the muscles around the injury.

Anybody who has gone to be physical therapy post-injury knows that regaining range of motion is a big part of the struggle. But, what we don't consider is that building up the muscles around the injury is also a big contributor to whether or not we re-injure ourselves. A big reason that I re-injured my knee is because I did a REALLY poor job at building back up the hamstring muscle that atrophied while my leg was immobilized! So, for me, a big part of supporting the deficiencies in my knee have been building up my quad, hamstring, and glute muscles!

Realize IT never has to be over.

One of the other mistakes I made in rehabilitating from my knee and ankle injuries was stopping my PT exercises when I was dismissed for physical therapy. As I mentioned, in the case of my knee, my hamstring muscle never fully recovered. Not only that, but I never regained my full range of motion in that knee. You can see the difference when I stretch my quads! Same goes for my ankle! Because I stopped my PT exercises as soon as I was "done with PT" my range of motion never quite recovered there either!

If you want to prevent injuries, especially chronic ones, you have to keep the PT going! Keep stretching! Keep working your range of motion! Keep doing all of those exercises!

DON'T MAKE TOO MANY EXCUSES - JUST TRY. 

When you're recovering from an injury, there's a lot of fear. There's a lot of things you convince yourself that you can't do. The psychology of injuries is by far one of the hardest parts to get through. 

I can't tell you how many times I convinced myself that I just flat out couldn't do something (like doing Insanity Max 30) "because I have bad knees." I knew in saying that that I was just scared. Ever since my last season playing soccer, in which I was injured more often than I was healthy, I got very nervous about doing anything that might bother my knee. I didn't want to hurt myself again. Didn't want to be on crutches. Didn't want to go back to PT, or worse, go under for my 4th ligament repair. I was very nervous about it. But, sometimes, you just need to try though! Every time I'm doing a workout, I at least try once. If I am uncomfortable, don't feel good about my knee's stability, then I start considering modifications! But, don't modify unless you really feel like you're seriously risking injuring yourself by doing the move. Don't let your fear dictate anything. 

 

Be smart. Be careful. But, don't let your injury define you.

There will be things that you can't do, or that you probably shouldn't do. But, you'll get back to where you want to be regardless.