My Top Three Metabolic Protocols For People With Knee Pain

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Before I get into my three favorite metabolic protocols for people with bum knees, I have a very important announcement to make.  No, it has nothing to do with a cannonball (ALA:  Will Ferrell, in the movie Anchorman).

No, it has nothing to do with hitting a 600 lb deadlift (trust me, when that happens, you’ll know).  And no, it has nothing to do with me divulging any plans to release a product anytime soon (although, that will definitely be in the cards at some point this decade year.  I promise).

Actually, the truth is, my girlfriend and I signed a lease earlier this week, which makes it official:  we’re moving in together.  Yay for co-habitation!!!

Note to Lisa:  Just a heads up babe – I pee in the shower.

Anyways, it’s a big step for sure, but it’s something that we’ve been discussing for a while now.  We found a ginormous apartment in an area that we love in the city, and we’re really excited to make it ours.

The move in date is in less than a month, which means, among other things, I need to go through my t-shirt drawer and decide which ones I want to take with me.  You could say that collecting vintage t-shirts is a hobby of mine, and while some (Cobra Commander) I’m going to keep forever, others are so old and crusty that I could probably walk over to the local nursing home and donate them as penicillin.  HA!  Get it?

So, that said, if any of you have any words of wisdom (or encouragement), please, feel free to chime in below.  I mean, now that we’re moving in together, Lisa is pretty much obligated to make me ham sandwiches everyday, right?  Right?

Okay, enough with beating around the bush – lets get down to business.  Now, if you’ve been reading this blog for any length of time, it’s no secret that even though I’m 34 years old, I have knees that are seemingly older than Gandalf.  Zing!  Count it!  Man, I’m on fire today!

As such, while I’m still able to hit my lower body pretty hard, I still have to be careful when it comes to things like squatting (consistently), sprinting, and any other modality that puts a lot of stress on the knees.

Now, before I go on, let me be perfectly clear: despite what a lot of people say – you can ALWAYS train around an injury.  I won’t belabor the point – especially since I wrote on the topic already, HERE – but suffice it to say, while I definitely have to tweak my programming accordingly (not to mention stay on point with things like foam rolling and other soft tissue modalities), I still feel I’m able to get a great training effect and maintain (if not improve) my overall strength and conditioning levels following a few basic tweaks – seen below.

As the title above suggested, today, I want to focus more on the metabolic or conditioning side of things – because, lets me honest, when you have cranky knees, doing anything more than a light jog (or even walking) can oftentimes be problematic.

Here are my top three metabolic protocols in no particular order.  And, as it so happens – there’s no smoke and mirrors involved.

1.  Airdyne Bike Intervals

I’d argue that no one piece of equipment (other than the Prowler) is despised more in our facility than the airdyne bike.

When it comes to interval or metabolic training, not many pieces of equipment can trump the full body effect that the airdyne bike has on the body; which is why I like to follow what’s called the 180 Rule.  Which is this:  whatever you see the vast majority of people using in the gym (elliptical trainers, for example), do the exact opposite.  In layman’s terms, the equipment that no one ever uses tends to be the ones that are the most useful.

See that airdyne that’s tucked over there in the corner of the gym that you thought was part of an antique exhibit?  Yeah, you should use it.

People don’t use them because they’re hard, and they’re not fun (and coincidentally, they don’t have a flat screen television attached to them either).

While you can certainly keep things easy and just follow a simple 1:2 or 1:3 (work: rest) ratio – something like 15s of work, followed by 45s rest for a certain amount of time (say 10 minutes) – I like to kick things up a notch and follow a protocol popularized by Christian Thibaudeau:

1a: 30s, easy
1b: 20s, hard (and by “hard,” what I really mean is pretend that a lion is chasing you while you have a steak tied to your back.  GET MOVING!!!!!)

2a: 60s, easy
2b: 30s, hard

3a: 90s, easy
3b: 40s, hard

4a: 120s, easy
4b: 50s, hard

5a: 150s, easy
5b: 60s, hard

6a. 180s, easy
6b: 70s, hard

Cool down for 5 minutes, and allot some time to catch your breath.

And yes, if you don’t have access to an airdyne bike, you can still use a regular bike here.  The only thing you need to be cognizant of is that you must make sure to increase the resistance on the sprints, and lower the resistance during rest intervals.  And clean up your pool of sweat, you jerk!

2.  Slideboard

I’ll be honest here and say that there was a time where I felt the slideboard was a foo-foo piece of equipment that I would NEVER use.  Then, I actually took my head out of my ass, started listening to people like Mike Boyle (who expounds on their efficacy religiously), and finally started seeing just how valuable and versatile they can be.

The slideboard may be the best, most cost effective conditioning mode available for athletes exclusive of actually running (which for those with bum knees, ain’t gonna happen).

Taking a page from Boyle, the slideboard offers the following:

  • Places the athlete n a sport-specific position, almost regardless of sport.
  • Positively stresses the abductors AND adductors muscles.
  • Allows athletes to work in groups of three to four on one piece of equipment
  • Provides work capacity training in an interval format with no adjustments, all for under $600.

What’s more, it’s a VERY joint friendly modality to use when someone suffers from knee pain.  Moreover, think about how we generally train as a society:  we tend to be VERY linear with our movements, doing things in a straight line all……….the………freakin………time.  With the slideboard, however, we can now train lateral (side-to-side) movement, which undoubtedly is an important component of any well-rounded program.

Keeping things simple, I prefer to use standard work: rest ratios here.  Meaning, one would basically slide for 20-30 seconds, rest of 60-90 (or longer) seconds, and repeat for a required amount of time.

3.  Stadium or Hill Sprints

My friend Nia Shanks is going to love this, since she’s ALWAYS telling people how running hill sprints is the bees knees.

I have to say, I kinda agree.

Now that the weather is nicer here in Boston, every Sunday my girlfriend and I head over to Harvard University and run sprints up the football stadium.  Here’s me doing my last sprint last weekend:

 It’s fairly standard:

Sprint Up (or walk briskly, depending on current fitness level)
Walk Down
Hate Life

Because there’s very little (or less) stress on the knees running up stairs (or a hill), this is a fantastic modality for those with knee issues.  But, in reality, it’s a phenomenal workout regardless, and I defy anyone to argue otherwise.

So, there you have it – my top three metabolic protocols for people with knee pain.  While it’s definitely not an exhaustive list by any stretch of the imagination, I feel that these are the three that can most easily be implemented by most people given equipment availability.  Have one to share?  Let er rip below!


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Comments for This Entry

  • Jegg

    TG, why do you have bad knees? Genetics, improper training as a young lad, injuries, etc...?

    May 11, 2011 at 8:21 am | Reply to this comment

  • Stephane

    I'm personally obsessed with hill sprints. They make me cry everytime but the benefits are well worth the pain...usually!

    May 11, 2011 at 8:47 am | Reply to this comment

  • Nia Shanks

    Congrats for you and Lisa! I'm so glad that we all know you pee in the shower. Thanks for sharing. I have never done stadium sprints, but want to give it a try. Although I won't be doing it at any place as cool as Harvard. ; ) Hopefully I don't clip a toe and eat concrete.

    May 11, 2011 at 9:01 am | Reply to this comment

  • Greg R

    Congrats on the move. I have been co-habitating since September, if you want a copy of our "Chore Wheel" I can send that to you.

    May 11, 2011 at 9:04 am | Reply to this comment

  • Michael Gray

    Congrats Tony, just make sure you don't pee if she's downstream. And Airdyne sprints-I hate them soooo hard!!!

    May 11, 2011 at 10:31 am | Reply to this comment

  • Chris

    Intervals on the rowing machine.

    May 11, 2011 at 10:53 am | Reply to this comment

  • Dean Somerset

    The best co-habitation advice I could give anyone is simply to know when to pick your battles and which ones to go to war over. The little shit will just drive yu apart, but the big stuff has to be dealt with before it starts running your lives. Always ask if something is really a big deal to you, or if there is a way you can work together to find a solution. This was my biggest learning curve to living with someone. That, and realising they don't like it when you walk in on them while they're sitting on the toilet and saying something like "Hey, does this milk smell okay to you??"

    May 11, 2011 at 11:16 am | Reply to this comment

  • Mike A

    Remember, TG, she can tell you what to do OR how to do it. But never both. Stadium sprints crush souls.

    May 11, 2011 at 11:29 am | Reply to this comment

  • Nock

    Tony, My only advise is that be prepared to learn a whole new side of your girlfriend that you didn't know before GOOD and INTERESTING ones. Good luck.

    May 11, 2011 at 11:50 am | Reply to this comment

  • Domenic

    I had the great idea of doing 200 meter sprints up what seems to be the steepest grade allowed on a road. Planned on doing 10 sets. Did 2. Spent the next 25 minutes writhing on the ground until the pain in my legs subsided enough to let me go inside and stare blankly at the wall. I also had no gas in the tank for the next week during workouts. Have to work on incorporating those in again somehow... Not having knee pain myself, Tony how are car pushes on the knees?

    May 11, 2011 at 2:14 pm | Reply to this comment

  • Penny

    @Dean great advice. I have a friend who decided that if a problem existed and it took him 2 minutes or less to fix himself (i.e. switch the direction of the toilet paper from over to under) it wasn't worth making an issue out of with his wife.

    May 11, 2011 at 3:17 pm | Reply to this comment

  • Tony Gentilcore

    @ Jegg: it's a compilation of things, really. I make it sound like they're worse than they really are - but I'd be lying if I said that they never bother me. For me, the biggest culprit is the fact that I spend half my days walking around on hard, rubber matting. If I'm diligent with the soft tissue work, though (foam rolling, manual therapy like Graston, ART, etc), I usually keep it manageable.

    May 11, 2011 at 4:04 pm | Reply to this comment

  • Tony Gentilcore

    @ Smitty: Thanks, dude. And a HUGE congrats goes out to you for making the homepage of Yahoo today! Gotta love those asshats who left comments like "this guy doesn't know what he's talking about - he's probably never stepped foot in a gym before." I got a nice laugh out of that one! @ Stephane: how bad is it that when my girlfriend and I signed out lease to our new place, I immediately noticed that HYOOOOOOGE hill (albeit a street) behind out apartment?????? @ Nia: When you come visit sometime, we'll go to the stadium....;o)

    May 11, 2011 at 4:07 pm | Reply to this comment

  • Tony Gentilcore

    @ Greg R: dude.....WTF!!! Don't give Lisa any ideas!!!! @ Dean: hahahahahahahahaha. Well, if it's any consolation, I brush my teeth while she's peeing. That counts for something, right? @ Domenic: WOW, that sounds brutal dude. As it so happens, I was going to add sled pushes into the mix, but figured most people wouldn't have access to one, hence why I left them out. But yeah, sled and/or car pushes would be right up there on my list!

    May 11, 2011 at 4:10 pm | Reply to this comment

  • Samuel

    I've never touched a slide board in my life so maybe it's harder than it looks, but I would definitely rank kettlebell swings or snatches up there.

    May 11, 2011 at 8:30 pm | Reply to this comment

  • Jeroen

    Divide chores so that each of you does the things he/she finds most important. If you want the kitchen clean but don't care about the bathroom, you do the kitchen. Makes chores less frustrating, and you're less likely to start fighting about how the other does theirs.

    May 12, 2011 at 2:32 am | Reply to this comment

  • R Smith

    Tony, On the move in, it's quite simple: Since your girlfriend IS hot, just nod and say "You're right, I AM an idiot" when she disagrees with you. Seriously, man, congratulations and all the best. I normally do football field sprints for at least one metabolic day in the summer. However, Sunday I ran hill sprints and felt (a) like they were a mofo physiologically but (b) could immediately tell there was less stress to my knee. RS

    May 12, 2011 at 3:46 am | Reply to this comment

  • Brock

    Just read Smitty's article and 20 comments or god. They cannot all be real. Wow...just wow. In any event, I, too, am surprised you didn't include swings in your choices, as I would think stadium sprints would be a lot harder on the knees (though my knees are A-OK, so I have no idea).

    May 12, 2011 at 5:44 am | Reply to this comment

  • Lisa

    Dear Greg, Tony would definitely like a copy of your chore chart!

    May 12, 2011 at 3:12 pm | Reply to this comment

  • Michelle

    Tony, Been reading your blog for a while now and really enjoy your humor. I have found (through many experiments) my knees hurt a lot anytime I eat grains. If I eat bread,cereal,pasta etc, my knees will ache. Just something to think about.

    May 12, 2011 at 3:40 pm | Reply to this comment

  • Smitty

    @Tony - thanks bro, really appreciate it. Those comments were insane.

    May 15, 2011 at 5:37 pm | Reply to this comment

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