Size Matters Not: A Case for Strength Part III


Who should be strong and why?

Clearly athletes benefit from more strength, but what about someone who doesn’t label him or herself an “athlete?” Well, strength is like money in the bank: No one ever complained about having too much. No matter who you are, you will benefit from more strength. Here’s a list of who can benefit from strength and why:

  • Endurance athletes 
    Paula Radcliffe holds the women's world record in the marathon.  She's squatting 155 lbs.

    Paula Radcliffe holds the women’s world record in the marathon. That looks to be about 150-160 lbs. that she’s squatting.

    Plenty of research exists showing that the ability to put more force into the ground, into the pedals or into the water will make you faster. For runners, heavy strength work enhances the spring-like qualities of the Achilles tendon and other connective tissue that aids in running. More strength can help the endurance athlete maintain good form as he or she tires during an event.

    No one is too old to be strong!

    No one is too old to be strong! This image is from a Tampa-area senior powerlifting meet.

  • Senior citizens
    I mentioned previously that proper strength work creates stronger bones. That’s good for anyone with bone density issues. Beyond that, strength goes hand-in-hand with balance. Strength enables you to better keep yourself from falling and it will help you get up if you fall.
  • Martial arts champ Gina Carano is strong thrive as a fighter.

    Martial arts champ Gina Carano is strong enough to beat you up.

    Do you want to look good?
    It’s interesting, when you get strong, you tend to look strong. Posture often improves as part of the process. For a lot of people, heavy strength work works nicely to stimulate the metabolism, especially if they’re new to heavy lifting. Further, multi-joint exercises like squats, push-ups and the like do a great job of creating impressive arms, shoulders, legs and all the rest.

  • Do you do any manual labor?
    Any kind of yard work, house work, moving and carrying stuff, putting stuff overhead, shoveling snow, going up and down stairs etc. will be a lot easier if you’re stronger. The work you do in the gym should enhance your life outside the gym. Exercises like squats, presses and deadlifts loaded with enough weight will definitely help with manual labor.
  • Do you like to feel good?
    Strength training carries some impressive and interesting psychological effects. A review of literature from the University of Georgia found the following psychological benefits from weight training:

     “The weight of the available evidence supported the conclusion that strength training is associated with reductions in anxiety symptoms among healthy adults (5 trials); reductions in pain intensity among patients with low back pain (5 trials), osteoarthritis (8 trials), and fibromyalgia (4 trials); improvements in cognition among older adults (7 trials); improvements in sleep quality among depressed older adults (2 trials); reductions in symptoms of depression among patients with diagnosed depression (4 trials) and fibromyalgia (2 trials); reductions in fatigue symptoms (10 trials); and improvements in self-esteem (6 trials). “

(From my observations: For some magical reason, deadlifting a new 3-rep max has a much more powerful and positive effect on the mind and emotions than does curling 2 lb. periwinkle dumbbells for 30 reps.)

How to get strong

  • Reps and sets:
    In a nutshell, the way to get stronger is to lift heavy. How heavy? Look at the chart. If the training objective is strength then we’re looking at lifting something for fewer than six reps. The weights used are 85% of your 1-rep max (1RM) or greater.

    Effective set/rep schemes include: 2-5 sets of 5 reps, 3 sets of 3 reps, 5 sets of 2 reps and 6 sets of 1 rep.

  • Exercises:
    The best strength-building exercises are multi-joint exercises. They include but aren’t limited to the following:

    • squats
    • deadlifts
    • overhead press
    • bench press
    • rows
    • cleans
    • snatches
    • push-ups
    • pull-ups
    Olympic silver medalist Allyson Felix can deadlift 270 lbs.

    Olympic silver medalist Allyson Felix can deadlift 270 lbs.

    A solid strength workout can be built around one or two, maybe three of these exercises (squat, overhead press, row for example). There’s no need to do them all in one workout.

    In contrast, single-joint exercises like bicep curls, tricep extensions, leg extensions/curls and calf raises aren’t as well suited to enhancing strength. They have their place and they can be included in your strength workout but never at the expense of the big lifts.

    Most of these exercises except for push-ups and pull-ups should be done with a barbell. Other implements like dumbbells and kettlebells can certainly be used but a barbell is the ideal tool for this type of work. As push-ups and pull-ups become easy, weight can be added.

    Remember, the idea here is to increase your strength. That means weight should be added to the exercises from week to week. You can also add reps to the already-challenging weight you’re lifting. Accordingly, you should track your weights, sets and reps. You should strive for progress.

    Finally, good form is vital! Heavy lifting is quite safe when done properly. If you’re hesitant then you should seek out a good strength coach or personal trainer. It’s difficult to learn how to do these exercises without good coaching. Reading a magazine article or watching other people in the gym probably won’t quite cut it.

    To wrap up

    I hope I’ve convinced you of the value of strength. When we’re strong we tend to look and feel strong. Through strength training we can build a strong healthy, useful body without any worry of looking overly muscular.  Remember, you can get very strong with virtually no risk of looking “too big.” Sorry, I’m wrong. It’s impossible for you to get “too big.”

    Seeing progress in the gym builds confidence and enthusiasm and gives purpose to our workouts. We should expect progress from exercise. Watching the weights go up is a great way to quantify our work in the gym.

    Strength has real-world use. It enhances athletic performance and allows us to better take on life’s daily challenges. Strength can keep us safe too, especially from falls and injuries.

    Finally, for you to get strong you must lift heavy!

    More resources

    I didn’t invent any of this information presented here. If you’re interested in learning more, here are some books and online resources for you. There are lot more resources out there. Don’t get confused though: To get strong, pick up something heavy! (Have I said something like that already?)

    • Books

      • Power to the People, Pavel Tsatsouline

      • Starting Strength, Mark Rippetoe & Lon Kilgore

      • Practical Programming for Strength Training, Mark Rippetoe & Lon Kilgore

      • Easy Strength, Dan John & Pavel Tsatsouline

    • Online

Size Matters Not: A Case for Strength Part II


In Part I of this series I suggested that you should see progress in your exercise routine. Further, I broached the idea that muscular strength and muscular size are not necessarily the same. Finally, I argued that getting “too big” is nearly impossible for you to do. This is Part II of the conversation.

Big vs. strong. What’s the difference?

Muscle bulk is what a lot of men (especially young guys) want from their exercise program. For many of you though, your fitness goals don’t include bulking up. Most women I encounter want to get leaner and essentially smaller. Obesity is a big problem in America so many of us definitely don’t need to consider enlarging ourselves. Endurance athletes don’t need to haul around extra muscle as it can hinder performance. Because of all this we see a lot of people lifting rather light weights for very high reps (15-20 or more). The problem is, you can’t actually get stronger this way.

Let me offer this thought to you: You can get stronger–without getting bigger! You can learn to create more force with your muscles without much if any additional muscle growth. The two circumstances are not the same. Strictly speaking, bigger muscles can be stronger than smaller muscles, but strength is much more than that. Strength is also very much the result of changes within the central nervous system (CNS). Here’s more on that.

Neurology of strength

Zoe Smith is a record-setting British Olympic weightlifter.

Zoe Smith is a record-setting British Olympic weightlifter.


It’s helpful to understand a little bit about processes by which we get stronger. Besides some potential muscle growth, what happens when we strength train? Without getting overly science-y, here’s a description:

  • Better intramuscular coordination:
    This is learning to use more of an individual muscle. Muscles are made up of muscle fibers. Those muscle fibers are innervated (“fired”) by nerves. The nerve plus the muscle fibers it innervates is known as a motor unit. Untrained individuals can recruit only so many motor units for a given task. Effective strength training enables us to recruit more motor units within an individual muscle.

    Strength training also changes the rate at which our motor units fire. Untrained people fire their motor units more slowly than trained people. Proper strength training can enable us to fire our motor units very quickly. The result is we can be stronger and/or faster and muscle growth is unaffected.

    At the same time, strength training also teaches us to synchronize these motor units to fire together.  All of this is skill, and it has nothing to do with muscle growth.

  • Better intermuscular coordination:
    This is better coordination of muscle groups. In looking at almost any common human movement (sitting to standing, running, reaching, pushing, pulling, lifting something off the ground, climbing stairs, etc.) multiple body parts move together. Proper exercise selection (multi-joint exercises like squats, lunges, rows, presses, etc.) plus appropriate loading of these exercises enable us to develop stronger movement patterns rather than just a stronger quad, calf, bicep, etc. This again is a way of becoming stronger without enlarging the muscles.

  • What else?
    Effective strength training gives us stronger connective tissue. Ligaments and tendons become stronger just like the muscles. Our bones also get stronger if we load them effectively. A good strength program is a very effective way to protect against injury and increase bone density in people of all ages and abilities.

Examples of Stronger, Not Bigger

The majority of sports actually don’t require athletes to be particularly big. American football linemen need to be big in order to

Greek weightlifting legend Pyrros Dimas.  Incredibly strong but not stereotypically massive..

Greek weightlifting legend Pyrros Dimas. Incredibly strong but not stereotypically massive.

shove opponents out of the way. It’s a similar situation with sumo wrestlers. Shot putters need to be big so they can put a lot of mass against the shot. Beyond that, very large athletes are often at a disadvantage. They can’t generate as much power relative to their body weight. They can’t endure as well. Thus, for many athletes, some degree of increased muscle mass may be a good thing, but being “too big” is not an advantage. Strength however is always in demand.

Olympic weightlifter Julia Rohde.  Strong--not huge.

German Olympic weightlifter Julia Rohde. Strong–not huge.

Most sports involve sprinting of some sort. More strength helps an athlete sprint faster. Does more bulk help? Only up to a point. A massively muscle-bound body doesn’t help.

Weight class athletes such as boxers, weightlifters, martial artists, and wrestlers must stay within a certain weight range to compete. Now, we’ve all seen the stereotypical massive superheavyweight weightlifter or powerlifter. Look at the lighter weight classes of these sports though and you won’t see such hulking physiques. You’ll see lean, strong athletic physiques. These people are always looking to get stronger and more powerful without getting bigger.

Gymnasts are excellent examples of athletes who must be very strong and

Gymnast Danell Leyva is very strong but not overly bulky

US Gymnast Danell Leyva is very strong but not overly bulky.

powerful yet clearly don’t benefit much at all from enormous amounts of muscle bulk. Have you ever seen a gymnast that was “too big?”

So there are numerous examples of people who require great strength but have no need of excessive muscle. How exactly do they get there? I’m glad you asked! Stay tuned for Part III of this series.


Thoughts on Posture: Part II


In the previous post, I discussed a few thoughts, ideas and myths surrounding our posture. A key concept is that posture actually isn’t tied very strongly to back pain. There are still good reasons to learn and practice good posture though.

Proper posture while lifting

Let’s think of a squat or deadlift. In these exercises, the legs are the engines that drive the exercise. They provide the “oomph” to move the barbell (or whatever implement) we’re holding in your arms/hands. The trunk is the transmission between the engines and the arms/hands/object.

The deadlift done wrong (left) and well (right.)

Keeping the spine braced in a neutral position ensures the best, most efficient transfer of force from the legs into the barbell. If the spine twists or bends then we leak force and risk injury.

Hold this posture during a push-up.

Glutes, abs and shoulder muscles are engaged. Keep it this way during a push-up.



Similarly, look at a push-up. Here, the arms and the shoulders are the drivers and the rest of the body is the implement we’re moving. We again want to keep the trunk rigid and braced, not loose, deflated and floppy. With proper technique we get a more thorough range of motion and stimulate the working muscles more. By doing a push-up in good posture, you’ll essentially get more out of the exercise than if you do it with poor posture. Risk of shoulder and back injury is reduced too.

Bad push-up!  No!

Bad push-up! No!

We can expand our view of posture out to any number of sports from running to golf to tennis to whatever else you like. In the vast majority of our sports, we want to keep solid posture so we can most effectively transmit force (usually) into the ground and into something like a club, a ball or an opponent.

In the grand scheme, good solid posture will enable you to lift more weight which will enable you to reach your fitness goals faster and more effectively. We can also make our sporting movements more effective through the use of good posture. You’ll avoid injury too which will allow you to train longer and more consistently.

Posture and safety.

Okay, in the last post, I mentioned that pain isn’t strongly linked to posture. Yet in this post (above) I’ve suggested that braced, neutral posture while lifting can help prevent injury. Am I contradicting myself? Not entirely.

If we load our joints at the far ends of where they can move then we do risk doing damage to joint tissues and this may bring on pain. So we want to avoid excessive spinal flexion, and/or spinal extension, and/or spinal twisting when lifting. Yes our spine can and should bend and twist, just not under heavy load. Rather we should put the spine in neutral and brace with the trunk muscles before we lift.

Posture for looks

Why do most people work out? Looks, no? For most of us, looks is somewhere on our list of reasons we exercise. We want to look lean and strong. Adopting good, erect, tall posture will instantaneously improve our appearance. Incredible! Tall posture makes us appear leaner and stronger. Slumped posture makes us look pudgy and weak. Look at the pictures and you be the judge.

(Ironically, when I look around the gym, I see lots of people exercising in very bad posture. Presumably they want good looks yet they engage in activities that only reinforce bad posture. Crunches may be the most effective way of promoting slumped, head-forward-style bad posture.)

Posture and confidence — (Yes posture and the brain are linked!)

Power Posture!

Power Posture!

The same tall posture described above makes you feel better and more confident. Don’t believe me?

He looks like a leader.

He looks like a leader.

Here’s the abstract from a study looking at this phenomenon (emphasis is mine.):

“Building on the notion of embodied attitudes, we examined how body postures can influence self-evaluations by affecting thought confidence, a meta-cognitive process. Specifically, participants were asked to think about and write down their best or worse qualities while they were sitting down with their back erect and pushing their chest out (confident posture) or slouched forward with their back curved (doubtful posture). Then, participants completed a number of measures and reported their self-evaluations. In line with the self-validation hypothesis, we predicted and found that the effect of the direction of thoughts (positive/negative) on self-related attitudes was significantly greater when participants wrote their thoughts in the confident than in the doubtful posture. These postures did not influence the number or quality of thoughts listed, but did have an impact on the confidence with which people held their thoughts.”

Here’s an excerpt from an article in Scientific American on the same subject:

“More impressively, expansive postures also altered the participants’ hormone levels. Using salivary samples, Carney and colleagues found that expansive postures led individuals to experience elevated testosterone (T) and decreased cortisol (C). This neuroendocrine profile of High T and Low C has been consistently linked to such outcomes as disease resistance and leadership abilities.”


“Together, these recent discoveries bolster the notion that power is grounded in the body. Not only does power change the body, but altering one’s postures changes one’s power, or at least the psychological experience of it.”

Finally, for a little more about the power of posture, here’s Amy Cuddy discussing the topic in a TED Talk:

4/24/14 Workout


This was a challenging workout. We’ve changed barbell exercises from the deadlift. This new exercise is something like the first pull of a power clean in which we pull the barbell up to the high hang position and hold for five seconds. I’m calling it a “high hang hold.” That was followed by a bunch of double push jerks and 1-arm snatches. I realized I can better work on my technique with the 12 kg bells rather than the 16 kgs.

  • High Hang Hold: 225 lbs x 3 reps x 5 seconds – 260 lbs. x 3 reps x 5 seconds – 295 lbs. x 3 reps x 5 seconds
  • Double push jerks: 12 kg x 200 reps
  • 1-arm kettlebell snatch: 12 kg x 150 reps done continuously
  • Bike ride: 1 minute on/1 minute off x 5 times repeated twice.


I Met My ACL Surgeon and Workouts: 4/15/14, 4/17/14, 4/19/14 & 4/22/14


ACL business

Last Thursday I met both my ACL surgeon and my physical therapist. Both come through Kaiser Permanente.

After my conversation with surgeon Dr. Kurt Spindler of the Cleveland Clinic, I had several important questions to ask regarding ACL reconstruction. I wanted to make sure my surgeon has thorough experience and continues to do ACL reconstructions on a regular basis. I wanted someone familiar with athletes and I wanted someone who would be closely involved with my rehab.

Dr. Melissa Koenig answered my questions very thoroughly. I feel that I’m in very good hands with her. She was complimentary and supportive of my efforts thus far to maintain as much mobility and strength as I can prior to surgery. She thought I’d do quite well.


Several workouts to document. Here they are, including one long (for this time of year), wet, tough bike ride.

  • 4/15/14
    • Squat: Worked up to a 3 RM at 225 lbs.
    • Double 1/2 snatch: 16 kg x 10 reps x 4 sets
    • Double push jerk: 16 kg x 10 reps x 4 sets
    • 1 arm snatch: 20 kg x 5 reps each arm x 3 sets
    • 1 arm clean jerk: 20 kg x 5 reps each arm x 3 sets
  • 4/17/14
    • Deadlift: Worked up to 1 RM: 265 lbs. x 3 – 315 lbs. x 3 reps – 335 lbs. x 1 – 350 lbs. x 1 rep x 5 sets
    • Kettlebell rows: 40 kg x 5 reps x 3 sets
    • Double jerk: 16 kg x 80 reps in 10 minutes
    • 1 arm snatch: 16 kg x 80 reps in 10 minutes
    • Bike ride: 20 miles
  • 4/19/14: Somewhat light/easy workout.  Bike ride afterwards.
    • Power clean: 115 lbs. x 5 reps – 135 lbs. x 5 reps – 145 lbs. x 5 reps – 155 lbs. x 5 reps
    • Squat: 95 lbs. x 5 reps – 115 lbx. x 5 reps – 135 lbs. x 5 reps – 135 lbs. x 5 reps – 155 lbs. x 5 reps – 185 lbs. x 5 reps
      • I got to full depth on the squat for the first time since the knee.
      • In speaking with my physical therapist, he recommended working on my knee flexion.
      • A decently weighted squat is a pretty easy way to get the knee to flex!
    • Superset x 3 sets
      • Pull-ups: 4-3-2-1 reps each set
      • Stability ball leg curl: 15 reps
    • Superset x 4 sets
      • ab wheel:  6 reps
      • face pull: I used a thicker on each set for 15 reps – 15 reps – 12 reps – 12 reps
    • Bike ride: 41 miles and it was tough! Rode from Denver to Golden, over to Morrison and back into Denver via the Bear Creek Trail. Got rained on. Cold, wet, tired and hungry by the end. Food and alcoholic beverages were quite tasty afterward.
  • 4/22/14
    • Split squat: 95 lbs. x 5 reps each leg – 115 lbs. x 5 reps – 125 lbs. x 5 reps x 3 sets
      I don’t do these often enough. I’m glad the class instructor is having us do these. I’ll probably squat on the weekend.
    • Push Press: 115 lbs. x 6 reps – 120 lbs. x 6 reps x 3 sets
    • Double kettlebell jerk: 16 kg x 100 reps done in sets of 10
    • 1 arm kettlebell snatch: 16 kg x 200 reps done in sets of 5 each hand. I paused at 100 reps. Tough but very doable.
    • stability ball leg curl: 20 reps x 4 sets

My double jerk position needs more work.  I still need better lat and probably tricep flexibility to get in proper position.  It’s a work in progress and I’m making progress.

4/10, 4/11 & 4/13/14 Workouts


Several days gone by and I’ve had several good workouts. I did some power cleans for the first time since the ACL and everything felt fine. I also rode up Lookout Mt. in Golden, CO and again, things felt good. Here’s what it all looked like:


  • Power cleans: 135 lbs. x 5 reps x 5 sets
    • Knee was stable.
    • Weight felt fine.
  • Front squats: 135 lbs. x 2 x 5 reps
    • Easy/light day for squats
    • Front squats are more challenging than back squats but that means I can load myself lighter.
  • Good mornings: 135 lbs. x 6 – 145 lbs. x 6 – 155 lbs. x 6 – 165 lbs. x 6 – 175 lbs. x 6 – 185 lbs. x 6
    • Heaviest on GM I’ve gone since the knee.
    • I do these on light days, deadlift on heavy days.
  • Kettlebell snatch: 16 kg x 40 reps – x 50 reps – x 30 reps = 120 reps total
  • Super set: 3 sets
    • 1-leg squat: 30 lbs x 7 reps
    • cable anti-rotation: 15 lbs x 3 seconds x 10 reps


Lookout Mt. from the air.  My favorite climb.

Lookout Mt. from the air. My favorite climb.

Bike ride up Lookout Mt: about 2 hrs/20 miles.

  • Tough ride but good.
  • Early season climbing is always an eye-opener.
  • Knee felt fine.
  • Lunch and beers afterward! Yeehaw!



  • Jump rope & mobility work
    • First time for any jumping since the knee.
    • 5 x 50 reps
  • Circuit: 8 rounds
    • Weighted pull-ups: 20kg x 4 reps
    • Kettlebell swings: 32kg x 20 reps – 36kg x 15 reps – 40kg x 10 reps for all remaining sets
    • Push-ups: 10 reps – 3 reps plyo push-ups – 10 reps – 3 plyo reps – 10 reps – 3 plyo – 10 reps – 10 reps = 59 reps total
    • 1-leg hops: 20 reps
    • This was a moderate workout. I went at an easy pace and worked until I was moderately fatigued.

This past week I was successful doing power cleans, jump rope, and 1-leg hops. This is fairly aggressive stuff and everything held together well. I’m very pleased.

Surgery is scheduled for May 1. It’s a little tough to contemplate after seeing so much quick progress since the initial injury. That said, I’m ready to get fixed up.


4/8/14 Workout


It was a good workout today. I returned to the Tuesday/Thursday barbell & kettlebell class at the Glendale Sports Center. I really love this class but I haven’t been going because I probably haven’t yet been ready. But lately I’ve felt very solid so I figured it was time to give it a run. I haven’t done anything very powerful recently and I wasn’t sure how it would go with the kettlebell exercises. Can’t know ’til you try it though.

  • Squats: Worked up to 175 lbs. x 3 reps x 3 sets
    • Most weight I’ve done since the ACL
    • Can’t go quite as low as before but this is no surprise. I’m still below parallel.
  • Press: Worked up to 115 lbs x 3 reps x 3 sets
  • 2-handed Bent-over kettlebell rows: 16 kg x 10 reps – 20 kg x 10 reps – 28 kg x 10 reps
  • Kettlebell double push-jerk: 16 kg x 10 x 10 reps for 100 total reps.
    • Knee felt fine.
    • Technique is rusty.
  • Kettlebell 1-arm snatch: 16 kg x 20 reps (10 one hand then 10 in the other hand) x 5 sets for 100 reps.
    • Felt fine!
    • Probably will do a few tomorrow. I need to build some callouses on my hands.
  • Farmer walks: 32 kg

I’m very tempted to try a barbell power clean some time soon.

  • Road bike ride: About 20 miles
    • tempo ride
    • Done at a “comfortably challenging” pace.
    • Great day to ride. Felt good.

4/5/14 Workout


Oh joyous day! I did several sets of back squats! I love me some squats and it felt like a big breath of fresh air doing them. First time for barbell squats of any kind since the knee went out. I got down to a fairly respectable depth (just below parallel.) The knee felt pretty good. There was some tightness/bruised-type feeling on the outside of the knee but only at the deepest depth. I followed that with deadlifts and some other fun stuff. Here’s what it looked like:

  • Squats: 95 lbs. x 5 reps – 115 lbs. x 5 reps – 135 lbs. x 5 reps, 5 reps, 10 reps
    • Life affirming!
    • Felt very solid.
  • Deadlift: 155 lbs. x 3 – 205 lbs. x 3 – 225 lbs. x 3 – 2625 lbs. x 3 – 290 lbs x 3 reps
  • 1-arm kettlebell clean & press: 16 kg x 10 reps each arm – 20 kg x 10 reps each arm
  • Ab wheel roll out: 7 reps x 3 sets

I followed this workout with intervals on the bike: 1 minute on/1 minute off x 5 sets followed by several minutes easy pedaling, then I repeated it.

Relatively Good ACL News & 4/3/14 Workout


ACL News

I saw a non-surgical orthopedist yesterday and he walked me through my MRI. It wasn’t the worst news in the world. There were no bad surprises. I do have a grade III sprain aka a fully torn ACL. I have a grade II sprain of my MCL. No surprises there. The good news is my minisci are intact and undamaged. That’s great news! There’s also no bone damage. I’m really happy about both of these things. Surgery will be required but this injury could’ve been quite a bit worse.

I told him about my activities (staying as active and mobile as possible so long as I’m not in pain) and he approved. He said most people who get this type of injury sit down, prop up their leg, and move as little as possible. The muscles whither and their movement suffers. They go into surgery in bad shape and they come out worse. Recovery takes much longer under these circumstances.

This is no good. I’ll meet both meet with a surgeon and start physical therapy in two weeks. Some people have expressed exasperation and frustration at the pace of this process. I’m not one of them. I’m not the only guy wandering around Denver with an injury and this isn’t life threatening. I’m grateful that I have insurance, I don’t have some awful, exotic injury or illness and I’ve got people around me who can help. Anyway, the doc said surgeons typically wait on the surgery for two reasons: 1) We want to reduce swelling as much as possible and 2) We want to restore as much range of motion as possible. This stuff takes time and there’s no way around it.

4/4/14 Workout

  • Good morning: 135 lbs x 6 reps – 145 lbs x 6 reps – 155 lbs. x 6 reps x 3 sets
  • Super set 1
    • pull-ups x 4 reps
    • push-ups x 4 reps
    • goblet squat x 4 reps: I worked up from 16 kg to 20 kg to 24 kg
    • I accumulated 74 reps on pull-ups/push-ups but I didn’t time it.
    • My squat depth is getting better and I’m very happy about that. My knee is tolerating the movement well.
  • Super set 2
    • windmill: 16 kg x 5 x 2 sets – 20 kg x 5 – 14 kg x 5; What’s the windmill? Watch the video.
    • stability ball leg curl: 13 reps x 4 sets

    All’s well. Might get in a bike ride today.

ACL News & the 3/31/14 Workout


ACL information & Dr. Howard Luks’s excellent blog:

Got a call from Kaiser and apparently the MRI indicates I don’t have a fully torn ACL. There’s evidence of a big sprain (which is a type of tear) and some damage to the MCL. I don’t know about any damage to the minisci.

On the surface, this sounds good. I’m not certain though that a partial tear is much better than a full tear. Of course I got online and started looking up partial tears and such. I found the site of Dr. Howard J. Luks, MD of New York. His blog is incredibly informative and I got a lot of useful information on all things ACL-related. There’s this post on partial ACL tears which discusses the difference between an ACL reconstruction and an ACL augmentation:

“The difference between an ACL reconstruction and an ACL augmentation is fairly simple. During the process of an ACL reconstruction we will reconstruct or replace the entire ruptured ligament. Anatomically, the ACL is composed of two separate bundles and a complete reconstruction will compensate for both of those bundles. In an ACL augmentation, you have only sustained a partial tear. That means that a portion of your ACL remains intact and might be normal. Many high volume ACL sports medicine orthopedic surgeons are capable of reconstructing only the torn portion of the partial ACL tear. This leaves the normal portion of the ACL alone. There are many advantages to an ACL partial tear augmentation over a full ACL reconstruction. While the discomfort, and the nature of the surgery is virtually identical – – – it is far more likely that someone who undergoes an augmentation will have a much more natural feeling knee when all is said and done. The reason for that is because the normal ACL has certain nerves within it. Those nerves give the brain certain feedback as to the position of the knee joint. It turns out that those nerve fibers are quite important. If we preserve the intact portion of your ACL, then we are preserving those nerve fibers and hopefully preserving the integrity of your knee in the long run.”

Perhaps an augmentation is in my future? I’ll have to ask about that on Thursday when I meet with an orthopedist.

Another post, 4 Tips to Prepare You for ACL Surgery, included (you may have guessed) these four tips:

  1. The technique for performing an ACL reconstruction has evolved significantly.  Over the last few years nearly all high volume ACL surgeons have gone to an “anatomic” approach.  That means that during ACL surgery we put the new ligament in exactly the same position your native ligament was.  Believe it or not, that’s not how we were originally trained how to do it.  The older technique was easier… which is likely the reason why some surgeons still use it.  Take Home Message:   An “anatomic” reconstruction has become the gold standard.  It is a more technically challenging procedure, so be sure to review with your surgeon what technique they plan on using.
  2. Volume matters !  An ACL surgery is a technically challenging procedure. ACL surgery should be performed by those of us who are experienced ACL surgeons.  Take Home Message:  Be sure to find a surgeon that performs a fair number of ACL reconstructions each month… not a few each year. 

    ACL Surgery

    The Dark Side of the Moon?

  3. When we reconstruct the ACL we need to create a new ligament. We can choose to use your hamstring tendons, a piece from your patella, or a donor graft from cadaver tissue. Different grafts are better suited for different situations.  Women tend to be “quadriceps dominant” so a patella graft might better suit their needs.  A patella tendon graft might be better suited for high level contact athletes.  A hamstring graft is a strong graft well suited for most all activities.  The research shows that a cadaver graft in a young active person should probably be avoided due to a high failure rate. Take Home Message:  One graft does not suit all needs for people considering ACL surgery. Be sure to do your research and talk to your surgeon about your goals so the proper graft can be chosen.
  4. If you have suffered an ACL tear, you are at very high risk for re-tearing the ACL in the same knee — or tearing the ACL in the other knee.  Many people have a predisposition due to a “neuromuscular” impairment.  (I hate big words too) That basically means the way you jump, land, pivot, etc needs to be evaluated to correct your biomechanics to diminish your risk of  requiring another ACL surgery.  Take Home Message: Physical therapy is an absolutely critical part of the overall recovery process.  Finishing up with a formal neuromuscular evaluation may play a role in diminishing your risk of a second ACL tear.

The first point about the anatomical graft was news to me. I’ve read a lot on ACL repairs and that bit was new to me. I’ll definitely have to ask about it when I see the doc. On to other things…

3/31/14 Workout:

  • Deadlift:
    • 155 lbs. x 5 – 205 lbs x 5 – 225 lbs. x 5 – 245 lbs. x 5 – 265 lbs. x 5 x 2 sets
    • Used the sumo stance
    • Knee never buckled.
    • Felt good!
  • Super set 1: 4 sets
    • step-up on plyo box: no weight x 10 reps
    • pull-ups: 20 kg kettlebell x 5 reps
  • Super set 2: 4 sets
  • Ab wheel: 5 reps x 3 sets

Everything felt decent. Went up in weight on the deadlift and felt fine. I tried the sumo stance a while back and the knee wanted to cave in. Today it didn’t. Good.