December 2022

Knee OA Does NOT Excuse You From Squats & Lunges

For those who suffer with osteoarthritis (OA) of the knee(s), the often painful and sometimes threatening idea of a squat or lunge might stand in the way of both therapy and fitness training. We have covered this topic with respect to causes, effects, and treatments here, here, and here. Both of those weight-bearing exercises are called ‘closed kinetic chain’ (CKC) in that the feet are in contact with the ground or a solid surface unlike knee extensions where the feet are free to move (open kinetic chain.) Yet CKC exercises are not only more functional, they are better for the development of strength and coordination of the muscles of the knees and hips, which “mediate knee pain relief.” 

The medial compartment of the knee is where most OA hits as it is the site of the most contact between the femur and the tibia. As time goes on, a malalignment of the leg bones occurs which further exacerbates pain and dysfunction. So understanding the forces that occur during normal gait in relation to those that occur from CKC exercises will give clinicians and patients more comfort in using these exercises to enhance function.

Researchers tested 28 older adults with knee OA and malalignment on the muscle forces and internal loading during gait with a medical brace vs a single-leg heel raise, a double-leg squat, and a forward lunge. If, they proposed, “weight-bearing exercises generate larger lower-limb muscle forces than walking without increasing knee contact forces,” then these can be deemed safe and useful exercises for OA patients. 

The squat and lunge generated higher quadriceps and hamstrings forces than walking. Joint contact forces were lower during heel raises and squats but similar between lunging and walking. “These results support the inclusion of these types of weight-bearing exercises for people with knee OA,” the authors conclude.       

MSSE Sept. 2022

Lift Weights to Maintain Lost Weight

Weight management is easier than weight loss, but not much. Generally, to lose weight you have to fight off hormonal mechanisms that try to keep body fat right where it is. We have posted dozens of blogs and newsletters about this issue; here are samples of a series we did in 2017: Part 1, Part 2, and here’s from another series: Part 2,  Part 3. Between insulin, ghrelin (a hunger stimulant), leptin (a satiety stimulant), and others that signal to eat or not, as any dieter can attest, it’s a struggle. And yet we know at some level you have to restrict calories (in) and work calories off/out. We also know it’s nearly impossible to work out long or hard enough to burn off even a normal, healthy diet. One slice of pizza is 2-3 miles of jogging!!!

A study recently demonstrated, once again, that exercise helps to prevent weight regain after weight loss in overweight premenopausal women participating in a weight loss program. The question was, which program best preserved fat-free (lean muscle) mass (FFM), diet alone (D), diet with cardio (D+C), or diet with resistance exercise (D+RE)?

A weight loss program designed to achieve a BMI of <25 k/m enrolled 141 premenopausal women and followed for a year. On average, they lost ~25#, ~11# of fat and 0.5# of FFM during the weight intervention period. Those who’d regained 20% more weight during the yearlong follow-up period had lost the most FFM during the diet phase. And those who lost their weight by dieting alone lost the most FFM whereas the D+C lost some muscle mass and the D+RE lost no FFM.

On an individual level, regardless of which group you were in, those who lost the most muscle mass tended to regain the most weight. In other words, diet AND lifting weights are the way to lose.            

MSSE July 2022

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