Exercise landscapesingleleghipextension
My knees tend to buckle when I squat heavy, and I often get knee pain if I squat for too long. I alternate between cycles of leg presses and leg curls to give my knees a rest from squats, and this helps, but I get more out of squats. Would knee wraps help?

Knee wraps are essential in competition powerlifting because they cause a high amount of elastic energy to be stored during the descent of the squat, and this energy is released during the upward phase. This energy release enables more weight to be used and the lift to be performed faster. Also, because the wraps alter the technique of the squat (such as by restricting the motion of the hip joint), powerlifters must spend a good deal of time training with knee wraps as well.

However, I’m not a fan of knee wraps for typical trainees or bodybuilders. One problem with knee wraps that cover the patella (kneecap) and are pulled too tightly is that this may increase the friction between the patella and the underlying cartilage, because the wraps compress the kneecap into the thighbone. The theory is that this effect may increase the risk of injury and knee pathologies such as arthritis. In fact, in one study comparing the incidence of osteoarthritis provide pain relief for many conditions.
 That being said, how about changing your approach from trying to treat the symptoms to fixing the cause? The source of this type of injury is often a relative weakness in the vastus medialis oblique (VMO), a quadriceps muscle that crosses the knee joint and thus is an important muscle for maintaining knee stability. If the VMO is weaker than the other quadriceps muscles, this imbalance can cause an unnatural tracking of the kneecap.

When you see a trainee’s knees collapse inward during squatting, this
is often a case of weak VMOs. Trying to correct this problem initially with full squats may not be wise, as the altered biomechanics of the knee could worsen the condition. Instead, I have most trainees who demonstrate this fault first focus on special stepup exercises, such as the Petersen stepup, which begins with the heels elevated and is performed at progressively higher elevations. Eventually the stepups enable these athletes to progress to conventional stepups and then to full squats.

What exercises are taboo? I’ve heard negative things about upright rows, dumbbell lateral raises, hyperextensions, and dips.

Well, at least you didn’t say full squats—dispelling that myth has been a lifelong challenge of mine. Getting back to your question, it’s not so much that an exercise is “bad” but that it can become bad if poor technique or poor training methods are used. Let’s start with training methods.

I see a lot of “boot camp” programs using Olympic lifting movements as a form of energy system training. Yes, performing a set of 10 in the power clean-and-push press gets the heart pumping and certainly works muscular endurance, but it is extremely difficult to maintain proper form in this exercise with such high reps. I’ve seen boot camp programs compound the problem by supersetting high-repetition deadlifts with high-repetition power cleans, making it virtually impossible to maintain proper form on either exercise. In both these cases, it’s not the exercise being performed that’s the problem but the repetitions per set and the exercise order—and I should add that a great alternate to such workouts for energy system training would be strongman training.

Another issue is that with more complex exercises you need someone to teach you good technique—reading an explanation of how to perform an exercise and looking at photos of
it is better than nothing, but not by much. If you don’t have someone to teach you proper technique in the deadlift or back squat, for example, you probably shouldn’t be doing them. Interestingly, the No. 1 sport for causing catastrophic injuries in the U.S. is cheerleading, and that’s because so many unqualified coaches are teaching gymnastic stunts. Is cheerleading dangerous? No—but doing high-level stunts without proper coaching is.

The risk of injury isn’t confined to free-weight exercises—machine exercises aren’t injury-proof by any means. Trainees who use too much weight in an isolation exercise such as a machine pec dec may jerk the weight to get it started, placing a lot of adverse stress on the shoulder joint. Likewise, although I understand the idea of using higher reps with kids who are beginning a weight-training program, having a 13-year-old do 20 reps in any exercise—machines or free weights—often causes them to lose focus and end up using poor form.

Another bad choice is to perform the same exercises for too long or to the exclusion of other exercises. Lack of variety can contribute to structural imbalances that can result in an asymmetrical physique and can increase the risk of overuse injuries. Bench presses and incline presses are great muscle builders, but they need to be balanced with horizontal pulling movements such as rows.

As a general guideline, every time you repeat a workout, you should be able to add 2% more weight on the bar for the same number of reps, or you should be able to do an extra rep with the same weight. Thus, if you bench-pressed 200 pounds for eight reps in one workout, during the second workout you should be able to lift 204 pounds for eight reps or lift 200 pounds for nine reps. If you can accomplish this progression or even improve upon it, then your training frequency is appropriate.