"The strong legs are needed to carry good days."
-Icelandic saying
When a terrific movie, book or idea seems to gain buzz and momentum over time, it is said to have "legs". Staying power is implied by the term. Are your legs what they can be? Or what they should be?
As an orthopedic surgeon specializing in sports medicine, more specifically knee problems, I am routinely evaluating the status of my patients’ legs. I have learned that one cannot adequately assess a knee problem in a vacuum, by only paying attention to the knee itself. It must be seen as part of a biomechanical linkage system that starts with the foot and extends up to the core area or midsection of your body. A critical component of that link is the quadriceps muscle, the protector of the knee, and much much more.
Your quadriceps muscle is the large muscle group on the front of your thigh (the hamstrings are the group on the rear thigh area). Your quads, as we often refer to them, are the largest muscle group in your body, and have a tremendous responsibility when it comes to your overall health and function.
A well toned, strong quadriceps will not only allow you to get around more easily, and function more efficiently, but it also protects your knee from injury and ailments. A small increase in quad strain was found in one study to lower the risk of knee osteoarthritis by 20-30%. Stronger quads also protect against falls and fractures. If there were an internal fountain of youth, your quads would be part of the foundation.
Unfortunately, when not exercised regularly, your quads will melt away, resulting in the leg weakness that I all too often see in my office. When you're knee is injured, or even if you are limping for a few days, you're quad muscle begins to rapidly diminish. Also, with age and inactivity, your important thigh muscle will vanish.
Your overall body muscle mass normally peaks at age 25-30 and there is a 10% loss of muscle per decade after age 40, which rises to 15% after age 50, and 30% after age 70! Some individuals are affected more so than others. This muscle loss happens gradually, almost imperceptibly. Strong and vigorous one day, weaker, even frail another. Your quads, being the largest muscle group in your body, are dramatically affected.
The good news is that much of this is preventable. Muscle can grow at any age if stimulated properly. The bad news is that there is a good bit of confusion about how one goes about gaining or maintaining quad (and overall leg) strength.
I often see patients recovering from knee surgery or injury who are not making adequate gains in thigh strain. Ditto for many healthy folks who take long fitness walks on a daily basis. They both tend to think that walking and standing a lot will build their quadriceps. Unfortunately, it doesn't work that way.
To build solid, quads with great strength and endurance, you need to work them specifically. Walking (even running) is great for your heart, and will build your calves, but it does little for your quads. “I’m on my feet all day” just doesn’t cut it.
My recipe for strong quads is to perform specific quad muscle building exercises like leg extensions, lunges and squats on a very regular basis. This needs to be a lifetime habit- and not just for guys. Women and the elderly need this type of exercise every bit as much as the starting line for the Philadelphia Eagles football team. Also, cycling is very specific for building quad strength and endurance, which is why it is a mainstay of knee rehabilitation. Just picture Lance Armstrong’s tree trunks going round and round. Do your leg strengthening exercises every other day. Do two or three sets of 12-15 repetitions in good slow form concentrating on tightening the front thigh muscle. While you are at it, you should also try to add other muscle groups (i.e. core, hips, hamstrings and calves) to your lower body strength building routine to really have sensational, durable wheels of steel.
If you are very weak or recovering from injury or surgery, it helps to see a therapist and you should also be doing your exercises more frequently, even several times per day. One great quad builder that I described in my book FrameWork is the "lock and lift". It is a great exercise that can be done easily at home, and is particularly good for individuals with patellar or kneecap problems who might not be able to tolerate more traditional quadriceps building exercises like those listed above.
To perform a “lock and lift”, lie on your back with your left knee bent and left foot resting on the ground. Next tighten and slowly lock your right thigh (pushing back with the right knee). Feel the VMO muscle (teardrop shaped vastus medialis oblique muscle on the inner side of the knee, just above the knee cap). Be sure it contracts and gets firm. Next lift your right leg 6 to 8 inches off the ground and hold 5 to 7 seconds. Keep feeling your thigh muscle and VMO to be sure they are staying tight at maximal contraction (until you get really good at this). This assures that your quad is doing the work, and not your hip. Hold 5-7 seconds and repeat 12-15 times. Next do your opposite leg. When this gets very easy, start adding ankle weights (start with 1 or 2 pounds and don't go over 10 pounds, or you will probably start using your hip again to do the lift). The key is concentrating on tightening and palpating the muscle for biofeedback-type information to assure that you are really working the muscle effectively.
Monitor your gains by checking both the tone and size of your thigh. Mark a spot with a pen four inches above the upper edge of your kneecap (with your legs straight and relaxed). Next measure the circumference of your thigh at that point. Recheck every month. It should be growing, not shrinking. You don't need to be Quadzilla, you just need to be strong. It is more important than you can imagine. Even Bette Davis once said "I will not retire while I've still got my legs and my make-up box." She obviously was on the right track.
FitTip: If you want to have "legs", build those legs.