Beating Knee Pain – Part I

One of the biggest problems in our society is knee pain. Seeing people in the older population having knee replacements is something that is becoming more and more common every day. Unfortunately knee issues aren’t just affecting the older population. These days more and more people in all age groups are complaining of knee pain and have no idea why the pain has started, what they did to cause the pain, or how to overcome the pain.

Before we go any further we need to understand the types of knee pains/injuries. Knee injuries can come in two different packages; acute or chronic.

Acute Knee Injury

If someone was to have an acute knee injury we are talking about a knee injury that happens instantaneously. This could be a torn ACL, MCL, or some type of meniscal tear. Acute injuries can happen do to contact (think football player that gets his leg caught in a pile and rolled up on) or a non-contact injury (think football player that stops, cuts quickly or plants thier foot in the ground and goes down with a torn ACL).

Willis McGahee’s Torn ACL (contact injury)

Jamaal Charles’ Torn ACL (non-contact)

Chronic Knee Injury

A chronic knee injury is when there is no damage to the interior knee structure. More often than not a person will complain of a general, localized pain. Most of the time these injuries occur due to poor movement patterns or a repetitive overuse issue. I would bet that most people that are complaining about knee issues fall into this category – if you tore your ACL or something of the like you probably would have known it the minute it happened.

Again, before we get into how to overcome your knee pain we first need to understand some of the common reasons as to why we have knee pain in the first place. In the first part of the knee pain series we are going to look at some of the reasons we have knee pain. Here are a few common reasons, in no particular order;

Suboptimal muscle strength and function

This may seem like something that we could classify in the ‘duh’ category, but many people flat out don’t have the proper strength and muscle function at the muscles surrounding the knee. Thankfully we can correct these issues. Unfortunately most people that go to the gym and perform some lower body exercises think they are doing themselves a favor but sometimes they are doing just the opposite. We’ll tackle specific exercises later on.

Poor biomechanical alignment

The knee in most everyone naturally caves in (valgus knee) a little bit creating an angle between the hip and the knee (Q angle). The more the knee caves the greater the angle between the hip and the knee is which is why women tend to have more knee issues than men (wider pelvis = greater angle between hip and knee). This is one of the biggest reasons we see a much greater rate of ACL injuries in college women as we do in college men – the Q angle is constantly putting women in a greater risk of knee injuries.

Poor mobility at the joints above and below the knee

This is where most people miss the boat, even doctors. A lot of knee issues are due to a decrease in mobility at the hip and/or at the ankle. If the hip has mobility issues then the knee will try to pick up the slack and help create the mobility that the lower body needs. The same goes for the ankle – if the ankle lacks mobility then the knee tries to pick up the slack. The problem is, the knee is a stable joint and when a stable joint tries to become a mobile joint, you can pretty much bet that pain in that stable joint is bound to follow.

Overuse

Again, this is kind of a no brainer. If you are constantly overloaded the knee, or any specific tissue for that matter, then there is a good chance pain is going to follow due to overuse. This can arise from trying to perform too much too soon, or just using too much volume and/or intensity in general. Its no wonder so many runners have knee issues – they place a ton of stress on their knees every time their foot strikes the ground.

In the next part of this series we will look at some of the ways we can strength train to avoid knee injuries. Some of the movements may not be new to you, however I will all but guarantee that some of the movements will be something you have never seen before.

Things to Read to Get You Over the Hump 4/25

Here are a few good reads to get you through the work week!

The Walk On by Jim Wendler

A really, really awesome article by Jim Wendler on his years as a walk on football player at the University of Arizona. There is so much good info in this piece that I would recommend anyone read this, whether you are a football fan or not.

Training Clarity: One Goal at A Time by Dan John 

I’m not going to lie, I haven’t even read this yet but I am so confident in anything that Dan John writes that I will throw it out there for everyone to read. Everything that Dan John writes is gold so have at it!

Is Your Box Too Small by Michael Boyle

Just like Dan John, anything that Mike Boyle writes is a must read. Mike is an absolute wealth of knowledge and someone that you can always learn from in one way or another. Another great one by Coach Boyle.

Q&A: Power Development by Mike Robertson

On issue that people in the strength and conditioning field can’t seem to agree on is power development. Some like Olympic lifts, some don’t. Check out what Mike Robertson has to say on the subject.

Interview With Brendon Rearick by Matt Siniscalchi

Here’s a good interview with Mike Boyle Strength & Conditioning coach Brendon Rearick. Check out all of Brendon’s thoughts on various subjects and learn some things from a really smart coach.

TRX Row

The first time I saw a commercial or an infomercial for the TRX trainer I thought it was a gimmick, something that would come and go like almost all the abdominal training devices you will see at 3am. Since then the TRX training system has taken off to the point where you’ll have a hard time to find a gym, strength & conditioning facility or college weight room that doesn’t have one — most places have numerous TRX systems.

That being said, I was wrong, and I was way wrong. The TRX trainer has to be one of the most versatile pieces of equipment you’ll find, something that could easily be incorporated into any training program.One of my favorite movements using the TRX trainer is also one of the simplest and most effective – the TRX Row. I’m a big fan of the TRX Row for a couple different reasons, none more obvious than the fact that it is so simple – it takes a real fool to mess it up.

One reason is because it is a rowing movement. It is something I could say until I’m blue in the face, but people just don’t do enough rowing/pulling movements. Everyone loves to perform pressing/pushing movements (benching) but overlook the rowing/pulling movements. If for no other reason, you should be performing rowing/pulling movements for shoulder health. Many strength coaches and physical therapists recommend a 2:1 ratio when it comes to pulling to pushing – some going as far as 3:1 (people with shoulder issues should feel free to even go as far as a 4:1 ratio).

Even though shoulder health is a great reason to add the TRX Row into your program, the biggest reason for loving the TRX Row is due to the fact that there are endless ways to continually make the movement harder and harder — you’ll be hard pressed to get to a point where you have to move on from the TRX Row. You can start out with a very steep angle, moving to a bent leg position, to a straight leg position, and then finally to feet elevated row. Once you have reached the point where your feet are elevated you can start to load to movement. You can start to toss on a weight vest or place a plate across your chest – get creative and continue to load more and more as you progress.

8 Ways to Improve Your Training

Here are 8 easy ways to improve your training program:

Warm up thoroughly

Every one overlooks warming up. Try to foam roll, stretch, and go through some type of dynamic warm up before every lifting session. You’ll be surprised how much better you feel during your workout, not to mention a little bit of injury prevention.

Add Carries to Your Training

I admit I am late to the party when it comes to carries. For the longest time I thought they were really overrated but carries can do a lot for core development – and your traps will be screaming at you the next day! There are plenty of options to keep things fresh whether it be farmer carries, suitcase carries, or even heartbeat walks – just pick one most days you train and don’t look back.

Give Single Leg Training a Legit Shot

I hate to admit this too, but I was late on the single leg training bandwagon as well. After a couple of years of consistent single leg training, I’m hooked. When it comes to lower body training I typically start with a bilateral exercise (front squat, goblet squat) and then all of my assistance work is single leg. This way I feel I get the best of both worlds and get a great lower body workout while keeping the spinal load to a minimum.

Add Some Explosive Training

Whether it is some hang cleans, hang snatches, dumbbell snatches, kettlebell swings, or even jump squats, add some explosive training to your program. Adding some of these movements to start out your workout 2-3 times a week would be a great place to start.

Use Push-ups as Your Major Pressing Exercise

Shoulder issues are pretty common these days yet people continue to bench. Talk about trying to fit a square peg into a round hole. Try doing some push-ups for your main pressing movement – with a little creativity you can do a lot to make the push up as challenging as a heavy set of benching.

Push and Pull Sleds Consistently

There is something about pushing or pulling a heavy ass sled after a training session or on an off day that screams ‘badass’ – and makes your scream for your mom. Get out of your comfort zone and reap the benefits from a conditioning standpoint as well as a mental toughness standpoint.

Listen to Your Body

Some days and weeks you’re just plain tired. Listen to your body and step off the accelerator a little bit. Using some lighter weights and skipping a tough conditioning session may be better for you in the long haul then beating yourself into the ground. I personally will take a de-load or back off week at least once every 3 months and that’s at the very most even if I feel pretty good and don’t think I need one.

Don’t be Afraid to try Something New

Don’t be scared of change. If you aren’t seeing the results you are looking for, change something. Try a completely different program. Try exercises that you haven’t been doing for quite some time. If you make a change for 6 weeks and it doesn’t work out for the best all you lost was 6 weeks. But on the other hand, you could make a change for 6 weeks and see some great changes. Definitely a risk I would be willing to take if you’ve hit a plateau.

Things to Read to Get You Over the Hump 4/18

Here’s a few good reads from the last week to keep you busy while trying to get through another productive day at work:

Is Foam Rolling Bad for You by Michael Boyle 

Great piece on foam rolling. There have been some articles out there and people out there claiming that foam rolling isn’t all that great for you, something I’d certainly disagree with. Improving tissue quality is a must and foam rolling is an easy and inexpensive way to do it.

Is Sugar Toxic? by Mark Young

Sugar has been the thing on the internet the last coulpe days/weeks and I’m not 100% sure why. Yes, sugar isn’t all that good for you, but on the other hand a little sugar now and again isn’t going to kill you. Nice to see someone not go crazy in one direction or the other and taking a logical approach to things.

The Myth of Corrective Work by Mike Robertson

Mike Robertson, one of the kings of corrective exercise, sheds some light on corrective exercise. Unfortunatley people don’t perform enough corrective exercise or the right kinds of corrective exercise in order to fix some issues that they may have.

Top 50 Old School Hip Hop Workout Songs by Jason Ferruggia 

A good list of songs for the older generation to add to their Ipod that doesn’t like all this new hip hop/rap like myself. A few gems on the list.

Tips for Healthy Shoulders

One thing that we continually see in strength training is athletes and weekend warriors having issues with their shoulders. No matter what category you fall into, having a shoulder issue can be a very debilitating injury even if surgery isn’t required.

We use our shoulders so much that overuse and every day wear and tear eventually adds up over time until we reach a point where things take a turn for the worse. Here are a few good tips and exercises you can take with you into the gym or in your own living room to help maintain or improve the health of your shoulders.

Doing YTLW’s Daily 

YTLW’s are a great way to warm up your shoulders before a workout. I make sure to perform them before every single upper body workout and if I remember I will do them before a lower body workout as well. YTLW’s are a great way to strengthen your rotator cuff and protect you against injury.

Using a Neutral Grip When Pressing With Dumbbells

The neutral grip allows a much more natural range on motion when performing any type of pressing movement. It also allows you to keep your elbows tucked in a little more then you would if you were to be pressing with a pronated (overhand) grip.

Use Rings When Doing Pull/Chin Ups

Taking it a step further then the neutral grip when pressing with dumbbells, using rings to do your pull ups or chin ups allows for a completely natural range of motion. The rings allow your shoulders to rotate any way they want, which is perfect for letting your shoulders do what they want to naturally do.

Use Push Ups as a Pressing Movement Whenever Possible

A lot of people shy away from doing push-ups because they think they are an inferior exercise when compared to other pressing movements like benching and military presses. The funny thing is, go into many gyms and you’ll see people can’t perform more than a couple correct push-ups. You can get very creative when it comes to the push up. You could simply load the push up by adding chains, weight vests, bands or even a combination of the three. You could also do push-ups with the TRX or with something like the “Perfect Push Up” that will allow the same natural movement as the ring pull/chin ups. The slide-board is also an option when it comes to the push up, adding a stability component that makes the exercise even more challenging.

Perform More Pulling Then Pressing Movements

Performing a lot of pressing movements can really take its toll on your shoulders. Because of that, it is often recommended that people ALWAYS perform more pulling movements than they doing pressing movements. For most people a 2:1 ratio of pulling to pressing would suffice, but people who currently have shoulder issues would benefit of a 3:1 or even a 4:1 ratio.

Performing Band Pull Aparts

Just like the YTLW’s, band pull aparts are a great way to build your rotator cuff. You can do these in various different ways. You could either do straight arm pull aparts with both arms at the same time or you could add a stability component to one of your shoulders by performing one side at a time. Either way, this is another great way to strengthen your rotator cuff.

None of these movements and tips alone are going to cure someone’s shoulder issues. However, if you are consistent with these (and other) exercises and tips to help maintain and improve shoulder health you will see many positive results over the long run. I know some of the exercises (YTLW’s and pull aparts) can be boring, but I feel it is a solid trade off if one can maintain healthy shoulders into the elder years.

Things to Read to Get You Over the Hump 4/11

Here’s a few good reads from the last week to keep you busy while trying to get through another productive day at work:

Food for Thought by Brendon Rearick 

Brendon touches on a few good things here but for the most part nutrition is the main topic. A lot of interesting things that make think about what you are actually putting into your body on a daily basis. I would definitely take a look at this and form your own opinion.

7 Great Core Exercises for the End of Your Workout by Kellie Davis

I’ve been preaching about building a solid midsection through exercises that aren’t sit ups and the like and so is Kellie. Here are 7 great exercises you can use to build a better and more attractive midsection.

Letting Go of the Fat Loss Mindset by Nia Shanks

Love this article. So many people are obsessed with losing fat and have been trying to do so for months and even years. With this mindset you don’t have any fun with their workouts and become obsessed until you look perfect, which I doubt you’ll ever do. Read up and change your mindset!

Safety Bar Front Squat by Molly Galbraith

Never tried them but I am certainly going to give them a shot sometime soon. I am a huge fan of front squats for various reasons and it looks like I found a new tool when doing some front squats. And by the way, Molly is freakin’ strong!