The Knee Pain Program

The main areas this program was meant to address are:

1) Improving soft-tissue quality of the muscles in the hip and thigh

2) Improving ankle range of motion

3) Strengthening the hip external rotators and abductors

4) Using isometrics (and one dynamic exercise-the reverse lunge) to strengthen the lower body

Foam Roll Circuit: Anterolateral Hip, Quads, Lateral Thigh

1 x 30s each position on each side

Lacrosse Ball Circuit: Lateral Glute, Posterior Glute

1 x 30s each position on each side

3-Way Ankle Mobility

1 x 5 each position on each side

A1) Side Lying Hip Abduction/External Rotation Hold

Week 1: 3 x 20s hold each

Week 2: 3 x 25s hold each

Week 3: 3 x 30s hold

A2) Split Squat Iso-Hold w/ Toe Pull

Week 1: 3 x 25s each

Week 2: 3 x 30s each

Week 3: 3 x 35s each

B1) Close Stance Glute Bridge Hold w/ MiniBand

Week 1: 3 x 20s hold

Week 2: 3 x 30s hold

Week 3: 3 x 40s Hold

B2) 3-Way Squat Circuit: Knees Out, Hands Behind Head, Hands Overhead

Week 1: 3 x 10s each

Week 2: 4 x 10s each

Week 3: 4 x 10s each

C1) Lateral MiniBand Walk

Week 1: 3 x 6 steps each

Week 2: 3 x 8 each

Week 3: 3 x 10 each

C2) Reverse Lunge

Week 1: 3 x 8 each

Week 2: 3 x 8 each

Week 3: 3 x 8 each

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The Problem with Physical Therapy

Those of you that know me personally know that I hold physical therapists in a very high regard. I’m fascinated by the education they receive. They truly are the only profession that is taught how we move, and expected to be able to apply their knowledge in a way to manipulate human movement in the interest of health.

Unfortunately, recently I’ve been hearing from several people that have gone to multiple physical therapists with no luck. I don’t want to throw physical therapists under the bus, but it’s frustrating when I ask people what they did at physical therapy and the answer comes back “Ice, stim, and stretches” every time. Stretching I’m okay with. Ice and stim treat symptoms, not causes.

If these modalities don’t provide long-term results, then why do PTs use them? Simple. Insurance! PTs are given a very limited number of visits to make someone feel better. Ice and stim reduce pain rapidly, so people feel better. The underlying problem is likely still lingering (unless a little rest was really all someone needed), but they feel better, which is pretty important.

But there needs to be a happy medium. Something between treating symptoms and treating the cause. Of course, the best way to treat an injury is to avoid it altogether. I’ve spent countless hours reading physical therapy texts to try to improve my understanding of human movement for just that reason. If you can spot movement abnormalities before people get hurt, you can probably save them the hassles of rehabilitation.

My next post will have the program I put together for the girl with patellofemoral syndrome and chondromalacia. Stay tuned!

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Hockey Knee Pain

One of the things that became painfully clear after a year working with a collegiate women’s hockey team is that females are plagued by knee injuries. The demands of the game and consequent injuries are considerably different between college men’s and women’s hockey. What I learned, though, is that many injuries that I heard about weren’t the result of anything hockey related.

At the beginning of the season, several girls complained about feeling a slight strain of their quads and hip flexors while sprinting. That doesn’t seem uncommon, except it was over 30 minutes into the session after an overly comprehensive warm-up, core work and jump training. It was also about 10 yards into a 30-yard sprint. In my experience, most muscle strains occur further out than that. I was perplexed. After some questioning, I learned that ALL of the girls with those complaints regularly ran for distance regularly or were consistently involved in spinning classes. Now we’re getting somewhere.

Some soft tissue work, anterior hip stretches, and posterior hip activation and strengthening cleared that up. A long discussion on the potential benefits (e.g. increase energy expenditure) and risks (anterior hip tightness, various overuse injuries, chronic knee, hip, and lower back pain) associated with spinning classes and distance running also helped them understand why they feel the way they do.

Recently, one of the girls told me about knee pain she’s had that has prevented her from running. She had actually been to a couple doctors and physical therapists and learned she had patellofemoral syndrome (which seems to be a garbage term for knee pain that is tossed around as much as shoulder impingement), and chondromalacia. None of her therapy time had lead to any long-lasting improvement in her symptoms.

I’m not going to delve into all the reasons females have a difficult time surviving the stresses of running, but the primary causes of these difficulties are a wider pelvis and just being weak. As you might imagine, this story has a happy ending. Three weeks after starting a program I put together, she ran for 45 minutes pain free. I don’t necessarily condone her decision to jump right back into a long run (and she knows that), but was pretty thrilled she was able to go for that long without any pain.

Check back in with me this week. In the next couple days I’ll be discussing the reason why many people don’t have long-term success with physical therapy. I’ll also be posting the exact program template that I gave the girl with the knee pain. She’s been running consistently over the last month or so without pain, so hopefully you can pick up on a thing or two from it that may help you or someone you know. As always, I’d be interested in hearing your feedback.

Keep Training Smart

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The Truth About Skating Treadmills

Skating treadmills have become big business, hailed as the cure for slow hockey players. A look at the research shows that hockey players tend to increase their stride frequency on a skating treadmill compared to on-ice training, probably because of the increased friction of the skating treadmill surface. That makes sense. The take home is that for any given skating speed, you’ll have to turn your feet over quicker on a treadmill than on ice.

Random tangent: Growing up, I remember hearing lots of coaches emphasize the importance of lengthening your skating stride. I don’t disagree with this coaching cue at all, but thought it is necessary to present that research on different stride types has shown that those utilizing short/choppy strides, on average, were just as fast as those using longer strides. Obviously, for any given speed, utilizing shorter strides will require a higher stride frequency, but some people are just wired that way. With more experienced hockey players, I’m less likely to try to change their stride type than I am improve their edges and overall athleticism.

I’ve learned to be skeptical about cure-all solutions. The skating treadmill is a tool, with specific uses. If you’re considering paying to use a skating treadmill, consider the following things:

Do you have a good forward skating stride?
Are you comfortable on both your inside and outside edges moving forward and backward?
Can you quickly change directions while skating forward AND backward?
Can you quickly pivot between forward and backward skating?
Have you done anything to improve the strength/power of your legs and hips?

Truthfully answering these questions is extremely important. Here’s why:

The skating treadmill is an EXCELLENT tool to help hockey players perfect their forward skating stride and to get a ton of medium and high speed repetitions in to reinforce the new movement pattern. Unfortunately, I suspect that most people just throw their hockey players on the treadmill and don’t do much to coach the QUALITY of the movement. If used properly, I think the skating treadmill can be effectively used to improve skating stride and forward skating speed.

Unfortunately, the skating treadmill will do very little for most of the aspects of skating used commonly in games. Consider questions 2, 3, and 4. You won’t be on your outside edges or transitioning from forward to backward skating on a treadmill.

Once you perfect your skating stride, the key to speed is to drastically improve your muscular size and power. This can be done at the same time as skating treadmill training, but it’s important not to overlook. Most elite level hockey players have legs the size of tree trunks. This not only implies lower body strength and power, but means that a large percentage of their body weight will be in their lower body, lowering their center of mass, improving their stability, and making them harder to knock off the puck. See how these all go hand in hand?

To your success,

Kevin Neeld
OptimizingMovement.com
UltimateHockeyTraining.com

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The Only Way to Cruise

First things first. The other day I mentioned I would be providing a high frequency training template. I will be, but instead of posting it, I’ll be sending it out in an upcoming newsletter. If you haven’t yet, grab a free copy of “Strong Hockey Core Training” and sign-up for my newsletter. Even if you already invested in my Off-Ice Performance Training Course, it’s still worth signing up for the newsletter to get updated information and other freebies. Sign-up window in the upper right corner of this site.

Moving on…

On Saturday I got back to New York after a 7-day cruise through the Caribbean with Emily. It was probably the most fun week of my life. Up to this point, my foreign travel has consisted of hockey trips to Canada, and one accidental journey through part of Mexico during a cross-country drive with my brother. We spent one day each in: St. Thomas, St. Maarten, Antigua, St. Lucia, and Barbados.

If you know me at all, you know I’m exceptionally boring. On an average week, I’m busy with something kinesiology or training related for about 14 hours a day, about 4-6 of which is spent reading. I get about 7-8 hours of sleep, and spend the last 2 hours eating the same foods (pepper, onion, and cheddar cheese omelettes, ground turkey, spinach, broccoli, and smoothies). Some would call me a workaholic. I wouldn’t disagree. I just happen to enjoy my work, so I don’t mind putting the time in.

Having said all that, Emily made it clear that no constructive work would be done at anytime on this cruise, which was an ultimatum I agreed to without hesitation. I needed a break. It was time to relax and branch out. It was a week of firsts. Last week, for the first time ever, I:

Have been on a cruise ship
Been outside North America
Ate snails
Ordered Shrimp, three times I might add
Ate Wahoo…it’s a type of fish
Ordered three desserts and ate all of them
Enjoyed a bowl of Strawberry Bisque
Eaten Cream of Asparagus Soup
Rode a jetski
Ordered a Mojito with an unaltered self-perception of manliness
Feared for my life (Emily, driving the jetski at full speed through choppy waves straight toward the shoreline, turns her head and says “I can’t see anything. I’m going to close my eyes. Let me know if I hit anything!” She later added, “I had NO idea what I was doing” haha)
Spontaneously slow danced in the middle of a hallway
Saw SEVERAL senior citizens ripping their clothes off to win a cruise-hosted contest
Saw several men provocatively dancing together to with the same contest
Got a tan! Due to my Irish, German, and English heritage, my skin tone usually varies between eggshell white and translucent. In fact, I’m so pale, the people at the “Bodies” exhibit asked if I would be part of their tour, as it is indeed rare that you can see the muscles right through the skin in a life human.
Stood up in the open back of a jeep while speeding through poorly paved roads in a rain forest
Saw a banana plantation (it was cool to see where they come from since I’m single-handedly keeping the banana industry afloat by eating 5-6 a day).
Snorkled above a ship wreck and with sea turtles
Tasted banana ketchup
Went a week without checking my email or voicemail once. Nor did I send a text message. First week without outside communication in as long as I can remember.
Been to a cigar lounge
Saw a towel animal (On different days, our room was inhabited by a towel elephant, monkey, and what Emily described as a “Sexy Antelope”)
And lastly, interacted with such a diverse population. I made friends with two bartenders from China and a small island off the coast of Africa, a piano player from England, a waiter from the Philippines, and a couple with the wife from Russia and husband from Albania. I learned more about foreign culture in one week than I have in 18 years of school.

It was a great break from reality. I’m already looking forward to my next escape 🙂

Hockey Training Take Home: Take a break every now and then. You’ll feel well-rested and rejuvenated, allowing you to get back to training hard and making progress.

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