Tag: continuing education

Fixing Your Knees

Recently, I posted the exact program I used with a female college hockey player this season to help restore functional ability and minimize pain related to chondromalacia and patellofemoral syndrome. If you missed it, go check it out here: The Knee Pain Program

I wouldn’t consider myself a knee expert, far from it actually. But I would consider Mike Robertson a knee expert, and I’ve learned a lot from studying his work.

Quick Side Note: Mike and Eric Cressey put out, in my opinion, the best product in strength and conditioning to date: Building the Efficient Athlete. It’s the only product in the industry that really addresses functional anatomy, which is crucial to understanding both performance and reasons for injury. I highly recommend it to anyone that is serious about taking their performance (or that of their athletes) to the next level.

One of the major things I’ve picked up from him is to look at the hip for clues as to why the knee hurts. This year I noticed a common theme in my female hockey players: Most of them had noticeably internally rotated femurs while standing. You can tell this by having someone stand in front of you without shoes on and look at the direction their knees point from the front and back.

For those of you that aren’t functional anatomy geeks (yet!), the patella (or knee cap) sits between two bumps on the bottom of the femur called condyles. To help you picture this, curl the knuckles of your pointer and middle finger on your right hand and then spread those fingers apart. This is indicative of your femoral condyles (on your right leg). Now place your pointer finger of your left hand between the groove, acting as your patella. Now rotate your right hand inward, without changing the location of your left finger. What you’ll find is that your left finger will pull out of that groove slightly.

This is exactly what happens when someone has an internally rotated femur. Basically this means that anytime the athlete bends their knee, the patella won’t be tracking in the groove, but rubbing up against that lateral (or outside) femoral condyle. You can imagine why this friction may create problems and lead to knee pain!

You can begin to address this by both stretching the internal rotators of the hip (mostly the adductors/muscles of the inner thigh), but the best thing to do is strengthen the hell out of your hip external rotators. Referring back to the program, I address this with “isolation” and activation exercises: Side Lying Hip Abduction/External Rotation Holds, Close Stance Glute Bridge Hold w/ MiniBand and Lateral MiniBand Walk; and then lead into more functional movement patterns: Split Squat Iso-Hold w/ Toe Pull, 3-Way Squat Circuit; and Reverse Lunge. The idea is to activate/excite the muscle, then integrate it into normal movement. After all, being really strong on your back or side won’t help at all if you aren’t strong on your feet (or skates).

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Reactive Core Training Wrap Up

Another one of my favorite reactive core training exercises is the overhead medicine ball perturbation. Same concept as previous exercises: maintain a stiff, stable core in the presence of an external force or perturbation. Holding the MB overhead maximizes instability as it raises your center of mass (higher COM=greater instability). Check it out:

[quicktime]http://kevinneeld.com/videos/Overhead%20MB%20Perturbation.mov[/quicktime]

To maximize the functional carryover, you can combine a couple different core MB exercises. For instance, you could pair an overhead floor throw with the overhead MB perturbation. Check out the overhead MB floor throw:

[quicktime]http://kevinneeld.com/videos/Overhead%20MB%20Floor%20Throw.mov[/quicktime]

It would work like this. You would explosively slam the ball into the ground 3 times. After the third time, you’d freeze in the start position, with your arms extended overhead, squeezing the ball hard with both hands. At this point, a partner would provide small perturbations to the ball, and you would try to prevent all movement. This would continue for 5-10 seconds, then you’d perform 3 more slams, 5-10 more seconds of perturbations, 3 more slams, and 5-10 seconds of perturbations. That would be the end of one set.

See how it works? You just combine an explosive upper body/core power exercise with a reactive core stabilization exercise. Now you’re alternating being explosive and stable.

Think that might help on the ice?

You betcha!

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Reactive Core Training-Exercise 2

[quicktime]http://kevinneeld.com/videos/Pallof%20Press%20Perturbation.mov[/quicktime]

Are you noticing a theme here? These are all the same exercises I’ve shown you before, but with a more advanced external sensory stimulus added. The greater the challenge to stability, the more carryover to athletics. I love these exercises for a couple reasons, but mostly because they are so simple to progress.

Start with the Pallof Press Iso-Hold (holding in the extended position).
Progress to Pallof Press for reps (extend your arms, then bring them back to your chest, then extend, etc.)
Progress to Pallof Press Iso-Hold with perturbation
Progress to Pallof Press with perturbation

Simple. Effective.

NOTE: It is not necessary to have Tony Gentilcore in a tight T-shirt to perform these exercises. Any partner will do.

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Reactive Core Training-Exercise 1

[quicktime]http://kevinneeld.com/videos/Side%20Plank%20Perturbation.mov[/quicktime]

Adding a partner perturbation turns this basic core stabilization exercise into a reactive core (and shoulder!) stabilization exercise. It also ties in a team dynamic, as your athletes learn to work in pairs or small groups. The goal is the same as the regular side plank: maintain a neutral position. The only thing that’s changed is the sensory input. Stay tuned for more exercises over the next few days…

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Functional Core Training

My schedule has been exceptionally busy this week. Papers/articles to write, presentations to prepare, marketing to do, etc. No complaints-I’m fortunate to spend the large majority of my day doing things I’m passionate about. But because I’m limited on time, I’m going to keep it short and sweet today.

More on Core Training…
Core training receives more publicity than any other aspect of training. I’ll spare you (for now) my long rant about how most people fall victim to the brilliant marketing of worthless products. The fact is, even people with a great understanding of how to train the core for its true functions, stability and force transfer, still miss out on one thing. In many instances, the core functions reactively. In other words, some movement (sensory input) causes the core muscles to fire (motor output) to produce stability. While I love planking, those exercises are limited in their ability to train the core to be reactive. I go into this in a bit more detail in the Core Training Session (which is available for free download for a limited by entering your name and email address in the box to the right) of my Off-Ice Performance Training Course. Over the next couple days, I’ll be posting my favorite reactive core exercises. You’ll probably notice some similarities with other exercises I’ve presented in the past. Stay tuned…

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