To keep your knees healthy, follow these tips .
1. Purchase some knee sleeves
Ill make this first one easy on you. Go out, buy some knee sleeves, and wear them every time you train your legs.This could be quad-dominant day, hip-dominant day, leg day, or whatever you want to call it. Just put them on before the workout, warm-up thoroughly, and bask in the joy that healthy knees bring to you.
2. Dont skimp on your warm-up
This idea is beautiful in its simplicity, yet often ignored for various reasons such as Im in a hurry or I dont need to warm-up because Im 22 and therefore ten feet tall and impervious to harm. Well, Id love to see what that lack of warm-up is doing to your joints, pal Beyond improving your training performance for numerous reasons, warming up reduces the viscosity of synovial fluid (the stuff that fills your joint space), providing better lubrication and healthier joints in general.
3. Want healthy knees Focus on ankle and hip mobility
It may sound counterintuitive, but when we have knee issues, where do we focus most of our attention? The knees, right? You know what else? Thats a big part of the problem.The fact of the matter is that knee issues are typically due to issues at other areas of the body, not the knees themselves. Lack of hip mobility in all planes can not only lead to knee pain, but back pain as well. Eric Cressey and I covered about a zillion hip mobility exercises in our Magnificent Mobility DVD, so Id highly suggest checking it out.However, one area we didnt cover as in-depth was ankle mobility, and this area is often poorly addressed, or worse yet, not addressed at all. After reviewing Mike Boyles Functional Strength Coach DVD series, I realized how poor sagittal plane ankle mobility is in many athletes. Here are some drills to help out.In the first exercise, all youre going to do is set up next to a wall with your feet a few inches away from it (you may even want to start with your toes touching the wall at first). Rest your hands on the wall, place all your weight on your heels, and then stay tall and try to shoot your knees over your toes In this second exercise, youre going to place a small board underneath your toes to put you into a dorsiflexed position. I find it easiest to place this board in front of the wall so you can balance yourself with your hands. While staying tall, youre again going to try and shoot your knees over your toes. Dont worry if there isnt a ton of range of motion at first; itll improve as you practice it.
4. Get your glutes firing
This is another area that not nearly enough of us are addressing, as most who have patello-femoral pain are only worried about isolating the vastus medialis obliquus (VMO). In research by Ireland et al. (1), they found that athletes with patello-femoral pain had significantly decreased strength in both hip abduction and hip external rotation. How much is significant? These subjects were 26% weaker in hip abduction and 36% weaker in hip external rotation. Now that we know what movements to train, what muscles are most affected? Specifically, were talking about getting your gluteus maximus and posterior fibers of the gluteus medius firing. So before we do low-body work, we should be getting some activation work in to make sure those muscles are stimulated and ready to go. X-Band walks are perfect here.Youll see in the video that the set-up is a little funky, so hopefully seeing it will make it easier than me trying to explain it. Big things to focus on here include turning the toes out slightly and bracing the core throughout. This will prevent you from using the Weeble-Wooble substitution pattern that typically occurs in hip abduction movements. Stay tight, tall, and use those glutes and you should be just fine.In maintenance phases (where Im focusing on max strength), I may only do one set before training. In phases where motor control and recruitment are the priority (for instance, in the early off-season or a transition phase), I may perform three or even four sets of these exercises before training.
5. Forget about isolating the VMO
A lot of athletes and lifters are interested in getting that VMO to fire, especially those with patello-femoral (PF) pain. This anterior knee pain, in many cases, is due to soft-tissue imbalances between the stronger tighter lateral knee structures and the weaker inhibited medial knee structures (the VMO). This muscle imbalance leads to a lateral (outside) pulling of the patella into the femoral condyle, resulting in knee pain.The obvious solution here would be to isolate and then strengthen the VMO, but it just doesnt seem to be that easy. In fact, there doesnt appear to be any true VMO isolation exercises. Sure, terminal knee extensions (TKEs) hit the VMO, but its not isolated.In an article discussing muscular control of the patella, Malone et al. (2) flat out state, The concept of VMO isolation through specific exercise should no longer be part of our lexicon.It should be noted that each and every knee is different, requiring a specific and individualevaluation and treatment program. Im not trying to rehab people here, rather help them prevent the need for rehab. However, I just dont see the need for direct VMO isolation exercises in that treatment program, as their use hasnt been justified in research at this point in time.
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