NEWS & EVENTS
  One of the most prevalent movement flaws we see on a daily basis is an inward collapsing of the knee during cutting, squatting, and jump landing patterns. This is especially true in females, who tend to have a more difficult time preventing this motion due to their skeletal structure (wider pelvis). This pattern can lead to a variety of knee injuries, the most threatening of which is the well-known ACL tear.
Retraining Proper Movement Patterns
The approach we take in retraining this pattern includes educating our athletes on what the pattern should look like, strengthening the muscles on the outside of the hip, which is influential in pulling the upper leg and knee out, and practicing proper technique in a variety of athletic movements (including speed training, plyometric training, resistance training, and conditioning). This approach has proven extremely effective for just about every athlete we’ve had. The exception is athletes that have a flat foot (or two). When the foot flattens out (or pronates), it drives the lower leg into internal rotation. My colleague John Pallof calls the talocrural joint (what many refer to as the “ankle joint”) a torque converter, since inversion and eversion (inward or outward tilting) at this segment leads to internal and external rotation of the lower leg. He also pointed out that a few degrees of excessive inversion (as is the case in individuals with flat feet or “over pronation”) translates into even more degrees of internal rotation of the lower leg, which translates into even MORE degrees of internal rotation at the hip.
Try This!
One way to illustrate this concept is just to move your arm in large circles. If you look at the diameter of the circle made at your arm by your shoulder, it will be considerably smaller than the diameter of the circle made by your hand. In the above example, your lower leg would be your upper arm (small circle) and your hip would be your hand (large circle).
In athletes that have difficulty keeping their knee out, despite a few weeks of training and coaching under their belt, I take a closer look at their feet and am starting to notice a common theme.
If you look closely, you'll see that the achilles tendon appears to head straight down, and then take a somewhat sharp turn toward the outside of the foot. This is indicative of an over-pronated foot. This athlete appears to have the problem on both feet. Can you imagine what his knees will look like?
See how his knees appear to point inward? In a correctly positioned foot, the achilles would appear more vertical and the back of the knee would be facing straight back instead of rotating toward the inside.
There is some debate about whether we can restore an arch in our feet through training. I’ve run this question by my friend Ryan Chang, who was a fellow grad student when I was at UMass Amherst, but current works as a Pedorthis at Kintec Footlabs and has done biomechanics work for Adidas, and he seemed to think getting an orthotic was the better route. John Pallof agreed. It’s better to get a corrective orthotic in there early to prevented undesirable motion at the knee and hip. As I mentioned in last weeks newsletter, unwanted motion accumulates into serious injuries. Knee meniscus tears and hip labral tears are amongst the many injuries that could result from this. If your feet look like the gentleman’s in the picture above, it may be worth scheduling an appointment with a specialist to see if you’re right for orthotics. John Pallof was kind enough to pass along his “go-to” resource in this regard: Sole Supports (http://SoleSupports.com). If you go to the site, you can find a provider that’s near you (There are 9 within 25 miles of Endeavor). My hope is that you take this information seriously and don’t push this stuff to the back burner. I recently heard my friend Joe Heiler (a PT from Traverse City, MI) mention that Jan Eckstrand presented research at the 2009 Soccer Industry Medical Symposium 2009 stating that an analysis of 70 teams from 18 countries over 8 seasons (over 9000 injuries!) revealed that previous injury was BY FAR the best predictor of future injury. This isn’t to say that previous ankle sprains are predictive of future ankle sprains (although they are); this means that ANY injury is the greatest predictor of ANY future injury. This point CANNOT be overlooked. Injury prevention should be the primary goal of every athlete, and is the primary reason I think athletes need to be training year-round.
To your continued success,
Kevin Neeld, MS, CSCS Director of Athletic Development kneeld@endeavorfit.com (856) 269-4148 P.S. Call or stop in today for more information or to sign-up for one of our Athletic Development Training Programs, GUARANTEED to get you the results you deserve.
P.S.2. Please forward this to your friends, family, and teammates that you think will benefit from the information. If they're interested, they can sign up for our weekly newsletter here: Endeavor Sports Performance Newsletter
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I’m going to start this one with a quick question: What is the primary function of the rotator cuff? If you answered external rotation (or internal rotation), you are wrong. Even if external (and internal) rotation is a function of the rotator cuff, it is not its main function. The primary function of the rotator cuff muscles is to stabilize the humeral head in the glenoid fossa. Your rotator cuff needs to stabilize the humeral head to prevent it from moving in the joint capsule when you press, row, throw, etc. Now let’s consider the type of exercises we use to train the rotator cuff. We all typically use some kind of external or internal rotation based movement at the shoulder to train it, right? Now that we know that the primary function of the rotator cuff is one of stabilization, we might want to incorporate rotator cuff exercises that will train this function. The most basic exercise for this purpose would be the supine dynamic stabilization with the help of a partner. The goal is to resist any random perturbation the partner is going to apply to your arm and try to prevent it from moving. (The perturbations the partner apply to your arm should be light pushes, they should be random to keep you from guessing which way he’s going to go next and there should be at least a second between each pushes so your shoulder has time to stabilize completely). There is a variety of progressions with this exercise alone just by getting your arm in a different position, changing your body position, or even by just closing your eyes (which will increase the proprioceptive challenge of the exercise since you can’t anticipate the perturbations). Here’s one variation in the half kneeling position with the arm abducted. And finally, the 1-Arm Wall Stability Ball Hold, that we use quite a bit at Endeavor with a lot of our athletes. Kevin Neeld actually came up with this one. At first you’re going to see the basic exercise, and then a progression we use by simply adding a partner perturbation to the ball or forearm. For a better understanding of the rotator cuff and how to train it for optimal performance, I would highly recommend you check out Eric Cressey and Mike Reinold’s new product: Optimal Shoulder Performance. I attended this seminar back in November, and I have to admit that the investment was worth every penny (I’m actually the big fat head in the red hoody we see constantly during the lecture parton the DVD!). -David Lasnier
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This was a recent post at KevinNeeld.com that I wanted to share with you. Forgive my anatomical nerdiness… Everyday at Endeavor I see people doing “rotator cuff” exercises. I’m not against doing some cuff work, but people often make a fatal mistake-they load too heavily! Your body has amazing adaptive powers. If you use heavier weights, you’ll recruit larger muscles often at the expense of the muscles you’re targeting. Consider these two examples: 1) Exercises involving glenohumeral (”shoulder”) external rotation are usually performed to the rotator cuff muscles that assist in external rotation (teres minor, infraspinatus). If the load is too heavy your posterior deltoid will take over and imbalances around your shoulder are exacerbated. 2) High load core exercises (e.g. rollouts) can become very rectus abdominis (the “6-pack” muscle) dominant, sometimes at the expense of the transverse abdominis. The same is true for teaching people to “fill up their belly” with air to stabilize their spine without teaching them to pre-tension their core first. The problem with this is that the rectus doesn’t attach to the spine or share the lumbodorsal fascia connections that the transverse abdominis and obliques do, meaning your core strength may not create the spinal stability you’re looking for. One of the things I’m starting to include in more programs these days is intentional low load exercises like: -Alternate DB Row (intention: stimulate spinal stabilizers) -Standing Belly Press (intention: stimulate “inner core” in anti-rotation pattern) -Alligator Breathing (intention: teach diaphragm breathing) I love helping people get strong, but I think low load training is necessary to improve stability and overall movement quality. After all, if stabilizers aren’t doing their jobs the larger surrounding muscles need to split attention between creating stability and demonstrating strength/power. The key to strong, powerful, efficient movement is appropriate joint stability. Keep training smart! Kevin Neeld
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