Here are some answers on knee pain when you lunge, plus checking in with a few answers from EFI readers.

Over the week, I received a bunch of questions from readers and I want to take some time to answer them.  I can’t answer them all but I will do my best to get back to everyone.  If you don’t hear back from me after a few days, just send me a reminder email.

Knee Pain When You Lunge

Rick,

I purchased your muscle imbalances revealed package on the weekend and I
just wanted to say I love it so far!! Extremely informative.

Just one question. I have a client right now whose left knee is really
bothering her. It makes cracking noises every time she flexes her knee. She
is alright for hip flexion exercises like squats but for lunges she cannot
perform anymore because of her knee.

I just watched the Maximizing Strength and Stability of the Knee and I am
curious if those exercises will work for her condition.

The doctor gave her exercises like the Bulgarian lunge on the bench but
that is putting too much pressure on her knee. I do not agree with that
exercise choice and I was wondering if you could help me.

My client is overweight so I’m thinking there is too much pressure on her
knee joints but how do I get around this? I have her do squats on the Bosu
ball and leg extensions on the TRX, to really focus on her knees to make
them stronger but are there other exercises that I could be doing?

Thank you for your time!

–
SB

SB,

I am so glad that Muscle Imbalances Revealed has been such a benefit to you.  It is a bit of a labour of love.  Glad it is helping you out.

Yes,  a lot of the exercises in the knee component will help out.  Many of the exercises are in my Knee Injury Solution program.  There are all kinds of levels of exericses plus videos and descriptions of the exercise in Knee Injury Solution.

Here are some videos that I have done that may help you.  You can see more on the YouTube channel.

Video #1

Video #2

Video #3

 The Bulgarian Squat is a good exercise but I would call it an advanced exercise that the average person cannot do.  It puts a lot of  load on one leg.  Often times the weakest point in the leg will give way and with most clients it will be their knees.  With the client being overweight, this makes the situation even worse.

I am a big fan of regressions.  The more you can modifiy an exercise, the happier the client will be.  The more regression exercises you have the more you can change things up to challenge them, keep them guessing, doing new things and keeping them pain free.

One quick thing you can do for knee pain when lunging is decrease the distance between the feet with the lunge and also move the trunk in a forward position.  This decreases the range of motion of the lunge which make the knees happy plus the forward trunk activates the gluteus maximus more which decreases the stress on the knee extensors.

When it comes to other exercises, try the modified lunge that I talked about above.  You can also try bilateral ball squats against the wall or unilateral ball squats.  This decreases the stress on the knees.  You can also try lunging onto a risor or a back lunge.

Let me know how this goes.

If you have something else to add, just leave a comment in the comment box below.

Here are details on my Knee Injury Solution program:

Thanks for the question, SB

Minimalist Shoes for Day to Day Use

Hi Rick,

Great article on minimalist shoes. I’ve seen them around but had no information as to their benefits. I just simply thought it was another fad shoe.

On that note, I was wondering if minimalist vs traditional shoes are good walking or work shoes (for nurses and/or massage therapists who work on their feet often).

Your insight is appreciated,

CI

I headed off to ask Curb, and this was his reply.

Take it away Curb:

I’d look at a couple of things for shoes that you use for standing in for long periods of time:

1. Wide toe-box.
2. A lower heel drop than regular shoes; you don’t need zero-drop (level heel and forefoot) though you can certainly try this but 4-8 mm is fine.
3. I would add a bit of cushioning and not go with a completely cushion-free sole.

Hope that helps!

Curb Ivanic, MS, CSCS

Thank you CI and Curb.

Tips for New Grads

When the spring comes, I always get asked about tips for new grads.  I will be doing an interview in the future about this.  I just got in touch with an old colleague of mine and he has agreed to do an interview on tips for those going through a human movement or exercise science degree.  Watch for it.

Exercises After Hysterectomy

Hi Rick,

Do you have anything for clients returning to exercise after abdominal
hysterectomy?

Best regards,
JE

Janice,

I do not have anything for that specific condition.

I often times start people off with the exercises in Core Stability of the Back ebook. You can check it out here.

Make sure the person has medical clearance to start an exercise program and the medical team supervising has provided you with exercise guidelines.

Heads Up – Live Courses and Internship

I am working on a bunch of live presentations and an internship.  I will have more details on them soon.

I will put them up here.

That is it for this week.

Have  a great weekend and stay injury free.

Rick Kaselj, MS

.

I know when I talk about core stability, some people will roll their eyes.

There is always a discussion in the fitness world on what the core is and if we should be focusing in on it.

Well when it comes to injuries, I focus on the core.

It is looking like core stability is playing more of a role when it comes to injuries.

I know in previous Injuries of the Month (patellofemoral pain syndrome, sacroiliac joint pain and piriformis syndrome), core stability has been a component of the exercise program that I have recommended.

I wanted to highlight some research that talked about injuries and core stability.

What They Looked At

They looked at 80 female and 60 male intercollegiate basketball and track athletes.

This was very interesting. They measured core stability by testing:

• Isometric hip abduction strength
• Isometric hip external rotation strength
• Back extensor endurance (modified Beiring-Sorensen test)
• Quadratus lumborum endurance (side bridge test)

Interesting Points in the Introduction

• Decrease in lumbo-pelvic (or core) stability has shown an increase in lower extremity injuries, especially in females
• The injuries that females are at greater risk for are: anterior cruciate ligament (ACL) ruptures, patellofemoral pain syndrome, iliotibial band friction syndrome, and stress fratures (femoral, pubic, tibial, and metatarsal).

What They Found

These were the main results from the study:

• Males produced greater hip abduction, hip external rotation and quadratus lumborum measures
• Athletes who did not sustain an injury were significantly stronger in hip abduction and external rotation
• Hip external rotation strength was the only useful predictor of injury status

Rick’s Comments

Often times when we focus on working on the core we think of crunches or bridge variations. It is interesting how this research expands on things further and looks at core function in different planes of movement and different movements. I like the fact that it highlights the importance of looking at hip abduction and hip external rotation strength. Many times this is not mentioned or covered in an exercise program.

Here is an exercise that I give to work on hip movement and strength:

A few comments on the exercise.  The exercise can be used for:

• Educating the movement of hip movement from the rest of the body.
• A dynamic stretching of the hip rotators.
• A body weight active hip rotator exercise.

The directions given and the cueing can change the function of the exercise.

Where to get more information – Leetun DT, Ireland ML, Willson JD, Ballantyne BT, Davis IM. (2004). Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc. 2004 Jun;36(6):926-34.

If you are looking for exercises to strengthen the external rotators of the hip, these are what I use:

Easy and Effective Exercises for Tennis Elbow

I am working on this month’s Injury of the Month. It is Tennis Elbow.

I was doing my research on the injury and came across this article, which was interesting. It talks about isometrics for an injury and really highlights the new trend in exercise rehabilitation.

What They Looked At

They wanted to see if isometric exercises were as effective as medication for pain relief in those with lateral epicondylitis (tennis elbow).

They had two groups:

• Group 1 – Were shown the exercise and then they did it at home
• Group 2 – Began the exercise after 4 weeks of medication

Interesting Points in the Introduction

• An increase in symptoms from exercise will decrease the compliance rate to the exercise program
• Performing the exercises too aggressively can increase the risk of irritation or injury
• The above two points are obvious but nice to see them highlighted in an article

Tennis Elbow Exercise Performed

The researchers only gave one exercise.  Here are the details of the exercise:

• The subjects did the exercise in a sitting or standing position with the arms flexed to just below shoulder height.  Then the wrists were moved in a slow controlled manner into extension with the fingers relaxed. The focus was on moving the middle finger towards the elbow in order to target extensor carpi radialis brevis.
• The exercise was performed without pain and in a controlled manner.
• Four sets of 50 repetitions with each repetition being held for 10 seconds, done daily.

What they Found

• After one month, group 1 had a greater decrease in their pain levels compared to group 2
• At 3, 6 and 12 month follow up there was no difference between the groups
• Those that did not feel any benefit from the exercise program after one month were referred on to shock wave therapy

Rick’s Comment

Interesting to see the benefits of isometric strengthening on an injury, specifically with lateral epicondylitis. Isometric exercises are not exciting but effective when it is comes to an injury and the safest of the three types of contractions.

A lot of the research out there focuses on eccentric exercises for tennis elbow. This article highlighted the benefits of an isometric exercise which is less stressful on an injured area.

The number of repetitions was a surprise to me. Over a day performing 200 repetitions or about 33 minutes of exercise sounds like a lot. This is a trend that is occurring in exercise rehabilitation. The standard used to be 1 set of 10 repetition but this is fading away and does not correlate well with what many people do during the day (number of movement cycles performed in a day). Performing low load (isometrics) more frequently transfers more over to what one does on a daily basis and assists in recovery.

Just so you know, the tennis elbow exercise program will be coming out at the end of the month.

Where to get more details – Park JY, Park HK, Choi JH, Moon ES, Kim BS, Kim WS, Oh KS. (2011). Prospective evaluation of the effectiveness of a home-based program of isometric strengthening exercises: 12-month follow-up. Clin Orthop Surg. 2010 Sep;2(3):173-8. Epub 2010 Aug 3.

That is it for another edition of the research review.  I hope this helps you out when it comes to core stability and injuries, plus a great little tennis elbow exercise.

Rick Kaselj, MS

Let’s get to this week’s questions.  Starting off with a question on scoliosis exercises.

Lessons from Albert Einstein about Scoliosis

“Hello Rick,

I have scoliosis which I’ve been diagnosed since I was 14 years old but haven’t taken the time to take care of it.

iIm 20 now and am currently attending a Schroth method practitioner (I own the book, but it’s too complicated and detailed for me), a method where you stretch your tight and short muscles and strengthen the weak. Breathing exercises are also a big part of it but we haven’t gotten any deep with this yet.

Anyway the practitioner I go to said that I should first work on my posture until we get into stretching the imbalanced muscles, so basically she makes me sit on a swiss ball with my back straight, take a wooden rod and mobilize my upper back by doing behind neck presses etc. and then proceed to do exercises like clam shells on a yoga mat. Makes me doubt if I’m heading in the right direction.

I looked through your website and see 2 products that are related to my problem. One Effective Exercises for Scoliosis and the other one is Muscle Imbalances Revealed. Which one would work for me best?

Thanks a lot.”

K

I understand your frustration, I get complaints that I am not technical enough.

I do what I can to keep it simple because if you can’t explain it in a simple manner, then you probably don’t fully understand the information.
I think some guy name Albert said something to that effect:

“If you can’t explain it simply, you don’t understand it well enough.” – Albert Einstein

I would suggest going with Effective Exercises for Scoliosis.

Muscle Imbalances Revealed can be advanced for someone with no fitness or health background, plus Effective Exercises for Scoliosis relates to the challenge you are having.

The manual is written for fitness professionals but I know what will be most beneficial will be the 12 week exercise program.  I tell you what to do and have photos and descriptions of each of the exercises, plus I am always easy to reach if you have a question.

Congratulations on taking control of your health and seeking out solutions.

All the best.

Rick Kaselj

Your Spelling and Grammar SUCKS!

“Hi Rick,

Thanks for all of the great info in your blog posts. You seem very passionate and committed
to your work and seem genuinely interested in hearing feedback on your posts. I’m a registered massage therapist of 14 years and read many different health related blogs and articles, and I just wanted to give you some constructive feedback.

Something that you might consider doing is having a copy editor or at least someone with editing skills scan your posts and articles before you put them up on the web. Spelling and grammatical errors end up being distracting for readers and tend to dilute the professional aspect of the posts. For example: writing “I got a great post for you” rather than “I have a great post for you” is grammatically incorrect and immediately distracts the reader from the following content. If it occurs frequently, it actually undermines your expertise. I understand that you may be going for a more casual way of delivering info to people to make it more accessible, but readers still appreciate good writing. Spell checking posts would also be very helpful. If you are delivering information to the public as a skilled professional and someone with a special skill set, the written form of your information should be equally skillfully constructed. You can still maintain your personality, humour, and individual style in your posts, but cleaning up the spelling and grammar will do wonders for the presentation and quality of your work. It can make the difference between ground beef and tenderloin on a handle!

I hope that you receive this in the spirit with which it was intended. You clearly put a lot of effort and time into what you do! Good luck with your blog!”

Sincerely,

CC

Spelling and grammar have been an issue for me forever.

I once had a sociology instructor tell me in third year university, “It is a disgrace to the university that you made it this far with such poor spelling and grammar.”

That was not much fun.

I Could Use These Excuses:

1. I can focus on the fact that I grew up in a Croatian family and we mainly spoke Croatian but  I keep writing and blogging.
2. I could focus on the fact that I am a little bit of a slow learner.  It may be because I am almost blind but I keep writing and blogging.
3. I could use the fact that my mind races and I have a very difficult time sitting.  I am sure I could go out and get a diagnosis for this, but I keep writing and blogging.

The Truth

1. I had someone edit my stuff, but it would slow down the process of getting things done.
2. I do have a friend that helps me and she goes back and cleans up my past blog posts.  She keeps saying I have improved so much since Junior high school.  I am proud of that.
3. I have accepted the fact that I will only get better with my spelling and grammar if I write and blog more.  Kind of like an elite athlete, you get better with practice or doing.
4. I know my spelling and grammar will frustrate some but those that look past it and see my passion will take what I share and run with it.

That is It

When you read my blog or get emails, expect me to do the best I can at the moment with my spelling and grammar.  I promise you the emails or blog posts have been read twice, spoken out loud twice and spell checked.

If you can not look past one of my weaknesses and see the passion that I have for injuries and exercises as I work to my mission of helping 1,000,000 people become injury and pain free by 2020, then I guess I am not for you.   Good bye.

Rick

Core Stability of the Back

Some kind thoughts from a happy reader:

“I initially bought Core Stability of the back to prepare myself to teach a knee and back pain class.

It was very helpful because Rick was really detailed in the instructions of the exercises which helped me to be effective in teaching them.

I also use them with my other low back clients and have been told that the exercises really helped them. I myself like the mini anatomy lesson in the beginning of the book. The lesson helped me to better understand how the abdominal and low back muscles work together, mainly due to the easy to understand language.

It’s hard to compare this product to other products because there isn’t a lot of post-rehab and corrective exercise products on the market. And what little there is on the market, your products are the only ones I can really afford right now.

I appreciate your products very much because as trainers I feel that we need post-rehab and exercise therapy education because we are increasingly running into clients with these injuries, and many products are dedicated to physical therapists, athletic trainers, and chiropractors, things we can’t really use.

But thanks for what you do, it’s much appreciated.”

Pamela Brown, MA, ACSM-cPT, CSCS, PRCS
Alabama
Exercise Physiologist

That is it for this week.

Have a great weekend.

Rick Kaselj, MS

Looking forward to seeing everyone at this weekend’s Core Stability courses.

Core Stability of the Shoulder

DESCRIPTION:

OBJECTIVES:

I don’t know why I like doing these research reviews so much.

I always end up learning something or it confirms what I am doing.

I try to break them down for you so they are easier to understand and you can get the take home message from them.

For those that want a lot more detail, I have included the reference so you can read the original article.

Lets get to the research.

Do Elite Athletes Have Muscle Imbalances?

What They Looked At:

They looked to see if elite athletes performing team or individual sports had muscle imbalances.  They looked to see if they did with MIR investigation.

What Did They Find?

They found a variety of muscle imbalances in the trunk and pelvic region.  They feel muscle imbalances may be related to injuries athletes get.  They suggested that each sport needs to be looked at to determine what muscle imbalances are common and what specific muscle rehabilitation can and needs to be done.

So What?

It shows that athletes do have muscle imbalances.  It is tough to say if these imbalances are needed in order to excel in their sport or are leading to injury or decreased performance.

It is cool that the concept of muscle imbalances is being discussed more and more.  Even in research papers.

I wish I had more to say but I was not able to get the full journal article as it was still being processed.  I look forward to getting it soon enough.

It was interesting that they identified muscle imbalances using MRI, I have never heard of this before.

Where to get more information:  Franettovich M, Hides J, Mendis MD, Littleworth H. Muscle imbalance among elite athletes. Br J Sports Med. 2011 Apr;45(4):348-9.

Is a Single Leg Squat a Good Indicator of How Your Hip Functions?

What They Looked At:

The researchers wanted to see if a single-leg squat was a good tool to determine poor hip muscle function because lately the focus of addressing knee pain has been by focusing on the hip.  They felt that people that performed better on a single leg squat would have earlier onset of gluteus medius activity, greater lateral trunk strength, greater hip abduction strength and greater external rotation strength.

They had 5 people evaluate 34 participants when performing a single leg squat.  They measured the muscle activity of the participants when it came to their hip strength based on electromyographic activity.

What Did They Find?

They determined that a single-leg squat is a good tool to determine if someone has poor hip muscle function.

So What?

I have been using the single-leg squat for an assessment for a long time and use it in the Core Stability of the Hip program.

It just highlights that getting your client to do a single-leg squat is important and will give you a good idea of what you need to focus on in your exercise program.  If you or your client perform poorly on a single-leg squat, you will need to work on gluteus medius, lateral trunk, hip abduction and external rotation strength.

Where to get more information:  Crossley KM, Zhang WJ, Schache AG, Bryant A, Cowan SM. Performance on the single-leg squat task indicates hip abductor muscle function. Am J Sports Med. 2011 Apr;39(4):866-73. Epub 2011 Feb 18.

What is a Good Test for the Core?

What They Looked At:

They looked at a dynamic core test of a chop and lift test and compared it to a static endurance posture tests of the Biering-Sorensen and side-plank.

Cool Points that Were Brought Up:

- “Trunk musculature absorbs, produces and transports multidirectional forces to and from the upper and lower extremities by maintaining a balance of stability and mobility.”

- “Researchers have hypothesized that defects in muscular capability (power, strength, endurance) and motor control (amplitude, timing) lead to poor trunk stabilization and can alter performance or increase injury susceptibility.”

What Did They Find?

The chop and lift is a good power test to test dynamic trunk control.

So What?

I have seen the chop and lift around for a while.  I have not used it very much but I will now.  I will use the two endurance tests to measure directional endurance for the core but will add the chop and lift in order to look at more dynamic core function.

Always great to take the time to read these research articles.

Where to get more information:  Palmer TG, Uhl TL. (2011). Interday reliability of peak muscular power outputs on an isotonic dynamometer and assessment of active trunk control using the chop and lift tests. J Athl Train. 2011 Mar-Apr;46(2):150-9.

That is it for today.

Time to put the papers away and head to work.

Have a great day!

Rick Kaselj, MS

.

I was training a client and she was getting knee pain when she was squatting.

I wanted to share with  you what I did it in order to get rid of her knee pain when she squatted.

I know it will help you and your clients.

Your Core Maybe Causing Your Knee Pain

The squat is important but at times it can bring on knee pain.  If you do get knee pain when you squat, look at your core strength.

This is not the only thing to look at, but one of the things to look at.

Let me explain what I mean.

When we are standing, we don’t use much of our core.  When our trunk or upper body starts to move forward, we need our core to support and stabilize our spine.

The trunk moves forward when we do a squat.

If our trunk moves more than 45 degrees forward, the extra weight of our bodies moves over the balls of our feet and leads to greater activation and stress on the knees by pressing the knee cap (patella) and the knee joint together.

This shift in weight is a compensation pattern for a weak core.

If you move your upper body so your trunk is less than 45 degrees, you put greater stress on your core. The deep and superficial muscles of the core have to work harder to keep you in the position but this also shifts your weight so it is over the middle of your feet and heels.  This shift in the weight on your feet will decrease the stress on the knee.

Now lets go through some exercises you can do to improve your core when squatting.

How to Strengthen Your Core For Less Knee Pain

Standing to ¼ Squat

You can begin by moving from standing into the squat position with the trunk less than 45 degrees forward.

I teach this with one hand on the stomach and one hand on the lower back.  I get my clients to activate the core and then move from standing into a squat position.

I will get them to hold the squat position for 10 seconds and then move back into standing for 10 repetitions.

We are working on the activation, endurance and strength of the core, and good motor patterns for the squat.

¼ Squat Exercises Exercises

After they have mastered the “standing to 1/4 Squat” exercise, I will get them to hold a 1/4 squat position and perform a variety of exercises.  It can be narrow grip rows or pec fly exercises.  They activate their core and hold the quarter squat position during the full set of the exercise.

I hope this gives you some more ideas on what to do if you or your client has knee pain when squatting.

Before I go, here are some kind words that I just received.

Here are some kind words that I received about Knee Injury Solution from a Personal Trainer and Pilates Instructor:

Rick’s Knee Injury Solution program is without a doubt a huge asset to anyone! I was excited to find out that many of the exercises are easily incorporated into a regular training routine without even noticing.  Many of the things we already do, such as planks, but Rick lays out how to put them together in proper progressions to gain success!  What is also great, is that you don’t need to have background knowledge to understand the program.  More and more people are complaining about knee, hip and foot pain, why not address these issues now?  Anyone can do the Knee Injury Solution program with Rick’s simple, progressive explanations of not only how to perform each exercise, but how to perform the exercises correctly (or correct for instabilities).

Knee Injury Solution is a tool I needed to get my clients permanent results. Thank you Rick for your insight!

Stacey Prejza

Kind Feedback from a Personal Trainer that Has Been Helped by Muscle Imbalances Revealed:

That is it.

Thanks for reading and we will talk to you soon.

Rick Kaselj, MS

Core Stability of the Lower Back

DESCRIPTION:

OBJECTIVES:

Yesterday, I headed to the big city (Vancouver) and did an in-service for the personal trainers that are part of the personal training department at the Arbutus Club.

The week before was a private in-service in Richmond and this week it was Vancouver.  It has been a lot of fun doing these small and personal in-services.

I just got another invitation from the City of Burnaby to share some of my tips, tricks and exercises to their group fitness instructors, weight room instructors and personal trainers.  I am looking forward to hearing what they would like me to share.

If you would like me to come out to your fitness facility to share some information on exercises and injuries, just send an email to support(at)exercisesforinjuries.com .

While I was out in Vancouver, I had done a video for you after my in-service at the Arbutus Club.  I thought I had the camera on the right setting for video recording but I guess I just took a picture of myself.

Here is the goofy photo:

I had done the video on a foot issue that one of the trainers had and what she can do about it.  I will re-do the video and get it to you next week.

Now lets get to a question that came up during the in-service.

One of the trainers asked:

What do you do when your client just wants to work on their 6 pack?

#1 – Education on 6-Pack and the Core

Start off with education on the 6-pack and the importance of the core as a whole.

I know this can be tough.  With many of our clients, it is hard to change 20 year old beliefs.  Change needs to start somewhere and you can do your best to get it moving.

Rectus abdominis (6 pack) is important for a healthy body, but equally important are all parts of the core.

Take some time to educate on what the 6 pack is, what the core is and how they work individually and together.

I go through this in detail in the Core Stability of the Rehab Client (Focus on the post injury client) and Core Stability of the Back (Focus on the fit and healthy client) courses.

#2 – Muscle Balance and Imbalances

The world will not end and the client will not break if they do some 6 pack or abdominal training but we want to balance out the body by working out all parts of the core.

Focusing on one part of the core will lead to muscle imbalances which will lead to pain, injury, decreased fitness results and poor performance.

#3 – Plane of Movement Core Training

When it comes to training the core, I look at training the core in three planes of movements for the healthy and fit client.

Sagittal Plane (Forward and Back Movement)

If your client wants to work 6 pack with traditional abs exercises, that is fine but I want to balance things out by working the opposite direction of the sagittal plane.

I would get them to work on the lumbar extensors (lower back).  For example, I would get them to do Superman’s and back extension exercises to neutral.

Therefore we have balanced out the sagittal plane and we have countered the forward bending (flexion) movement that has been done with the abs exercises.

Frontal Plane (Side to Side Movements)

I would follow up the sagittal plane movements with frontal plane movements (side-to-side movement).

One of the exercises that I like are side planks.

Transverse Plane (Rotation Movements)

Lastly, I would move to transverse plane movements (rotation).

One exercise that I like is moving from a side plank to a front plank.

Sum It All Up

It is always a difficult balance between providing what your client wants, preventing injury and future benefit.

If your client does the 3 sets of exercises above, they will feel their core and get a better burn than if they just did crunches.

Rick Kaselj, MS

P.S. – If you want more resources on abdominal training, core training and back injuries, here are some for you.

Live Courses that Will Interest You:

• Exercise Rehabilitation of the Lower Back

• Core Stability for the Rehab Client

Some Core Products that May Help:

• Core Stability for the Rehab Client DVD course

• Core Stability of the Back

That is it.

Have a great day.

I had a tough time getting started today.

It’s one of those days when I was not sure of what to write about.

But, I think I got it.

Here we go.

Private Knee Injury Course

I have been asked to do more private fitness education classes for fitness professionals in the Vancouver area.  Companies and fitness professionals have been asking me to come to their facility and teach a group of 5 or 10 people about an injury topic they are interested in.

It has been fun getting these personal requests and setting up private fitness education courses for them.

In March, I have another one for a group of fitness professionals who want me to talk about knee injuries and exercises.

They have some specific questions about what to do with collateral ligament and meniscus injuries.

I know what I would do, but I always like to head to the research to see what’s new.

I am reading this article right now:

Edson CJ. (2006). Conservative and postoperative rehabilitation of isolated and combined injuries of the medial collateral ligament. Sports Med Arthrosc. 2006 Jun;14(2):105-10.

The article is okay -  there’s a strong focus on diagnosis and what to do right after the injury.

Not much about what you should do when it has been multiple months (or years) since your medial collateral ligament other than wear a brace.

I will have to keep searching.

The main thing that I do is look at the hip and the core stability of the hip.

When it comes to the medical and lateral collateral ligaments, they provide stability in the frontal plane (side to side) and so does the core stability of the hip.

When the core stability of the hip is poor, it puts greater stress on the collateral ligaments.

One thing I make sure to do is assess and look at the hip, to make sure it has good stability so that there is less stress put on the collateral ligaments.

Special Population Cheat Sheets

I have been looking at the last few Strength and Conditioning Journals.

In the last few issues, they have included a cheat sheet covering what to do for specific special populations when it comes to designing an exercise program.

The one I am reading now is multiple sclerosis.

I have been saving them on my computer and putting them into my “Special Populations” folder.

I am going to refer back to this one, and to others I find.

If you get the journal or have access to the journal, I would recommend doing the same.

A Few More Kind Words

“Plantar Fasciitis Exercise Solution is a very comprehensive program that not only describes the causes and consequences, but also tells you how to go about healing the problem and giving relief where possible.  Provides alternative ideas to suit all clients/patients.  The best thing of Plantar Fasciitis Exercise Solution was the whole thing really.  Specific advice for exercises and stretches, what to avoid and what to do.  Great!”

Joanne Butler

Bendigo, Australia

Fitness and Athletic Development Coach

Well that’s it, have a great day.

Rick Kaselj, MS

.

Last week, I headed to the gym to workout with Lou Schuler and Alwyn Cosgrove.

Well kind of.

I took their new book, The New Rules of Lifting for ABS to the gym with me.

I did a workout based on the exercises in their book, and I wanted to go through some of the exercises that I liked.

#1 – Dumbbell Two-Point Row

Start Position

End Position

I am a big fan of unilateral work.  I focus on this a lot in my Lumbar Fusion Exercise Program.

Technique:

Select a dumbbell weight that you can do 8 to 12 repetitions with.  Beginning in a hip width to shoulder with stance.  Activating the core and bending the upper body at the hips while still keeping the upper body in alignment.  Have the dumbbell straight down while still activating your scapular muscles.  Lift the dumbbell up while focusing on pulling through with the elbow and having the muscle around the shoulder blade do the work.  The core is activated preventing movement in the sagittal (forward and back) and transverse (rotation) planes.

#2 – Dumbbell Offset Squat

Read the rest of this entry »

Advance Core Stability

DESCRIPTION:

OBJECTIVES:

Core Stability for the Rehab Client

DESCRIPTION:

OBJECTIVES:

I took an hour off to head into the coffee shop and look at some journals.

I am sitting here, listening to Christmas music and checking out what is new in the journal world.

Here we go with the first article.

Do the Buns in a Pitcher Affect the Shoulder?

What They Looked At

They looked at the relationship of how the movement of the pelvis and torso (trunk) affected the shoulder in high school pitchers during the pitching movement.

Cool Points

I like reading the discussion of a research paper as there are always really cool things in there, like this:

- the trunk leads to 50% of the kinetic energy and force produced during throwing

What They Found

They found that the rate of torso rotation strongly related with the shoulders.

Baseball pitchers may exhibit a decreased ability in controlling torso rotation which increases the risk of shoulder injuries.

They feel high school pitchers, when performing their strength training, should focus on creating a strong core, including gluteus maximus, in an attempt to control the rate of torso rotation.

Take Home Message

I think the above results can translate over to others, even if you are not a high school baseball player.

Torso Rotation – Working on torso rotation is important for all.  Doing exercises that work concentrically, eccentrically and isometically is very important to prevent shoulder and lower back injuries.  You can do this with plank variations.

Gluteus Maximus Work – It is important to do gluteus maximus work in your exercise program.  It has to be more than just squats and deadlifts.  Single leg work is more transferable to real life when it comes to gluteus maximus.

Where to get more info – Oliver GD, Keeley DW. (2010). Pelvis and torso kinematics and their relationship to shoulder kinematics in high-school baseball pitchers. J Strength Cond Res. 2010 Dec;24(12):3241-6.

I go through some of the gluteus exercises I use in The Most Effective Gluteus Maximus Exercises :

Read the rest of this entry »

Hey, it is Friday and I am going to ramble.

It has been a while since I actually rambled on Friday.

I Know You Are Sick of If, But I am Not

The rave reviews and incredible feedback for Muscle Imbalances Revealed 2.0 keep pouring in:

“Muscle Imbalance Revealed 2.0 has proved an invaluable investment. As a strength and conditioning coach working with swimmers from all age groups, Muscle Imbalance Revealed has provided me with a wealth of new insight into the role and function of both the hip and shoulder.  Through both the assessments and mobility exercises both myself and my athletes have a much better understanding of imbalances and how to correct them. It is an amazing educational tool and I highly recommend it.”

I am very thankful and happy that MIR2 has been able to help so many trainers, coaches, and therapists from around the world.

Read the rest of this entry »

Another research update.

I am so glad I take the time to do this.

There is all kinds of great stuff that comes out every week.

The Problem with Overtraining Your Abs

The article focused on those performing Olympic lifts but they did bring up some interesting points that can be carried over to injured client.

In order to hold a load over head you need good stability in the flexors and extensors of the trunk plus good deceleration of the flexors of the truck.  Not being able to do so increases your risk of injury and decreases you ability to hold a load overhead.  This is important for the athlete but also the general public.  Overhead movements are essential for all and have been avoided of late in the fitness industry due to the perceived risk of injury.  I make sure I do a least one over head pressing movement with my clients but if your client can’t do a proper overhead weighted movement make sure to look at their trunk flexors and extensors.

Many times truck flexion (abdominals) exercises are done on a daily basis while lower back exercises maybe done 2 to 3 times a week.  This leads to muscle imbalances in the flexion and extension muscles of the trunk.  This imbalance could lead to an alteration in the tilt in the pelvis which had an effect on latissiums dorsi which an increase the risk of injury in the shoulder.

The writers provided a sample exercise program to train the trunk flexors and extensors.  The exercises were lever abdominals, medicine ball seated twists, bridge with arms lifted, marching bridge with arms lifted, dumbbell farmer’s walk, supine weighted extended hold, hyperextensions with arms out straight , hyperextension to row with
weight (medicine ball or plate), hyperextension with weight (plate or medicine ball), and barbell over head circle walks.

I wrote a little report on core training that may interest you.  Here you go:

Read the rest of this entry »

What I do When a Back Flare Up Hits

Yesterday I has my first back flare up in about two years.

I was a work and I was in an awkward posture lifting something.  As soon as I lifted, I felt that little click.  I hoped it was nothing but I could feel the pain increase in my back and all the muscle in my lower back tighten up.

I was right in the middle of work and could go now where.  I had to keep working.  There was no lieing down.  I had to take care of it right now.  I was able to get through the day by managed my back pain and doing 3 things to decreased my lower back pain.

Let me share with you a three things that I did right away as soon as I felt my lower back flare up in order to decrease the pain.

Read the rest of this entry »

Hey, it is Friday, lets ramble.

Well, let me ramble.

More Rambles about Facebook

It is very cool to get comments like this on my Facebook account:

Read the rest of this entry »

I just got the latest issue of BCAK Kinnected magazine.

There were a lot of great articles in it and they also were kind enough to publish one of mine on abdominal hallowing and hamstring injuries.

I don’t know why I keep typing hallowing, it should be hollowing.

Since it has been printed in the magazine, I am now able to share it with you.

It is one of those research summaries that I have done a number of times and fitness professionals have liked them.

Lower Abdominal Hollowing During Prone Hip Extension May Prevent Hamstring Injuries

What is the Big Deal?

Details of the Study

Review of Core Stability for the Rehab Client DVD

Read the rest of this entry »

I was up in my office on Saturday night while my wife was putting our son to sleep.

I took a few minutes to look over some journal articles that came out.  I have highlighted some that may interest you.

Using Core Exercises to Rehab Your Diaphragm?

Adding Balance Training  for a Total Knee Replacement Client is a Good Thing