There were so many great entries, and a lot of nice things were said about myself and my various products. Thank you so much.
Just after the video below, I headed into the Fitness Centre in the recreation center to train a rotator cuff injury client that came from Victoria to see me. While I was there, I saw 4 other fitness professionals that recognized me and who had very kind things to say about the blog. Thank you.
Now, here is what people have been waiting for:
The Winner of the Knee Injury Solution program is……
This is what the Winner of the Knee Injury Solution Program gets…..
Can the Knee Injury Solution Program Help You or Your Clients?
If you would like to see if the Knee Injury Solution could help you with your knee injury or your clients with knee injuries, CLICK HERE to find out.
Thank you so much for reading the blog and for leaving comments.
Please keep commenting even if there is not a prize to be won!
Have a great day, and I will talk with you on the blog soon.
This is what is included in the Knee Injury Solution Program:
9 exercises that you can do to prevent knee pain
A quick 10 minute workout that you can do anywhere to make your knees stronger
The exercises to do after knee surgery to increase range of motion and decrease pain
Exercises to do in order to make walking easier and pain-free
A guide for those that have knee pain due to an ACL injury to read and have a better understanding of their injury
This is what you have to do in order to be eligible to win a copy of the Knee Injury Solution Program:
Go to the comment area and answer this question: “How will having a go-to exercise program for knee injuries help yourself or your knee injury clients?”
It’s that simple.
I will be reading all the comments over the next few day and will pick the winner Monday evening.
An injury involving the anterior cruciate ligament is a serious matter. The ACL is not adequately supplied by blood, which contains oxygen and the nutrients needed for tissue repair and healing. For this, an injury involving the ACL may take some time to heal, if at all. Over time, this can severely limit your physical activities, mobility, and independence. For severe tears, it may take 6 to 12 months (or longer) to restore knee function. Re-injury is also frequent once your ACL has been torn, resulting in degeneration of the knee joint.
In complete ACL tears, a surgical procedure is the most likely recommendation to avoid further injury and re-injuries and to restore stability. Although the results of an ACL reconstruction are promising, the cost is financially damaging. In the United States, a reconstruction costs between $20,000 and $50,000. An additional $3,000 is required for rehabilitation and follow up rehabilitation visits.
A neuromuscular training program is the best and most inexpensive way to prevent the occurrence and recurrence of ACL injuries. This training program consists of specialized balancing, stretching and strengthening exercises of the knee’s dynamic stabilizers, agility drills and plyometrics. These activities aim to improve knee stability on jumping, landing and pivoting. This program retrains you to use and move your body correctly, specifically the muscles and tendons surrounding the knee.
Neuromusclar training exercises are usually completed within 15 minutes. It is recommended that these exercises be included in your regular exercise regimen 2 to 3 times per week.
The incredible success of Muscle Imbalances Revealed 2.0 has really taken the industry by storm.
Trainers, coaches, and therapists from around the world have been using it to help their clients overcome injuries, bust through fitness plateaus, and prevent injuries.
It has been amazing to see how this little product has helped thousands of fitness & health professionals, which in return has helped hundreds of thousands of people.
Sad to say, the battle continues.
We need to do more to better understand, assess, and prescribe exercises to eliminate muscle imbalances.
In 2011, there will be more and more emphasis on muscle imbalances.
Muscle Imbalance is my #8 Exercise Rehabilitation Prediction for 2011
In fact, I just got approached by an Australian outdoor magazine to write an article on muscle imbalances and how it can affect the outdoor athlete. Very cool. I will let you know how it goes.
With the media starting to focus on it, so has the research.
I know these days we all get lost surfing the internet.
A site I visit, and visit to often, is Pub Med.
Pub Med is a site that is full of the latest and oldest research. I always go to take a look at what is new when it comes to exercise and injuries.
I know, kind of strange.
One injury I have been seeing more of is tendinosis.
Just last week I got an email from a fitness professional that does group fitness classes that has had 5 months worth of Achilles tendinitis issues from all the step classes she has been doing. My guess, it is Achilles tendinosis.
So, I will call the increase in tendinosis as Prediction #7 in Exercise Rehabilitation 2011.
Tendinitis versus Tendinosis
The first step is to define what tendinitis is and tendinosis is.
Better yet, I found a table that describes it much better than I could.
What are the best exercises for a disc herniation?
How do you do core regressions?
What can you do about SI (Sacroiliac) joint issues?
When should you do rotation exercises?
Keys to proper squatting.
What are the key relationships between the knee and hip?
How do you increase (gluteus maximus) function?
What trainer, coach, and therapist does not want to have one or more of these questions answered by one of the best?
So cool.
I am so excited for the weekend.
I am ready to learn and so is the small group of people, ranging from medical doctors to group fitness instructors, that have come from around the world to be here.
Having your questions answered from the best in the world in an intensive weekend seminar/course is so great.
I love bringing the best to Vancouver and can’t wait to bring more of them, like Justin Price.
I will have some more information on what I learned and some video clips from the course.
I have heard you loud and clear on the things that you want to see when it comes to injuries – elbow injuries, ankle injuries, shin splints, iliotibial band syndrome, tensor fascia latae issues, acute injury recovery tips, chronic pain injury tips, and dealing with pain at the back of the knee when walking. I will be working on this throughout 2011.
Let me clear out a few of the papers that I have put to the side and still need to look at. Now let’s get to the article.
What They Looked At
They looked at 10 anterior cruciate ligament (ACL) injury videos from women during handball and basketball in order to determine what biomechanical factors lead to the ACL injury.
Here is an example of the injury that they looked at:
What they did for the video analysis was very cool in the article.
Cool Points
Few cool things that they said in the introduction:
Noncontact ACL injuries in women occurring during cutting or one leg landing movements.
What They Found
At initial contact there was a valgus movement (knee going in).
The tibia rotated internally and then externally.
ACL injury occurred at about 40 milliseconds mark after initial contact.
The mechanism of injury was the valgus movement of the knee with the tibia rotated internally, and then after the tear, the tibia externally rotating.
The valgus and internal rotation movements contributed to the ACL injury.
A few other things that are not in the abstract:
6 injured left knee and 4 right.
ACL injury occurred during the game and were handling the ball.
There was a rapid valgus movement of 12 degrees.
There was a low flexion angle and injury.
Here is a great visual from the paper that I thought was great on how they feel a noncontact ACL injury occurs:
Take Home Message
Focus of a Prevention Program- Prevention programs should focus on good cutting and landing technique with knee flexed and without valgus loading of the knee.
More than Lines and Side Shuffle- I remember when I played basketball. All we would do for prevention were lines, side shuffles, and drills. This does not cut it anymore. More needs to be done with landing and preparing the knee in all planes of movement. This can easily be done with an 8 minute program that focuses on neuromuscular re-education of the knee. This can be done before a game or as a drill during practice.
Where to get more info – Koga H, Nakamae A, Shima Y, Iwasa J, Myklebust G, Engebretsen L, Bahr R, Krosshaug T. (2010). Mechanisms for noncontact anterior cruciate ligament injuries: knee joint kinematics in 10 injury situations from female team handball and basketball. Am J Sports Med. 2010 Nov;38(11):2218-25. Epub 2010 Jul 1.
I was there to live one of my dreams, which was to go to the NCAA March Madness Final Four Basketball Tournament.
It was an amazing experience.
Yes, it was Madness.
While I was out there, I met up with Mike Robertson.
While we were chatting about things, we did a quick video answering a question that I got from a blog reader about knee pain.
Have a look and listen to what Mike had to say:
(REMINDER – The Bulletproofing Your Client’s Knees & Lower Back Course increases by $100 this Wednesday. So if you want to go, save $100, learn great practical stuff, and get your CECS, CLICK HERE)
I like when I get to go to conferences, seminars, and courses. I learn a bunch of new stuff, and am reminded of stuff that I forgot – plus I get to meet other trainers, coaches, and therapists.
The cool thing I have seen of late is health and fitness professionals specializing more.
As you know, my specialization is effective exercises for injuries.
One person I ran into that specializes is Rochelle Gravance.
I have interviewed Rochelle before. CLICK HERE to view the other video I had done with her on knee pain.
You Need More Than Exercises to Overcome Knee Pain
Muscle Imbalances Part 2: The Long and Short of It
In the previous post, we looked at how a muscle can become overactive to compensate for a reduction in function somewhere else in the body.
The example of tight hip flexors from weak ankles was brought to the surface, and the concept of strengthening the problem to correct the symptom was discussed.
A lot of people weighed in on this concept with dismay that stretching tight muscles would not allow that muscle to lengthen!! For this post, we will look at another classic case of muscle imbalance and overactive fatigue, the hamstrings.
The 3 Hams
The three hamstring muscles cause the knee to flex and the hip to extend, and when activated on either the medial or lateral aspects, can cause tibial internal and external rotation and hip internal and external rotation. This is because it is a big two-joint muscle and plays a big role in pelvic function as well as knee integrity; it can play a huge role in the health of our backs, hips and knees.
One of the hallmarks symptoms and predisposing factors of low back pain is tight hamstrings.
We could look at this as being a chicken versus egg situation: did the tight hamstrings cause low back pain, or did the low back pain result in tight hamstrings?
If we look at a typical office worker, they tend to have a slightly kyphotic posture that gets worse over time. These desk jockeys will lose lumbar extension capability, tilting their pelvis and positioning it so that their hamstrings are effectively shortened. To provide some measure of stability to the now dysfunctional low back region so the keyboard hulks can keep their posture hovering over their computers, the hamstrings tense up and pull the back into a rigid, yet immobile structure.
What is the solution?
Stretch the tired hammies that are only trying to keep the place together?
If we stretch them now, the back will lose stability, and injury to the back will likely occur. This would be like taking structural supports away from a dam and hoping we have enough towels to clean up the mess afterwords.
With most back injuries where people are locked into a kyphotic posture, the major range of motion lost is spinal extension, and the affected muscles causing extension become stretched and weak. In this state, the hip flexor becomes the major muscle capable of causing some amount of spinal extension by pulling on the front of the vertebrae, which creates a shear force within the spine and pressurizes the discs, leading to an increased risk of injury. The hamstrings will balance this out by pulling the pelvis into a posterior tilt, which further pressurizes the discs and creates an imbalance between forces pulling the vertebrae down onto the discs versus those that pull up on the vertebrae. This will likely lead to disc issues, soft tissue trauma, and a lack of leg strength and back strength.
In the guest blog post Jon-Erik talks about something that has been a buzz in the fitness industry of late, barefoot running.
Take it away Jon-Erik.
To Barefoot Run?
I’ve been asked lately what I thought about barefoot running and found myself unable to answer. While I have read that everyone should run barefoot because it reduces injury risk and forces a more natural running stride, I also read that barefoot running wasn’t for everyone. Apparently, because of the barefoot running craze, physical therapists were still busy with running injuries…not from those wearing supportive shoes, but those who thought they could run mile after mile barefoot!
Barefoot running has received a lot of attention lately thanks to books like Christopher McDougall’s, Born to Run.
This entertaining book comes highly recommended to running enthusiasts, and is about the Tarahumara tribe based in northern Mexico. This tribe is also known as Rarámuri, which means “runners on foot” or “those who run fast.” The Rarámuri run in homemade sandals that only provide a thin barrier to the rocky, desert terrain – without injury. This is a very interesting fact considering they run extremely long distances (up to and more than 100 miles at a time).
Today I wanted to go through an effective exercise program for patellofemoral pain syndrome or runner’s knee.
Lets look at a research backed exercise program for runner’s knee.
What is an Effective Exercise Program for Runner’s Knee?
What They Looked At
The looked to see if a supervised exercise program helped with respect to recovery, pain, and function in patients with patellofemoral pain syndrome.
The Exercise Program They Did
People with PFPS were given a standardized exercise program for 6 weeks that was modified to the individual and was supervised by a physical therapist. They visited the physical therapist nine times in 6 weeks. In addition, they were instructed to practice the exercises daily for 25 minutes over a period of 3 months.
They looked at knee and hip motion during stair stepping (ascending and descengin) in female athletes with and without PFPS.
What they Found
What they found was females with PFPS descend stairs with the knee in a more flexed position and have the hip in a more adducted and internally rotated position at foot contact during stair stepping at a comfortable speed.
Take Home Message
The take home message is for those with PFPS, their gluteus medius is not working and needs to be addressed. I go into this in detail in the Core Stability of the Hip program.
Where to get more details – McKenzie K, Galea V, Wessel J, Pierrynowski M. (2010). Lower extremity kinematics of females with patellofemoral pain syndrome while stair stepping. J Orthop Sports Phys Ther. 2010 Oct;40(10):625-32. Read the rest of this entry »
I had a few emails from people asking for videos of ACL surgery.
I spent some time on YouTube and picked out the best ones I could find.
Here are two.
I hope they help show you what an ACL injury is, how they determine if you have an ACL injury and how they do the ACL surgery.
ACL Injury & Surgery Information
I like this video because there is great information on what the ACL is, causes of an ACL injury, how they test for an ACL injury, how they determine an ACL injury and how they do the ACL surgery.
If you missed part 1, you can see it here. If you missed part 2, you can see it here. If you missed part 3, you can see it here. If you missed part 4, you can see it here.
Risk Factors and Incidence
It is estimated that the overall ACL injury rate in the United States is about 200,000 annually. This figure suggests that 1 in 300,000 individuals in the U.S. will sustain an ACL injury for the first time each year. ACL injuries commonly occur between the ages of 14 and 29 years, occurring in non-athletes and athletes. Those engaged in football, soccer, basketball, soccer and skiing activities are the most susceptible to ACL injury in the athlete group.
Female athletes are more susceptible to ACL injuries than male athletes performing similar sporting activities and training. It is estimated that female athletes are 2 to 8 times more likely to sustain ACL injuries when compared with their male counterparts (Souryal & Adams, 2009).
Many factors have been attributed to the increased susceptibility of women to ACL injuries. Females have a narrower femoral notch, or the space at the bottom of the thigh bone where the ACL runs. This tight fit may cause increased friction between the ACL and femur during knee movements. Another possible cause is the greater Q angle, or the angle between the quadriceps and the patella tendon, in women. A larger angle is partly caused by a woman’s wider pelvis. This increases the risk for greater stress and ACL injuries. Other factors include increased joint laxity, inadequate strength and impaired neuromuscular coordination.
Let’s make just one giant assumption and assume that you know all about Wolverine from X-Men.
You know he possesses animal-keen senses.
You know he competes like a super-human weapon.
You know he has retracting bone claws made from space-age metal.
And, perhaps, most importantly, you know he possesses a special healing factor that allows him to quickly recover from virtually any wound, disease or toxin.