The Knee Bone’s Connected

I can feel the eyeballs of my loving wife grinding into my right ear as I stare at a woman running down the sidewalk.  I can understand the glance, it makes sense, and if she was to stare at some young gun guy jogging up a hill, I’d probably do the same.  However, I have to claim ‘professional interest’ as my reason for watching the runner.  I can’t help it.  When I witness two knees knocking together to the point of a friction fire I have to stare.  I have to wince and I have to wonder how many injuries that person has or will suffer from.  When I see feet  flaring out like they are tied to the persons elbows, I shudder at the thought of the $500.00 orthotics that someone put those feet into in an effort to ‘stabilize’ their foot fall.

On the other foot (see what I did there?) I find myself nodding approval at the graceful gait of a talented runner.  The commonalities amongst those good runners are a confident, upright posture, a ‘stack’ of shoulder, hip, knee and ankle perfectly lined up on top of one another, light arm movements and a relaxed, happy face.  I’m not quite there myself, unless I’m on a trail.  I can bounce and bound through the woods for hours.  On the road, I start to feel old biomechanical issues raise their painful heads within about an hour.  Usually my calves start to act up and I know that they struggle because my hamstrings need to do a bit more work.  I could go on with the CSI list of reasons that my gait gets ugly, but I digress.

I have the pleasure of training a particular young girl.  She is going to be an absolute force in whatever sports she settles into as she matures.  At the moment, she’s into lots of different things with hockey and soccer being the two main joys.  I’m niggling at track as a potential hot spot for her as I watch her develop but we will wait and see.  When I started with this client, her knees, and the right one in particular, raised a few red flags.  When she ‘loaded up’ or basically prepared to jump or run, her knee would rotate inwards and her foot would roll on to the inside of her shoe.  If you’re a trainer, you likely just nodded your head because we see this quite often, particularly in young female athletes.  Now, I’m not going to delve into all the Latin terms for what’s happening here.  I can’t stand the ‘Latin dropping’ that many training professional like to do.  Again, I had best digress although this Latin thing would make a good writing topic.  I actually took Latin in school, for a WHOLE YEAR and the only thing I remember is ‘Ecce Romani’ (speak Latin).  That was the title of the text book.

The reaction of the knee joint to a load is an interesting thing.  It opens up all kinds of potential training issues if it is not just so.  In young female athletes, the inward rotation of the knee upon loading is a red flag for potential knee injuries of which an ACL tear would be one of the most traumatic.  However, it can also relate to hip pain, shin splints, ankle sprains, foot pain…on and on.  So, back to my client.  What to do?

Young athletes need to learn how to move efficiently.  The beauty of this reality is that young athletes actually can learn to move.  Older athletes (in their late teens or early twenties) seem to have a harder time in relearning faulty movement patterns.  The young pups can be shown how to jump and go straight to it.  They can adjust a knee position or turn a foot slightly in with just a demo and a little prompting.

In this training instance, I started by teaching my client to coordinate her body through low load, simple movements such as body weight squats and lunges.  I included them in her warm up series as a means of not only getting her moving but also to hide the medicine in something fun.  We then took those movements and added to them.  For example, the lunge turned into a lunge with a ground touch to a back step into single leg balance.  Lots of steps there but she knows what it means.  We began to increase the load of her movements all while ensuring that she maintains solid biomechanics.  Yesterday, she completed some dynamic lateral bounds (hockey style) while maintaining the stack of shoulder, hip, knee and ankle.  It was a breakthrough of sorts and opened up a variety of additional training options for our workouts.  I’m very careful to never promise ‘no injuries’ to my clients.  The opposite is likely true.  Almost every person who competes gets injured in one way or another however, I can tell this client that her likelihood of certain injuries has decreased due to the fact that she has learned to move efficiently.

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