Today’s guest post comes courtesy of my wife Dr. Lisa Lewis who, later this summer, will be one of the presenters taking part in the Soul Sista Summit here in Boston the weekend of June 22nd.
As a psychologist, a performance consultant, and a lover of personal evolution and enhancement, I often talk to clients, trainers, coaches, and students about their dreams and their endeavors.
Whether they are personal, professional, or fitness-related…goals shape habits, require focus, motivation, and regulate how we execute all kinds of behavior. Typically, I hear people focus on their “weaknesses” – the barriers to behavior change, the “bad habits” that get in the way of change, the disappointments they feel toward themselves.
This negativity bias is natural.
We are inclined to focus on the negative, and for negative experiences and emotions to weigh more heavily on us than positive ones. Research on negativity bias demonstrates that a significantly higher ratio of positive emotions are required to counter balance negative ones – in other words, we need many, many more compliments than we do criticisms.
We need more pats on the back, and less kicks in the ass.
My clients will naturally beat themselves up, tear themselves down, and be hard on themselves, and have been working hard on those interventions prior to meeting with me. In my years of clinical and performance-enhancement work, I have come to see clearly that I will not add value or help to facilitate change by doubling-down on negative thoughts and feelings, or by centering goals around “weakness.”
Instead, I utilize a strengths-based approach – creating goal-directed action plans around what the client excels at, enjoys, and executes easily.
Because negativity will always creep into our thoughts and color our evaluations in a more intense way than positivity, focusing on strengths and capitalizing on what you do well will correct this imbalance, and allow for a clear, more efficient, and more productive approach to making change and facilitating growth.
Here is an example:
Jeff is 34-year-old investment banker who, when I met him, worked 90+ hours per week, lived alone in his city apartment, and spent Friday night through Sunday morning drinking to excess and using cocaine.
When he first came to see me he had “tried everything” to curtail his drinking and stop his cocaine use.
This included working longer hours, avoiding hard liquor and “only drinking beer” when he would go out out on the weekends, avoiding friends that used cocaine, and carrying around a mountain of guilt and shame wherever he went, because he “deserved it”.
Jeff’s opinion of himself was highly negative, and he explained that he was often “on edge,” irritable and agitated easily, and anxious most of the time. He told me he wanted to “cut the shit” and “grow up.” His approach to addressing the problem had been punitive, and his feelings toward himself and his approach to “fixing” himself were negative.
I proposed a different approach – one that utilized his strengths and would promote feeling good about himself.
As you can imagine, this Type-A, high-achieving client was skeptical. He rolled his eyes at the idea of “positivity” and let me know he had nothing to gain from “going easy on” himself!
But, my persistent, insistent, and consistent collaborative approach focused on negotiating for positivity and strength-building.
In weekly sessions with Jeff, I encouraged adding and then increasing physical activity – something this collegiate athlete had been missing in his professional life. Despite his tendency to focus on negativity, I was persuasive, and eventually, he remembered being strong.
Fast.
Athletic.
I wanted to capitalize on those positive qualities.
First he added two cycling classes on mornings before work, and soon that increased to five days a week. Next, he added boxing a few afternoons, then added in some strength training, and finally a yoga class on the weekend.
The more physically active Jeff was, the better all other aspects of his life.
By adding something he loved (and was good at), other behaviors naturally changed.
He was so exhausted in the evenings that he chose going to bed or watching a movie with a lady-friend over going out to drink and using cocaine. He was so drained from all that physical activity that he felt motivated to improve his nutrition, which also increased his motivation to limit his alcohol use.
He enjoyed improved attention and mental acuity at work, which was noticed by his colleagues, and most importantly, he felt proud, engaged, and “on his game”.
Today, Jeff works a bit less, drinks a lot less, and abstains from cocaine.
He enjoys an even temper, low anxiety, and feelings of confidence and pride.
He is planning to play on a community soccer team this summer, to train for his first boxing match in the fall, and to try the “Whole 30” diet during the upcoming month.
These are goals that Jeff has identified as interesting, meaningful, or just plain fun.
Although they may not look like treatment for substance abuse or anxiety at first glance, pursuing goals that result in positive feelings, behaviors, and self-appraisals led to a decrease in self-destructive behaviors and eradicated a self-reinforcing cycle of negativity.
My advice to you is to adopt a similar approach in pursuit of your goals!
Even though we may not know each other, I assume that, if you are reading this, you are goal-directed, driven, and probably tough on yourself. You have most likely exhausted all possible benefit there may have been from beating yourself up over your “weaknesses.”
What Do You Have to Lose by Trying a Different Approach?
Identify your goal.
Be as specific as possible.
Then, name the strengths and skills that you bring to the table.
They may not seem directly connected in the moment, so think broadly, and then weave those strengths into your action plan. If you love to bake, transfer those skills into preparation for your upcoming triathlon by baking some delicious protein bars.
If you were a dancer or a gymnast as a child, and you miss it, choose a dance-based exercise class to help you get back to regular exercise – don’t stress out about finding the “best” or the “right” workout.
Thank you for reading!
And best of luck in pursuit of your goals. Always remember that you have all of the ingredients you need, they’re inside of you, to make the change you want for yourself. If you want to read more from or about me, please visit my website: drlewisconsulting.com.
Soul Sista Summit
If you are interested in hearing me speak, and learning more about personal growth and a strengths-based approach, register here for the Soul Sista Summit.
This two day women’s only experience is designed for personal growth, and is hosted by Athena Concannon and Lauren Bradley. The summit consists of workshops and workouts, and an exploration into approaches to lifestyle, fitness, and nutrition that facilitate thriving.
At the summit, I provide a 2-hour presentation on using mental skills to enhance motivation, persist in health- and goal-directed goals, and to stop and reframe negative thinking patterns that keep you from your goals. Learn to leverage your strengths and your passion in pursuit of your goals. The Soul Sista Summit is Saturday, June 22nd, and Sunday, June 23rd.
If you are a woman and can make it to Boston this summer, I hope to see you there.
Melbourne, Australia: July 19-21st and Melbourne Strength & Conditioning. (<— Includes bonus “Psych Skills for Fitness Pros” pre-workshop with Dr. Lisa Lewis).
NOTE: The Early Bird rate of $100 OFF the regular price ends on May 15th.
Luke and I did this workshop last summer in London and figured it’s only fair to bring it State side.
Combined we have 30+ years of coaching experience (I.e., one Mike Boyle or Dan John) and this workshop will be two days where we uncover every nook and cranny as it relates to how we assess our clients/athletes and how we best prepare them for the rigors of every day life/sport.
This will be a unique opportunity for people to learn from myself, but especially Luke, who is one of the best and brightest coaches I know. This will be his first time teaching in the States.
For more information and to register you can go HERE.
This is a free self-paced mini-course from Jon Goodman and his team at the Online Trainer Academy. They are the experts who have helped more fitness pros transition to online training than every other company and coach combined.
You will learn:
1. The systems you need to repeatedly generate clients.
2. The marketing know-how to ethically and douchily (<– my word, not their’s) attract the right people.
3. The tools to get high-paying clients.
4. An action plan to make it all happen.
Every night after he eats dinner (when I’m home) Julian and I head out into the hallway to horseplay and to bother our neighbors. Love watching him develop his movement skills in a fun fashion. pic.twitter.com/ukL1cATE2e
The guys who put out the MASS (Monthly Applications in Strength Sports) Research Review – Greg Nuckols, Eric Helms, and Mike Zourdos – are holding a TWO-YEAR anniversary sale (congrats guys!) where all new subscribers save 30% OFF their subscription.
I can attest that this service is the SHIT.
If you’re interested in being a better coach (and saving yourself a TON of time) this is a way to do it.
25 years ago one of my all-time favorite hip-hop songs, Mass Appeal, was released by one of my all-time favorite hip-hop groups, Gang Starr.
Annnnnd, in one of the oddest (or appropriate?) segues I’ve ever attempted, two-years ago one of my favorite research reviews, MASS (Monthly Application in Strength Sport),1 curated every month by Greg Nuckols, Eric Helms, and Mike Zourdos (coaches who actually lift things), came to fruition and saved me from a world of ineptitude.
I’m unabashed in advertising my disdain for reading research.
I hate it.
There are many things I’d rather do than sit down and read an entire research article. Watch NASCAR, stick my finger in an electrical socket, attempt to give my cat a bath, anything.
That’s not to insinuate I don’t feel it’s important or worth my time. A coach (or athlete) who knows and truly understands the latest research has a huge advantage over his or her’s peers and competitors.
I wholeheartedly feel that what separates the average/ho-hum trainers and coaches of the world from the excellent ones is biceps their insatiable desire to not suck and take more pride in their continuing education.
What’s more, as Greg (Nuckols) notes:
“Most people are still quite uninformed about the science behind hypertrophy, strength development, and body composition. We’d never argue that science is inherently better than in-the-trenches experience, but we think science and experience work together much better than having either in isolation.”
What’s more (even morer), trying to keep up with the research on your own is overwhelming.
There’s something in the ballpark of 50-60 journals which publish research that’s relevant to hypertrophy and strength on a regular basis.
Conservatively that’s 1000+ articles per month.
Going through all that and combing all the studies relevant to helping make people bigger, faster, and stronger is time & labor intensive, to say the least.
Personally, the only way you could get me to do that is this:
Which is why I can’t say enough great things about MASS.
It saves you a metric shit load of time2, and it makes you smarter.
2-Year Anniversary Sale
If you’re a coach, physique or strength athlete, or just someone who likes to nerd out and talk about actin/myosin chains at the dinner table this will be right up your alley.
Starting TODAY (Thursday, 4/25) is your chance to take advantage of some BIG markdowns on the service:
$21 monthly subscription (normally $29)
$209 yearly subscription (normally $299)
$699 lifetime subscription (normally $999)
This offer only lasts for a week (5/2).
What Else Subscribers Get
A new PDF issue of MASS every month. Each issue contains s7 articles and access to 2 video presentations.
Mobile friendly versions of every article.
Access to online membership site with back issues.
7 audio roundtable discussions with Greg, Eric, and Mike every month.
Access to the private Facebook Group.
Access to NSCA and NASM CEUs
A movie quality Chewbacca mask
If you’re still on the fence you can check out the goods HEREfor a free sample issue.
Otherwise you can just trust that I have smart friends and excellent taste in the resources I recommend to people and go HERE to subscribe.
A few weeks ago the guys who host the popular Barbell Shrugged Podcast – Anders Varner & Doug Larson – reached out because they were going to be in Boston and were wondering if I had interest coming onto the show?
Anders and Doug showed up at CORE, set up their mics and laptops, handed me a pair of headphones and this is the result…..
None of us have pants on.
Kidding.
It was a treat to be invited onto the show and I think it came out really well. The three of us talk about everything from my start in the fitness industry to my early years writing for T-Nation (and meeting all the O.G’s of the strength & conditioning community) to Cressey Sports Performance to discussing a smorgasbord of coaching topics: training baseball players, adjusting technique to fit one’s anatomy, why most people don’t need to stretch to increase ROM, and how to implement warm-ups into programs.
Before we get to today’s “Exercise You Should Be Doing,” a quick parenting tip:
If or when your two year old wakes up from a nap and says his tummy hurts, and even if he seems in good spirits, don’t assume he’s just hungry (like I did) and then proceed to take him out for ice cream because it’s Easter.
Cause inevitably, what’s going to happen is what happened to me two hours later…..
Who Did I Steal It From? – I honestly can’t remember, but my inclination is to say Chad Rodgers of Show Me Strength.
Or, I don’t know, maybe it was Jesus.
What Does It Do? – Well, before I say anything on that front I should probably show you what the heck it looks like, huh?
Pretty fancy.
I’ve long championed the notion that the single (or 1-Legged) RDL is fairly advanced exercise as it requires a hefty dose of “things” to pay nice together:
– Lumbo pelvic stability
– Core control
– Stable spine
– Balance
– Hip extension
– Lat activation
– Stark’s shaking hands with Lannister’s
Many trainees are unable to perform a traditional single-leg RDL without my corneas resisting the urge to jump out of their sockets, which is why I’m such a stern fan of more “intermediary” variations such as the one that’s highlighted today.
It provides the support/balance many people need, albeit allows an opportunity to load the standing leg making it more or less a “fake 1-legged” version.
Key Coaching Cues: It takes a bit of trial and error and finesse to get the feel down, but one cue that helps a lot is to push the back foot INTO the wall while also pushing BACK with the standing foot.
This way you elicit a bit of a “wedge,” and thus more full-body tension.
From there, simply push the hips back towards the wall. I like to remind people they’re not lowering the weight with their arms, but rather pushing their hips back.
Continue as such until you feel the bulk of the pressure in the hamstring.
NOTE: The other advantage of this exercise is you can go heavier compared to traditional single leg RDL variations.
So, meatheads will love how this torches the hamstrings.
NOTE: Early Bird rate for this event is $100 OFF the regular price and the deadline is only a few weeks away.
Luke and I did this workshop last summer in London and figured it’s only fair to bring it State side.
Combined we have 30+ years of coaching experience (I.e., one Mike Boyle or Dan John) and this workshop will be two days where we uncover every nook and cranny as it relates to how we assess our clients/athletes and how we best prepare them for the rigors of every day life/sport.
This will be a unique opportunity for people to learn from myself, but especially Luke, who is one of the best and brightest coaches I know. This will be his first time teaching in the States.
For more information and to register you can go HERE.
SOCIAL MEDIA SHENANIGANS
Twitter
STOP telling your clients/athletes:
– They’re broken.
– They’re dysfunctional.
– They need to be fixed.
INSTEAD:
– Focus on what they CAN do.
– Show them there’s work to be done, but be emphatic on showing them success.
– Use more positive verbiage.
– Don’t do kipping pullups
It’s no secret that a well-balanced meal (typically, not always) contains the “big 3″….protein, carbohydrates, and fat. But how much of each should you eat? More importantly, how do you take all three and go about conjuring up a meal that doesn’t taste like cardboard box sprinkled with sawdust?
Thankfully the people over at Precision Nutrition made a nifty infographic to make things easier.
It’s been a bit, but Part III of Kevin Mullins’ “Corrective Exercise” series is finally here.
I’d sorta mirrors the anticipation everyone had for the Game of Thrones season premiere this past week, except not even close.
Sorry Kev: dragons will always reign supreme over ankle dorsiflexion…;o)
NOTE: Stressing the word “finally” above had nothing to do with Kevin actually writing the article (which he submitted weeks ago), but everything to do with ME and my nincompoopness in actually publishing it.
You are a fitness professional who wants to train people – AKA provide them with enough of a fitness stimulus to generate the results they’ve paid you for. You also want to help them overcome pain and dysfunction in their body.
Thankfully, this series of blogs have got you covered and smothered like Waffle House hash browns.
Which brings us to the final piece of the puzzle – corrective exercises for the knee and ankle.
Many people who would consider personal training deal with some level of knee or ankle problems. In fact, it could be argued that everyone walking around this beautiful Earth has dealt with knee or ankle pain/dysfunction at some point in their lives.
(Tony raises hand. I spent the better part of two years in the early 2000’s working around a cranky left knee.)
A proper discussion of these two joints, one mobile and one stable, would not be complete without a discussion about the role of the hips and feet in the function and performance of the knee and ankle. Our feet are our first and only contact with the ground during much of our lives. Any disruption of their optimal function is going to send dysfunction up the kinetic chain into the ankles and knees.
Just the same, the hip, and its multitude of muscle attachments, functions, and movement possibilities can have a dramatic impact on knee function. Tight hip flexors or imbalanced anterior/posterior chain development can change how the patella tracks over the feet – a recipe for pain or less than desirable movement outcomes. As a proud fitness professional, you should be capable of assessing, correcting, and training clients past many of the common problems that might land on your doorstep.
In this post we’ll explore the anatomy and physiology at play when knees and ankles are the weakness in someone’s kinesiology. We’ll discuss the interplay between the hip-knee-ankle-foot. Then, like the other articles, we’ll discuss five specific issues that most trainers encounter and show off a few new exercises that you can use today.
And then we’ll tie a fancy bow on this corrective series, gather all our jackets and move towards the exits. I hope you’ve found a friend
Basic Knee and Ankle Anatomy – Skeletal
(nerds only)
When looking at the knee joint, we are only considering four specific skeletal structures:
The Femur – the longest bone in the human body is also our primary weight bearing skeletal structure. The femur’s entire function occurs at the hip. It can move through flexion and extension, abduction and adduction, external rotation and internal rotation, and circumduction.
The Tibia and Fibula – load bearing bones of the lower leg. Their design allows for weight transfer in gait and for optimal loading of the lower body during any exercise that creates knee flexion or extension.
The Patella – a bone unlike most others in the body, the patella is interwoven with the tendons that cross the knee joint and serves as a cover for those tendons. The structure of the patella also improves the mechanical efficiency of these tendons.
The ankle joint is a bit more complex though. We must consider the bones of the foot to some degree.
The Tibia – The load bearing bone from earlier is also a major contributor to ankle function. The medial malleolus, a bony growth on the inside of your ankle is located on the tibia. At the ankle, the medial malleolus plays a role in ankle eversion and inversion.
The Fibula – Like the tibia, the fibula is a load bearing bone that also functions during ankle eversion and inversion. It’s bony process, the lateral malleolus, is located on the outside of the ankle.
The Talus – a unique bone in a variety of ways, the talus serves as the base for the tibia and fibula to plant upon. Both dorsiflexion and plantar flexion involve the talus changing position in relation to the rest of the foot. The talus also plays a role in eversion and inversion.
The Calcaneus – connected to the talus via the subtalar joint – the calcaneus functions as a base of support for the structures above it. It hosts insertion points for a variety of muscles and tendons – most notably the Achilles tendon. It is the largest bone of the foot.
(Foot) Metatarsal – critical bone structures that connect the toes (phalanges) to the larger structures of the foot. The metatarsals are critical for weight transfer and distribution and while they don’t move like other bones in the body – their ability to adjust to pressure is critical for elite performance.
(Foot) Phalanges – the toes are the final element of this puzzle. Understanding that the toes can and should flex and extend as a result of ground force reaction or conscious neural action is critical to optimizing the foot’s function. While there may never be a “toe day” – we need to train the function of the phalanges to ensure their relationship with the other foot bones, the ankle joint, and even the knee and hip, are optimal.
Basic Anatomy of the Knee and Ankle – Muscular
It is important to discern the muscles that act on the knee and the ones that act on the hip.
Sure, both are in the thigh and run the length of the femur. However, since the knee joint is designed for flexion and extension – we are only considering the muscles that do just that. With that said, realize that the muscles that do function at the hip must do so properly. Otherwise, the knee joint will act to compensate for dysfunction at the hip and that will cause a host of problems too.
The following addresses strict flexion and extension of the knee joint.
The primary flexors of the knee are:
The muscles of the hamstrings (biceps femoris, semitendinosus, semimembranosus)
The gastrocnemius, popliteus, gracilis, and sartorius are synergistic muscles
The primary extensors of the knee are:
The muscles of the quadriceps (rectus femoris, vastus lateralis, vastus intermedius, vastus medialis)
Now, when looking at the ankle we find simplicity and complexity at the same time. On one hand, there are a bunch of muscles that control the toes and ankle joint that aren’t needed in the typical fitness professional’s vocabulary. Simply put, most trainers don’t need to know the minor details of how the fibularis brevis functions, or where the insertion point of the flexor hallucis longus is.
But they need to know they exist.
(Although, more knowledge is never bad and anyone with an interest in self-myofascial release therapy should understand the interplay between these lesser known tissues).
We do need to know that ankle and foot function relies on many more players than just the prime movers. We do need to understand that dysfunction at the ankle could be a myriad of things and not just a blanket statement about someone’s gastrocnemius.
So, we will address the for major movements of the ankle and point out the muscles for each.
** Take note of just how many more plantar flexors there are compared to dorsi flexors. This could explain why we are so strong with our “calf-raise” exercises and why we typically can access a greater range of plantar flexion under control than we could with dorsi flexion. **
Primary Movers of Eversion
Fibularis and extensor digitorum longus
Primary Movers of Inversion
Tibialis anterior and posterior
When looking at this from a slightly higher viewpoint – we see that we have significantly more muscularity driving both flexions of our ankle joint. The lack of muscularity controlling eversion and inversion explains why we don’t load up on an exercise that challenges that motion. Moreover, it probably explains why “rolling” an ankle can be so devastating – we have so little musculature to control that motion.
Going a little broader, we see that muscles of the lower leg have multiple functions. The tibialis anterior dorsi flexes and inverts the foot while the tibialis posterior contributes to plantar flexion and inversion. The extensor digitorum longus everts the foot while contributing to dorsi flexion. These functions are not accidental – they are essential evolutions and developments of our anatomy to meet the demands of our life.
If we are to succeed in our experience as human beings, then we must be able to communicate with the ground effectively. Thus, the muscles that control our foot, ankle, and knee become our first point of contact with outside world.
Understanding their function, their interplay, and their contribution to elite performance is critical to maximizing the impact you’ll have on your clients and your purpose as a coach.
Basic Movement Physiology
The function of the knee and ankle are highly dependent upon the task we are trying to perform and whether the hips are involved.
For example, the knee will flex and extend during traditional deadlift, but not at the same degree that they would during a front squat. The same logic also applies to the amount of dorsiflexion needed from the ankles to meet that demand.
A different example points to our running stride.
The gait pattern that most elite distance runners take involve very minimal action at the ankles and toes. This sort of “hammer-foot” stride is highly efficient and puts the emphasis on the hips and knees to generate all forward locomotion. Sprinters, however, require maximum action from all the joints of the foot and ankle in order to increase velocity and compete successfully.
Thus, understanding physiology of these structures requires an understanding that optimal function is dependent upon the demands of the task.
Still though, a few notable things exist:
1. When the ankle is in full eversion or inversion – there can be an issue with one’s ability to flex and extend the knee. This is because of the change in position of the inferior aspects of the tibia and fibula creating an up-chain manipulation in their superior aspects (which form the knee joint). It is minor in most but could explain why individuals who live in eversion or inversion find discomfort in their knees.
2. Triple-Flexion (hip, knee, and dorsi-flexion) is the most loaded position of the body because of the major muscles that have created force (tension). In most populations, the greatest power will come from individuals in this position. The stacking of joints lowers the center-of-mass and improves the ability to generate tension.
3. Triple-Extension (hip, knee, and plantar-flexion) is the “tallest” the structures of the lower body will get. The process of going from triple-flexion to triple-extension typically generates the greatest joint velocities.
4. The running stride requires a rhythm between hip-knee-ankle-toe action. Upon foot strike, the toes should flex, which drive the ankle joint into plantar-flexion, assist in driving knee extension, and hip extension. The cycling leg does the exact opposite as it returns to the pre-strike position.
The Major Issues
The knee and ankle joints can be seriously injured during sports and accidents in life. None of the issues discussed below involve torn ligaments, broken bones, or even severe tendonitis. The conditions listed are ones that routinely plague clients who are either inactive or too active with poor function.
In fact, many of the issues of the knee come from overuse of the joint without proper interaction with the hip and ankle. Runners and lifters alike may experience knee pain when their form is off. Likewise, many untrained or detrained individuals deal with knee and ankle dysfunction as a result of their sedentary lifestyles.
And don’t forget about footwear.
There is a cost and benefit to each type of footwear that you and your clients are wearing.
Dress Shoes and Boots – great for making a suit look dapper, or kicking tail on a job site, but atrocious for allowing mobility in the foot. Basically, you feel like you are walking inside of bricks.
High heels – an entire day spent into plantar flexion is not good for anyone. Spending additional time walking in them can hurt the wearer’s ability to distribute their weight once they are out of the heels. Great calves though.
Flip Flops – If you are wearing these, then you are probably at the beach. Sweet. However, that sliding and gliding motion that you are using to keep them on is wreaking havoc on your ankle function while also driving too much knee extension.
O-Lifting Shoes – Having your heels elevated when driving your heavy squats or cleans is awesome – can you say performance? However, if you spend most of your day in these shoes than you can bet your bottom that you’ll begin to lose optimal ankle function since you aren’t feeling the ground.
With all of that said, let’s focus on the five most common things you’ll see in your clients and discuss exactly what is going on.
Lack of Dorsi-Flexion
A lot of people struggle to dorsi flex their ankle in response to loading. In fact, a lot of great coaches, including Tony, have pointed out the importance of adequate dorsi flexion for someone to succeed in a squat pattern.
High quality athletes and desk jockeys can both suffer from this issue. It isn’t simply limited to an inactive or undertrained population. It must be dealt with though if someone is going to optimize the function of their hip-knee-ankle and drive greater results in their programs.
Strengthening the muscles that drive dorsi-flexion while also “stretching” the ankle into these positions with bands or straps is usually the best intervention. We aim to increase mobility, improve strength and stability, and begin providing context and practice with traditional strength training movements such as the squat or lunge.
Runner’s Knee (Patellofemoral Pain Syndrome)
A sort of unofficial name, runner’s knee refers to the over-development of the quadriceps (knee extensors) while also keeping the hamstrings (knee flexors) and glutes underdeveloped. In addition, tightness and exhaustion of the plantar flexors can lead to instability and pain at the knee joint.
In fact, there is some evidence out there that shows that some runners experience a mild shift of their patella in space. Only a few millimeters – this shift can cause significant pain and contribute to the official name of the condition (patellofemoral pain syndrome).
The training for individuals presenting this issue is quite simple:
Release and relax the muscles that plantar flex the ankle and extend the knee.
Strengthen and tighten the muscles that dorsi flex the ankle and flex the knee.
Train the glutes to improve hip drive in the running stride
Traditional strength training and myofascial release typically take care of the problem, although a cessation of running in the short term is almost always a good idea.
Knee Valgus
One of the most misunderstood dysfunctions of “the knee” is a hip issue. Many trainers can coach “knees out” until they’re blue in the face and still get no change in the performance of their client.
First, knee valgus refers to the inability of the hip abductors and external rotators to fire appropriately, thus causing a collapse once tension reaches a certain threshold (such as the bottom of a squat).
Image Credit: prehabguys.com
Now, sometimes this only requires good coaching as the client or athlete simply doesn’t know they are doing it or that isn’t ideal that they are doing it.
We must be wise though. Coaching knees out could be driving excess ankle inversion, which changes the relationship of the tibia/fibula with the knee and could lead to torque being experienced in the knee joint as the body seeks to overcorrect the inversion. This isn’t a common worry – but it is possible.
The training cure though will involve strengthening the abductors and adductors of the hip to improve knee tracking in a variety of exercises. It is important to keep in mind that overtraining the abductors can lead to other problems that only arise when the adductors are forgotten about.
There could also be something going on at the ankle too…
Inappropriate Eversion and Inversion
This one sounds a little silly, doesn’t it?
Inappropriate sounds like someone left their pants at home.
But it points out a deficiency that a lot of people have. Whether it be from a lack of coaching and training, or the development of patterns by accident through sport and training – many people lack the right ankle position to complete the task they are attempting.
Think of that client that can’t stop squatting without eversion. Every repetition pushes them into their toes and insole (often leading to valgus). It could be coaching (or a lack thereof), it could be muscle weakness, or it could be a neural disconnect between their brain and their ankles (they don’t know they are doing it).
Just the same, there are people who can’t seem to run on their big toe. They’ll stride flat footed, especially on the outside of their heels, and wonder why they aren’t getting any better at running. These people have not unlocked enough plantar flexion or awareness of their inversion.
It is exceptionally common to see in long distance runners.
Having the wrong ankle position is coachable and trainable. You must relax what is overused and overworked and strengthen what is left behind. There will be specific protocol for whatever you are seeing. Simply look back at the muscular anatomy and select exercises and interventions that are appropriate.
Disconnect of Hips from Knee/Ankle Function
The final issue that people have with their knees and ankles is that they have no idea they have a pelvis. It is as if they believe their lumbar spine connects to the back of their legs…
No really, you probably have a client or twelve who seem to have no idea how to flex and extend the hips. As a result, everything hurts their knees and ankles. Squatting hurts, running leaves them achy, and they absolutely despise lunges.
They aren’t broken thankfully.
They just need to discover their glutes.
They need to learn how to flex and extend the hip with a lot of exercises that leave the knees out of it. So, deadlifts, hip thrust, banded abductions, Copenhagen side planks, and some anterior core work will do wonders to wake up their hips, stabilize their core, and allow them to excel and knee-dominant and gait patterns. Want to learn more about this? Check out my last installment on the hips.
The Exercises
1. Bulgarian Split Squat to Ankle Glide
https://www.youtube.com/watch?v=2WO3-DQenTI
Your goal with this bodyweight exercise is to create a crossover effect between knee flexion and dorsi flexion. By working with the single leg variation – you’ll enhance your clients focus on one specific ankle while simultaneously exposing them to pause reps for the single leg squat variation. You can train them and correct them at the same time.
2. Banded Dorsi to Heel Raise
https://www.youtube.com/watch?v=qrMjjZKkQ8Y
Great for runners and athletes, but effective for everyone, this ankle exercise only requires a band and a seat.
The goal here is to maximize both dorsi flexion and plantar flexion in the same movement cycle. This sort of training allows for you keep the muscles that control both actions in relative balance. This is not unlike being on a calf raise machine and allowing your heels to dip below the step.
3. Barbell Hip Thrust w/ Banded Abduction
One day I want to call Bret Contreras and thank him for his research on the glutes. (Although this video is of Ben Bruno – a stud coach in LA who does NOT like burpees). Discovering that the hip thrust provides more activity of the glute muscles than other exercises is critical for the development of aesthetic and athletic glutes.
Adding in the abduction component at the top is a sure-fire way to ensure your “knees-out” coaching cue for valgus hits home. The band ensures they move from the hip joint instead of just torqueing at the knees. Add in the isometric hold of the glutes and you’ll be sure to work the hip component of knee stability.
4. Duck Walks
https://www.youtube.com/watch?v=beIn56rJGmU
This is an absolute torture device. Duck Walks, loaded or unloaded, drive the body into that triple-flexion position we discussed earlier in the blog. This coiled position strengthens the posterior chain and improves dorsi-flexion by keeping our feet in a set position.
A highly integrated exercise – the duck walk can be used for neural prep or as a burn out after your primary work is done. Sure, its goofy and it doesn’t “seem” like it is going to do your body any favors, but try it and feel how your systems work together to hold isometric tension.
5. Reverse Nordic Curl to Nordic Curl Superset
https://www.youtube.com/watch?v=H-WpX-dnBuY
We want the quadriceps and hamstrings to be in relative balance for optimal knee function. Depending on our choice of sports or training – one may overpower the other a little. That discrepancy though shouldn’t be a chasm.
Hitting both versions of the Nordic curl in a single superset provides an opportunity to train the muscles in a unique way using only bodyweight.
BONUS: Sprinting
https://www.youtube.com/watch?v=3YqQum4emVw
The act of sprinting is one of the most athletic things the human body can do. The whole body must get in on the act if we are to excel.
Specifically, for the knee and ankle, sprinting helps drive a low-level of eversion while demanding quality cycles through plantar flexion and (mild) dorsi flexion and knee flexion and extension. Add in the function at the hip and we’ve found the perfect lower body exercise for improving someone’s function and interplay between these regions.
Obviously, not every client could sprint or should sprint. Be wise with your prescriptions and coach who you are with, not who you wish they were.
Finding the Exit
So, once again we conclude that we can intervene in our client’s discomfort and dysfunction with exercises that not only correct issues, balance muscles, and improve coordination, but also drive a fitness stimulus.
The knee and ankle are interesting joints in a sense that they have less muscle mass around them than the hips and shoulders. But that doesn’t make them any less important. In fact, their proximity to the ground – a constant in our lives – makes them more important than most trainers think. Everything that is dysfunctional at the foot, ankle, and knee will run up the chain into the hips and spine and even the shoulders.
Help your clients discover their foot stability, ankle mobility, and knee stability and you’ll help them discover a better body – both in performance and in aesthetics.
Thank You
Thank you for your time.
Thank you to Tony for allowing me to share my ideas on his website – a treasured space on the internet.
Whether you visit him for his pop culture references, his biceps veins, or his absurd level of knowledge about the body – you’ve made a great choice.
I truly hope you have learned something from this series and enjoy my writing style. I poured a lot into this, and into my book, Day by Day. I hope I can download everything I have learned (good and bad) from me to you every chance I get.
Like I say to my clients, “let’s get just a little bit better every day.”
Check Out Kevin’s Shit
You can read more of Kevin’s stuff at his website HERE.
Luke and I did this workshop last summer in London and figured it’s only fair to bring it State side.
Combined we have 30+ years of coaching experience (I.e., one Mike Boyle or Dan John) and this workshop will be two days where we uncover every nook and cranny as it relates to how we assess our clients/athletes and how we best prepare them for the rigors of every day life/sport.
This will be a unique opportunity for people to learn from myself, but especially Luke, who is one of the best and brightest coaches I know. This will be his first time teaching in the States.
For more information and to register you can go HERE.
SOCIAL MEDIA SHENANIGANS
Twitter
WALL PRESS 1-LEGGED RDL. I like this as an intermediary single leg variation.
A traditional 1-legged RDL is a very advanced movement and one not many can pull off. This takes balance out of the equation, but also allows ample loading of working leg. pic.twitter.com/RxOcTQ8cFd
Congratulations on (pick whichever pertains to you):
(A) Recently graduating college with a Health Science, Health & Wellness, Exercise Physiology, Kinesiology, or History in Shakespearian Literature degree.1
(B) Switching careers from accountant, computer programmer, or, I don’t know, professional mustache grower…to strength coach.2
(C) Passing your weekend personal trainers course.
You decided to enter the industry under the guise you’d get to wear sweatpants everyday (a definite perk) and make a boatload of money.
You’d put in your dues for a few months at a local commercial gym, build a client roster, charge anywhere from $60-$150/hour, and then graduate to doing stuff solely online and, fingers crossed, eventually reach the holy grail and become a social media influencer.
Some fuck-stick is all of a sudden an “influencer” because he has abs and posts shirtless pics of himself standing next to a Tesla?
How’d all that work out a few weeks ago when Facebook and Instagram went down for several hours and everyone’s influencing world came to a screeching halt?
Okay, I don’t mean to come across as a jaded, cantankerous curmudgeon. It’d be a bit hypocritical of me to poo-poo on the power of social media altogether.
I do owe much of my career to my website/blog/biceps.
That said, I’d be remiss not to offer a little dose of tough love and urge upcoming fitness professionals to heed the following piece of advice.
Social media is fleeting.
Think about: there’s nothing, nothing, preventing Facebook, Instagram, Twitter, hell, even MySpace (that still exists, right?) from pulling the plug tomorrow and reneging their platforms. I mean, granted, the likelihood of them abandoning billions of dollars in potential revenue is about as likely as me winning Kumite.
But still, it could happen.
And then what? The only thing you’re left influencing is a big fat NADA.
To be clear: I am not insinuating you should ignore the power of social media or not to use it to help grow your brand and/or business.
I am, however, in a not so subtle way, underlining the dangers of putting ALL YOUR EGGS into the social media basket.
What Will Separate You As a Fitness Professional From the Masses is to Not Be Like the Masses
I’m often asked by upcoming fitness professionals what they need to do to get to where I am in my career? What business books should they read? Marketing? Writing? No, wait, maybe they should invest in taking a course to optimize their SEO?
But I’d be lying if I said my mouth doesn’t usually end up agape, flabbergasted at the question.
I’ve been a coach for 17 years and feel I’ve only just now started to figure shit out. It’s so frustrating because we live in a society that feasts on entitlement; that if you just read “x” book or take “y” weekend course, the world owes you a six figure salary and a roster of professional athletes.
One piece of advice I always give, and it’s an unpopular one is this…
“Spend – at MINIMUM – a year working in a commercial gym.”
I did this for the first FIVE years of my career and wouldn’t change a thing. Eric Cressey did the same thing. Mike Robertson too. Cassandra Forsythe, Dean Somerset, Jon Goodman, heck, I even think Mike Boyle has reminisced over long, arduous years as a commercial gym trainer as the cornerstone of his prominent career as a trainer and coach.
Many of the top names in the industry share the same common denominator: (former) commercial gym trainer.
For me it was the only way to marinate myself in misery.
It was hard getting up at 3:45 in the morning twice a week to open the gym at 5 am.
It was hard working at such a low salary and to try to make ends meet.
It was hard working long hours, holidays, and weekends.
It was hard to learn how to “temper” my coaching style to meet the needs of my various clients.
It was hard dealing with different personalities and learning how to motivate people.
It was hard. All of it.
Misery is a strong word to use in this scenario (really, I was just aiming for a good alliteration). However, it seems appropriate.
Those initial years helped make me resilient and prove to myself that I could “make it.”
Coaching people, in person, provided me with so many (life) skills that helped shape my career. Possessing the ability to break down someone’s squat and honing my scapular upward rotation assessment skills have proved invaluable.
But equally as invaluable has been the ability to hold a conversation and partake in small talk.
“Oh my god, YOU like Balrogs too? Did we just become BFFs?.”
Shit, get back in task Tony.
Focus, focus.
What the hell am I trying to say?
Get off Instagram?
No.
I am not here to rag on your desire to grow a brand on social media or to build an online business. Go for it. But both have a higher degree of actually happening if you concentrate on doing one thing; the thing many upcoming fitness pros fail to understand and respect.
Today’s guest post comes courtesy of strength and conditioning coach Kevin Finn.
It’s a doozy with tons of information related to how to add slabs of muscle to your frame in the most time efficient and scientifically backed way possible.
So, pretty much everyone will be interested in reading it.
Step One: Optimize Your Training Split and Rep Ranges for Volume Accrual
First off, if you’re still doing a “bro split” and hitting your muscles once per week, you need to “get woke” as the kids say these days. It’s time to get out of the 90s and get that frequency up. Besides optimizing muscle protein synthesis rates over the course of the week, higher training frequencies allow you to accumulate more quality volume—both throughout the week and on a per session basis.
This is one of the reasons higher training frequencies are so beneficial. By upping your training frequency, you can still hit 10+ weekly sets per muscle while sidestepping that potential “per session cap” on volume.
With this in mind, utilize a split that allows you to hit each muscle a minimum of twice per week, and consider even higher frequencies for the upper body or for smaller muscle groups that recover well (calves, shoulders, arms).
Now that you’ve got your training frequency sorted out, you need to consider your rep ranges.
As you attempt to push volume, an issue that will invariably crop up is time. As much as I’d love to stay in the gym for 2+ hours, as a working dad, it’s simply not going to happen.
Some days I’m lucky to get an hour.
So, if time is going to be an issue, you should strongly consider ditching most of your lower rep strength work. In fact, if you’re trying to build muscle as your number one goal, you don’t have any business doing much work below the 5 rep range.
What? Blasphemy you say?
Well, there’s a couple facts to keep in mind when it comes to rep ranges:
1) Utilizing higher rep ranges is a much more time efficient way to accumulate volume: Higher reps allow you to perform more total volume as they require shorter rest periods, less warm-up, and they don’t beat your joints up like heavy loading does.
If the goal is to build muscle and you’re seeking to push volume, stick to moderate and higher rep ranges. Keep the bulk of your training based around 6-15 reps, and don’t be afraid to play around with reps as high as 15-30 on some of your accessories.
As long as you come sufficiently close to failure, you’ll build just as much muscle and you’ll be able to accumulate a lot more volume in less time.
One more time-saving tip:
If you’re still having issues fitting in the amount of volume you need to progress, I suggest following a split that will allow for the pairing of antagonist muscle groups so you can perform antagonist paired sets (APS). By performing APS, you get the time saving benefits of supersetting without tanking your performance.
Here’s how they work:
Take two exercises that work opposing muscle groups—like a shoulder press and a pulldown.
Perform one set of shoulder presses, rest about a minute or so, and then do a set of pulldowns. Rest for another minute and then repeat until you’ve completed all your sets for both exercises.
If you typically rest 2-3 minutes between sets, this will save you quite a bit of time, since you will be utilizing a portion of your rest periods to perform another exercise.
And, unlike with supersets, your performance won’t suffer due to excessive fatigue; in fact, there’s even some research that suggests performance may be enhanced.
APS work best with movements that don’t inflict a lot of systemic fatigue, so don’t try these with squats or deadlifts.
Key Takeaways:
Use higher training frequencies (2-4 times per week) to facilitate higher training volumes and increase the average quality of your per session volume.
Do the majority of your work in the 6-30 rep range as this is the most efficient way to accumulate volume and is less likely to leave you beat up and burnt out.
If time becomes an issue limiting your total volume, consider using protocols such as APS to get in extra volume without tanking performance.
Step Two: Be Flexible with Exercise Selection
Listen, if it takes you 40 minutes of warm-up, mobility work, and movement prep in order to get to your first working set of squats, we need to talk…
And if deadlifts tire you out so much you need 5-10 minutes between sets to recover, perhaps you need to consider a different approach…
Because the truth is, unless you’re a powerlifter, there’s no need to stay married to the big three, especially if hypertrophy is your main goal.
I love squats and deadlifts as much as the next guy, but these movements tend to be uniquely time-intensive and fatiguing. If you’re not careful, they can “crowd out” other movements that may give you more bang for your buck in terms of volume. Furthermore, some of us are simply not well-suited to these specific exercises and would do better with other movements.
Maybe hitting some heavy leg presses first and following that with some front squats and Romanian deadlifts would allow you to accumulate a lot more volume in a lot less time while still maintaining those same basic movement patterns?
Key Takeaways:
Unless you’re a powerlifter, there’s no reason to stay married to the big 3.
Do a “cost benefit analysis” on movements that cause a lot of fatigue or eat up a lot of your training time.
When attempting to maximize volume and recovery, the key is to come close enough to failure to maximize muscle fiber recruitment and adaptations without actually hitting failure—all while maintaining good form.
In general, the higher the intensity (in terms of percentage 1RM), the farther you can be from failure while still maximizing muscle fiber recruitment. Conversely, the lower the intensity, the closer you must come to failure.
Here’s a general rule of thumb I like to follow regarding average RPE ratings:
<10 reps = RPE 6-8
10-15 reps = RPE 7-9
15-30+ reps = RPE 8-10
There will always be exceptions to the above of course, but this will get you in the right ballpark.
Key Takeaways:
You don’t have to train to complete failure to achieve full muscle fiber recruitment.
For lower rep sets you can leave quite a few reps left “in the tank” and still maximally recruit muscle fibers.
For higher rep sets, you should come a little closer to failure.
In managing your “per set fatigue” by avoiding failure, you will be able to perform more total volume in that session and throughout the week.
Step Four: Mitigate Muscle Damage
I came up as a young lifter thinking the goal of training was to tear down your muscles so they are rebuilt bigger and stronger than before (no pain, no gainz). This lead me to pursue protocols that focused disproportionately on muscle damage. I’d take pride in my levels of soreness and relish the pain–never mind the fact that my recovery and performance were compromised for the rest of the week and I was hobbling around like an old man…
As more research comes out, it seems of the three proposed mechanisms for muscle growth (mechanical tension, metabolic stress, and muscle damage), muscle damage is likely the least important factor.
So the key is to allow for some muscle damage as a natural consequence of training hard and progressing, but not so much that your total weekly volume is compromised by impaired recovery and/or performance.
How do we do that?
One way is by taking advantage of the repeated bout effect.
The repeated bout effect is the phenomenon by which a single session, or bout, of a given exercise protects against muscle damage from future bouts. Put more simply, the more you perform an exercise, the more resistant to damage (and adaptation) the muscle becomes.
This is often viewed as a bad thing; after all, if the muscle becomes resistant to adaptation, doesn’t that make it harder to progress?
That may be true, but there’s another way to look at it…
Becoming more resistant to damage means your muscle are able to perform more volume with less damage per session. This is key because it can allow us to incrementally increase training volume to levels high enough to maximize hypertrophy while protecting against excessive muscle damage that will impair recovery and progress. One way I like to take advantage of this is by incorporating “intro weeks” into my training cycles.
When you first start a new training cycle, you’ve most likely changed quite a few variables—reps, progression schemes, exercises, etc.—and these changes will temporarily result in higher levels of muscle damage due to the novel stimuli.
By starting off with an intro week with slightly lower volume and intensity, you’ll still get a strong training effect and the easy dose of volume will inoculate you against the higher volumes and intensities coming down the line.
How low one should keep the training volume and intensity during an intro week will vary based on the individual, but I like to put the intro week somewhere in between a deload and an average “meat and potatoes” week of training. Think of it like a bridge between the two.
Another thing to consider in regard to mitigating muscle damage is exercise selection.
If deficit, stiff-legged deadlifts consistently leave you so sore you’re crippled for a week, you’re not doing yourself any favors by maxing out on them on the regular. Sure it feels like you’ve accomplished something (gotta sacrifice to win, brother), but it’s a short-sighted approach.
Don’t get me wrong, being sore is not a bad thing per se. And I think it’s good to include a few movements that load a muscle in a stretched position—especially if hypertrophy is the goal, but you need to do a cost-benefit analysis with these types of movements.
You may not need to give them up entirely, but tweaking the volume, rep range, and proximity to failure can help attenuate some of the excessive damage while still allowing for the positive aspects of the movement.
Key Takeaways:
Excessive muscle damage should not be the goal of training and may even negatively impact gains.
Take advantage of the repeated bout effect’s ability to protect against muscle damage by using intro weeks and gradually increasing volume and intensity as the mesocycle progresses.
Consider modifying the loading and progression schemes for particularly damaging exercises if excessive soreness is impairing recovery.
Step Five: Include Overreaching Weeks and Deloads
Just as you are most sensitive to volume at the beginning of a mesocycle, you are most resistant to volume toward the end. Thus, the natural counterpart to an intro-week at the beginning of your mesocycle, is an overreaching week to close it out.
An overreaching week is a week where you intentionally push volume a little higher than normal in an effort to maximize potential progress. When done in an intelligent manner, this can be an extremely productive and fun week of training. During this week you can go for slightly more damaging protocols, push a bit closer to failure, and/or up the volume to a level higher than you could normally sustain.
Immediately following an overreaching week, you should perform a deload week. The two go hand-in-hand.
A deload is more than just a preventative measure to protect against injury, it’s the second half of a “one-two punch” that allows you to expose your muscles to higher levels of volume by providing a window for recovery.
During a deload, you should reduce volume and both intensity of load and intensity of effort to allow for active recovery to occur. Without the recovery period, you would not be able to peak volume as high and your muscles would not have been exposed to those superlative levels of stress.
The higher the peaks, the lower the valleys.
Overreaching strategies:
While I consider deloads a mandatory part of a good training program, overreaching weeks are more of an optional piece. For some lifters (particularly those who tend to run themselves into the ground), any small benefits that may arise from the overreach could easily be outweighed by the increased risk of injury or burnout.
Thus, it’s important to remember an overreach is not an excuse to get sloppy with form or drastically change things up.
If hypertrophy is the main goal, you are primarily just looking to get some extra volume in and perhaps vary the training stimulus a bit. One method of doing this is to add a drop set or two to your last movement for a muscle group in a given session.
Thus, drop sets can add a nice little punch of volume without making your workout significantly longer, and we’re not so concerned with the fatigue because the deload in the following week will ensure recovery is adequate.
Key Takeaways:
Pushing a bit harder towards the end of a mesocycle can be a valuable strategy to potentially eke out some additional progress.
You must pair an overreach with a deload to allow the higher levels of fatigue to dissipate and any potential supercompensation to occur.
Regardless of whether you utilize overreaching strategies, regular deloads should be incorporated in your training.
Drop sets can be a very time efficient way to add some quality volume during an overreach.
Parting Thoughts and a Word to the Wise
You’ll note I didn’t include a sample training program with this article. This was intentional. I’ve instead chosen to outline some “broad strokes” concepts so that you can use these principles to improve on your programming now and for years to come.
By following the steps outlined above, you may find you now have the potential to double your training volume.
But just because you can, doesn’t mean you should.
Let’s say you’ve been doing around 10-12 sets per muscle group, per week on average. You’re training hard, eating well, and feel well-recovered between sessions, but you’ve hit a plateau. It’s very likely that you’ll benefit from bumping up your training volume. It’s the most logical next step. By using the strategies outlined above, you may find you are now able to fit in 20 quality sets per week.
Don’t jump straight to 20.
Just as you should progress incrementally when adding weight to the bar, you should view volume in the same way. So rather than doubling your volume right off the bat, simply add about 10% or so and see how you fare.
Did you progress? Was recovery okay?
If so, run it again. If it ain’t broke, don’t fix it.
Milk as much progress as you can out of your current level of volume, but keep an eye towards progressively and incrementally adding volume—both to test your limits and to keep those adaptations rolling. Your ideal volume is a moving target, but if you are paying attention to your training, tracking variables, and keeping your eyes on the prize, it’s a target you should be able to hit fairly consistently.
It doesn’t have to be a bullseye.
About the Author
Kevin Finn is a strength and conditioning specialist, online trainer, and the owner and creator of FitnessWalkthrough.com.
As a coach with a master’s degree in education, he specializes in breaking down complex information and arming people with the knowledge and tools necessary to transform their physiques and take their performance to the next level.
He has created some of the most comprehensive guides available online for skinny guys and girls who struggle to build muscle. Visit http://fitnesswalkthrough.com/get-jacked.html to get a free copy and learn more.
