Sunday, April 26, 2015

Guest Post: "I Pity The Fool:" 5 Tips For Strong & Healthy Knees

by Kennet Waale

When my good friend Kennet Waale offered to provide content for my blog while I was recovering from surgery, I jumped at the opportunity. Here are the delightfully educational fruits of his labor. If nothing else, be sure to watch the videos linked below for Ken's sexy Aussie accent. Heck, you might even learn something along the way. I know I did! Take it away, Ken.

The aim of this post is to provide you with five powerful tips on how you can improve your knee health and stay sane while enjoying your running, cycling, squatting, and sex.

The majority of anterior cruciate ligament (ACL) injuries occur with an anterior migration of the femur relative to the tibia coupled with excess rotation. The posterior cruciate ligament (PCL) is less prone to injury, with the opposite mechanism of that of the ACL.

ACL injuries are often non-contact and are seen when planting your foot where your foot and shin bone are standing still while the femur (politely) decides to keep moving.

Due to the shear fact that it might bore you, I will not outline in detail the typical mechanisms, but you can read more about them in THIS STUDY and find more clinically relevant information HERE.

5 Things You Must Do To Keep Your Knees Healthy

Even though there is never a 100% guarantee that injuries will not happen, practicing the basics below will serve as a very good start to decreasing the likelihood of injury while improving your performance. The tips are all equally important, nevermind the 1-5 ranking.

1. Strong Hips

Getting a strong ass is vital to ensure optimal positioning of the femur relative to the tibia for strong abduction, external rotation, and prevention of valgus (knock-knee) movements. If your hips are strong, you will be able to more efficiently and effectively control movements during landing and loading. Taking the study above further, we must create strong extension, external rotation, and abduction patterns to ensure healthy knees. With this also comes strong, controlled patterns in flexion, internal rotation, and adduction. Seems obvious, yet it is vital!

2 Favourite Exercises To Get Stronger Hips:

(Editor's Note: for more ideas on knee injury reduction through posterior chain training, check out THIS previous blog post of mine.)

2. A Strong Midsection

Strong and well-functioning hips depend on a well-rounded midsection. "Core" training goes hand in hand with developing strong hips and is absolutely critical to ensuring optimal function under load. Remember to always train anti-extension; anti-flexion and anti-rotation as well as their oppositions: extension, flexion, and rotation. Creating movement is important, but controlling unwanted movement is often even more important.

2 Favourite Exercises To Build A Strong Midsection:

(Editor's Note: Kennet has actually written extensively about his thoughts on core training for my blog before! See HERE.)

3. Mobility

Despite the fact that mobility is slowly becoming a "fad" these days -- and to some might even seem more important than developing strength and athleticism -- it should not be thrown out of the window. Mobility and flexibility are both important concepts in improving performance. Adequate levels of both are needed in order to ensure the ability to go through the required ranges of motion in a controlled and safe manner. Hip as well as knee and ankle mobility are all important. So is thoracic mobility.

My ALL TIME Favourite Sequences To Build Mobility:

(Editor's Note: For more no-nonsense ideas on mobility, watch/listen to my podcast with Matt Ibrahim of Mobility 101.)

4. Work Capacity

It is interesting to note how many injuries, in particular non-contact injuries, occur when the body is tired. Coordination, reaction time, game awareness, and much more all decrease as we are approaching fatigue during a game or set of activities. Strength, power, coordination, and all other performance measures mean little if you are not able to sustain it over time.

2 Favourite Exercises To Build Work Capacity:
1) Reverse Sled Drags (for time)
2) Low Box Step-ups (for time)

5. Foundational Strength

We can do as much "rehab" work as we want, but at one point in time we must start to develop higher levels of strength and get the baseline strength up to par. A weak individual will end up in a higher number of less-than-optimal positions versus an individual who is a lot stronger.

As an example, we know that those who have an unfavourable hamstring-quadriceps ratio will have a greater likelihood of hamstring and knee injuries. The "normal" ratio is between 50-80%, meaning that your hamstrings are on a general level weaker than your quadriceps (1). This is a valid takeaway message, especially if you are a female participating in sports, as we know that this ratio is lower in women (2). It is obvious, then, that strength is an important factor in balancing this equation.

2 Favourite Exercises To Build Strong Hamstrings:

(Editor's Note: I just so happen to have an entire blog post about introducing the deadlift. Read it HERE.)

"I Pity The Fool"

I Pity The Fool that does not train his ass properly!

Building bulletproof and healthy knees relies on various factors with one of the main factors being hip function. Making sure that acceleration through extension, abduction, and external rotation is very important. However, making sure that you also know how to control the deceleration of these movements is also important. For the midsection, that means controlling movement through anti-extension, anti-flexion, and anti-rotation. Finally, the importance of mobility, work capacity, and foundational strength cannot be overemphasized.

Happy knee injury-free training!

(1) Journal of Athletic Training: Isokinetic Hamstrings: Quadriceps Ratios in Intercollegiate Athletes
2) Journal of the Nigeria Society of Physiotherapy; Hamstring and Quadriceps Strength Ratio: Effect of Age and Gender; Jaiyesimi A. O., et al.

About The Author

Kennet Waale is a facilitator, coach, and founder of MoveStrong and He earned his Bachelor's degree in human movement studies as an exercise scientist at The University of Queensland. During his almost eight years of coaching, he has gone to work with athletes up to the Commonwealth and Olympic levels as well as general population clients.

Through workshops and seminars, he raises the standards amongst the professionals in the fitness industry -- bridging the gap between therapy and training. Other than travelling the world having fun, he pays particular interest in helping people relieve pain while getting stronger and moving better.

You can follow him on Twitter and Facebook by clicking the links below:

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