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Real Core Training Part Four

Anti-Rotation

Like everything in the fitness world, core training has evolved.  When I bought my first bodybuilding magazine in the late 90s, the word “core” wasn’t even used.  Instead, you would find ab workouts, oblique workouts, and sometime, low back workouts.  Like pretty much everything in the 90s, muscles were trained in isolation with little concern for how the musculoskeletal system was designed to function as a unit.  We have come a long way in our understanding of physiology, biomechanics, and injury prevention/reduction.

The core used to be trained and often still is through movement: flexion (anterior), lateral flexion, extension, and rotation.  Sit ups, crunches, side bends, and Russian twists aim to strengthen the muscles concentrically and eccentrically.  These build mass and thickness to the core musculature.  The second way we train the core is to recognize it as a stabilizer of the low back and hips.  This involves training this musculature to resist movement.  When it comes to increasing strength, power, speed, and reducing injury, this training is more important than dynamically training the core.  This style of training is referred to as “anti-core training” because we are resisting flexion, extension, lateral flexion, and rotation.  The other benefit of anti-core training is that it involves isometric contractions which are much less likely to create muscle hypertrophy, which individuals typically don’t want in their waist.  I typically recommend that 70-90% of your core training consist of anti-core work depending on your health/injury history and goals.

The key to good core training is understanding what you are trying to accomplish, as well as how to progress or regress the movement.  Here are the some of our favorites that we use at Fenton Fitness for each of the four anti-core categories.

Jeff Tirrell, CSCS, CSFC, Pn1

Anti-Rotation

Tall Kneeling Pallof Press: Grab some elastic tubing or a cable (anchored to something sturdy) and assume a tall kneeling position.  Hold with both hands and press outward away from body.  Do not allow your body to twist or rotate.  Increase load or stretch on tubing to increase difficulty.  Work up to 12 reps per side.

Half Kneeling Pallof Press: Set up in a half kneeling position.  Use the same execution as the tall kneeling version.  Make sure that you don’t allow your legs/hips to lean or twist.  Work up to 12 reps per side.

Standing Pallof Press: Assume an athletic stance with your feet just outside of shoulder width, slight bend in the knees, and slightly flexed at the hips.  Execute the same movement as you would for the tall or half kneeling Pallof press. Work up to 12 reps per side.

One Leg Pallof Press: Stand on one leg with the other leg flexed at 90 degrees at the foot, knee, and hip.  Execute the Pallof press the same way as the standing Pallof press. This is a much more a balance and overall body stability drill.  Tension/resistance will need to be reduced.  Be slow and gradual with your increases in load, volume, or frequency to allow your knee time to adapt.  Work up to 12 reps per side.

PUPP with alternating arm raise:  Assume a push up position with your feet slightly wider than shoulder width.  Raise one arm out in front of your body while maintaining spine and pelvic positions.  A wider feet position makes the movement more stable and easier, while a narrower foot position increases difficulty.  You can also slow the movement to increase difficulty.  Remember, top priority is no hip/spine movement before trying to increase difficulty.  Work up to 10 per side.

Landmine Anti-Rotations:  Place a barbell in a landmine and assume an athletic position.  Press the landmine away from your body and slowly make a rainbow arching pattern moving the barbell from one hip to the other.  Make sure that only your shoulder/elbow joints move, everything else stays stiff.  Work up to 10 reps per side.

Crawl: Get on your hands and knees with your toes dug into the ground.  Lift your knees slightly off the ground.  Keeping your back flat and stable, move your opposite hand and foot to crawl forward or backward.  Work up to 50 yards.

For video demonstration of these exercises, click here

Real Core Training Part Three

Anti-Extension

Like everything in the fitness world, core training has evolved.  When I bought my first bodybuilding magazine in the late 90s, the word “core” wasn’t even used.  Instead, you would find ab workouts, oblique workouts, and sometime, low back workouts.  Like pretty much everything in the 90s, muscles were trained in isolation with little concern for how the musculoskeletal system was designed to function as a unit.  We have come a long way in our understanding of physiology, biomechanics, and injury prevention/reduction.

The core used to be trained and often still is through movement: flexion (anterior), lateral flexion, extension, and rotation.  Sit ups, crunches, side bends, and Russian twists aim to strengthen the muscles concentrically and eccentrically.  These build mass and thickness to the core musculature.  The second way we train the core is to recognize it as a stabilizer of the low back and hips.  This involves training this musculature to resist movement.  When it comes to increasing strength, power, speed, and reducing injury, this training is more important than dynamically training the core.  This style of training is referred to as “anti-core training” because we are resisting flexion, extension, lateral flexion, and rotation.  The other benefit of anti-core training is that it involves isometric contractions which are much less likely to create muscle hypertrophy, which individuals typically don’t want in their waist.  I typically recommend that 70-90% of your core training consist of anti-core work depending on your health/injury history and goals.

The key to good core training is understanding what you are trying to accomplish, as well as how to progress or regress the movement.  Here are the some of our favorites that we use at Fenton Fitness for each of the four anti-core categories.

Jeff Tirrell, CSCS, CSFC, Pn1

Anti-Exension

Supine Bent Knee March

Lay on your back and lift your legs off the ground with your knees and hips at 90 degree angles.  Posteriorly tilt your hips so that your low back is pressed firmly into the ground.  Slowly lower one heel to the ground keeping your knee at 90 degrees and not allowing your low back to lift off the floor.  Bring this leg back up and repeat on the other side.  Work up to 10 reps per side.

Bent Leg Dead Bug

Assume the same position as the previous exercise.  Reach your arms straight up to the ceiling.  Keep your low back pressed into the floor and straighten one leg, getting the heel as close to the ground as possible without touching.  Simultaneously reach the opposite arm overhead without quite touching the ground.

Straight Leg Dead Bug

Lay on your back with your legs and arms all reaching up toward the ceiling.  Keep your leg straight. and slowly lower it toward the ground while simultaneously reaching overhead with the opposite arm.  Don’t allow your foot or arm to rest on the ground, and keep your low back pressed into the floor.

Hollow Body Hold

Lay on your back and press your low back into the floor.  Lift your feet, shoulders, and arms off the floor, keeping your low back pressed into the floor.  Keep your feet and arms as close to the ground as possible while also keeping your low back on the ground.  Hold for up to 60 seconds.

Plank

Lay on your stomach and place your elbows under your shoulders.  Put your feet together and lift your hips off the ground.  Maintain neutral lumbar, thoracic, and cervical spine positions. Contract your glutes, pull your ribs down with a forceful exhalation, and try to pull your elbows toward your toes (they won’t actually move) to engage your lats.  Try to create maximum full body tension.  Hold for up to 30 seconds.

Long Lever Plank

Use the same set up and execution as the plank, except that the elbows will be farther out in front of the shoulders.  The farther forward the elbows, the harder this will be.  Work up to 30 seconds.

Body Saw

Use the set up the same as the plank only with carpet sliders under your toes.  Use your shoulders to slide yourself into the long lever position and then slide back.  Make sure you maintain spinal and pelvis positioning during the whole movement.  Work up to 12 reps.

Physioball Rollouts

Start in a tall kneeling position with a Physioball at arm’s length in front of you.  Pull your ribs down and engage your glutes.  Allow your body to fall forward by letting your hands and forearms roll up onto the ball.  Once you feel you are going to break lumbopelvic positioning, reverse the movement to get you back to your starting position.  Work up to 10 reps.

TRX Fallouts

Use the same set up as with the physioball, but use a suspension trainer instead.  Set up with straps at mid-thigh height.  Execute in the same manner.  Lower the strap starting position to increase difficulty.  Work up to 10 reps.

Ab Wheel/Dolly Rollouts

Set up on your knees with your hands on an ab wheel or dolly and place your hands directly under your shoulders.  Begin to fall forward by flexing the shoulder (overhead) and extending the hips.  Go forward as far as possible without losing spinal positioning and then reverse movement back to the start.  Make sure shoulder and hip joints extend/flex at the same speed.

For video demonstration of these exercises, click here

Real Core Training Part Two

Anti-Lateral Flexion

Like everything in the fitness world, core training has evolved.  When I bought my first bodybuilding magazine in the late 90s, the word “core” wasn’t even used.  Instead, you would find ab workouts, oblique workouts, and sometime, low back workouts.  Like pretty much everything in the 90s, muscles were trained in isolation with little concern for how the musculoskeletal system was designed to function as a unit.  We have come a long way in our understanding of physiology, biomechanics, and injury prevention/reduction.

The core used to be trained and often still is through movement: flexion (anterior), lateral flexion, extension, and rotation.  Sit ups, crunches, side bends, and Russian twists aim to strengthen the muscles concentrically and eccentrically.  These build mass and thickness to the core musculature.  The second way we train the core is to recognize it as a stabilizer of the low back and hips.  This involves training this musculature to resist movement.  When it comes to increasing strength, power, speed, and reducing injury, this training is more important than dynamically training the core.  This style of training is referred to as “anti-core training” because we are resisting flexion, extension, lateral flexion, and rotation.  The other benefit of anti-core training is that it involves isometric contractions which are much less likely to create muscle hypertrophy, which individuals typically don’t want in their waist.  I typically recommend that 70-90% of your core training consist of anti-core work depending on your health/injury history and goals.

The key to good core training is understanding what you are trying to accomplish, as well as how to progress or regress the movement.  Here are the some of our favorites that we use at Fenton Fitness for each of the four anti-core categories.

Jeff Tirrell, CSCS, CSFC, Pn1

Anti-Lateral Flexion

Bent Knee Side Plank

Lay on your side and place your elbow under your shoulder and line your knees up below your hips.  Lift your hips off the ground and hold.  Work up to 45 seconds.

Side Plank

Lay on your side and place your elbow under your shoulder and straighten your legs out.  Stack your legs on top of each other and lift your hips off the ground.  Hold for up to 60 seconds.

Side Plank with Top Leg Elevated

Position yourself in the same set up as the side plank.  Once your hips are lifted off the ground, you will move your top leg away from the bottom leg.  Make sure that you don’t flex either hip when raising the top leg.  Work up to 30 seconds.

Side Plank with Top Leg on Bench

Lay on your side and place your elbow under your shoulder.  Place your top leg on top of a bench.  Lift your hips off the ground.  The bottom leg can squeeze the bottom of the bench or dangle in the air.

Suitcase Hold

Grab a KB/DB in one hand, stand tall, and maintain a neutral lumbar, thoracic, and cervical spine position. Make sure your shoulder blades stay down and back.  If possible, watch yourself in the mirror to ensure you aren’t leaning.  Hold for up to 60 seconds.

Suitcase Carry

Assume the same set up as the suitcase hold.  Start walking with a normal gait.  Make sure to not lean excessively.  Start with 20 yards per side and work up to 100 yards.

For video demonstration of these exercises, click here

That pain in your arm or hand could be coming from somewhere else.  Read Mike O’Hara’s article, Changing Locations to find out more.  Jeff Tirrell gives nutrition tips and Mike discusses the benefits of using an agility ladder.

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Stay independent longer by increasing your stair climbing capacity.  Mike O’Hara shows you how in his article, “Keep Climbing”.  Mike also discusses standing desks and the many benefits of standing while working.  Jeff Tirrell explains the effect of exercise on appetite.

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Our June issue brings information on preventing neck pain by strengthening your neck.  Mike O’Hara describes and demonstrates in a video exercises that will help strengthen the muscles of your neck.  In another article, Mike tells how grip strength can be a predictor of early death in some patients.  Be sure to read Jeff Tirrell’s article on performance based training.

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In our May issue, Mike O’Hara discusses the importance of walking.  If you have pain or difficulty with walking, there are things that help.  Mike demonstrates some exercises to get you ready.  Be sure to read Jeff Tirrell’s article on squatting, and read about Afterburn–a new class at Fenton Fitness that uses heart rate monitors while training.

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A Plea For Your Knee

In our physical therapy clinics, we treat patients with knee pain on a daily basis.  It has become more common to train younger clients with a history of knee injury and ongoing knee pain.  Jane Brody’s recent *article in the New York Times has some excellent advice on the care and management of knee pain problems.  I have some further suggestions and clarifications.

Less Mass

The mass portion of the Force = Mass x Acceleration formula needs to be at an appropriate level for your knees to stay healthy.  Carrying extra body fat creates an environment that invites knee wear and tear.  The common knee pulverizing mistake is to perform high impact exercise activities in an effort to lose fat.  If you are twenty pounds overweight, do not run, stadium step, soccer, tennis, or pickleball.  Start with strength training and low impact cardio.  Lose the fat first, and even then, the lower impact activity will be healthier for your knees.  From the overweight client limping into the clinic I get the “I need to move around to lose weight” protest.  I am sorry, but fat loss is primarily a function of dietary alteration.  Exercise has very little impact on body fat levels if you do not eat properly.

Train the Way You Wish to Play

A properly planned fitness program makes your knees more durable (fewer injuries) when you participate in your favorite recreational activity.  The training must be tailored to your activity goals.  If your goal is to play tennis, then you must perform three dimensional deceleration / acceleration activities as part of your training program.  Yoga will not prepare your knees for tennis.  If you want to water ski, then you must perform strength training for your back, hips, and knees.  Distance running will not prepare your knees for water skiing.  If hockey is your recreational past time, you need to be strong, well conditioned and competent in all planes of motion.  Long duration recliner intervals will not prepare your knees for hockey.

Look Above

If your hips do not move well, your knees will pay the price.  In this age of all day sitting and minimal physical activity, hip function is at an all time low.  Physical therapy patients with knee pain nearly always present with glaring restrictions in hip range of motion and strength.  If your knees hurt, dedicate some training time to restoring hip rotation and hip extension movement.  Learn how to perform some remedial gluteal activation drills.  Learn a proper hip hinge, squat and a pain free lunge pattern.

Think First

Participation in a single inappropriate activity can produce a lifetime of knee trouble.  That box jump workout of the day- maybe not.  The warrior, electric shock, mud hole, death run–bad idea.  Trampoline with the grandchildren–what were you thinking!

Be Proactive and Seek Treatment For Knee Pain

“Training through the pain” can take a graceful athlete and turn them into a lifelong speed limper.  The presence of pain changes the way your brain controls movement.  Left untreated, it can permanently alter neural signals and produce movement patterns that linger long after the pain has resolved.  Live with enough cycles of inefficient movement and you develop early breakdown in the knee.

Michael O’Hara, PT, OCS, CSCS

*What I Wished I’d Known About My Knees, Jane Brody, New York Times. July 3, 2017

Read the NY Times article here: https://www.nytimes.com/2017/07/03/well/live/what-i-wish-id-known-about-my-knees.html?_r=0

We all need basic competence in fundamental movement patterns to function at an optimal level. A deep and stable squat keeps us free from injury and competent on the field of play. In physical therapy, we evaluate performance of the squat pattern with nearly every patient. One of the most common and damaging squat faults is an inward deviation of the knee during the squat.

Genu valgus is the term given to the inward deviation of the knee during a squat. Female athletes often land from a jump in a valgus knee position. Lower back pain patients are often unable to transfer out of a chair or ascend a step without significant inward deviation of the knee. This movement fault is not a healthy method of moving and should be trained away as quickly as possible. One of the simplest exercises to remedy genu valgus is the mini band squat.

Prepare to be frustrated when attempting to restore a movement pattern. Training movement demands higher neurological control than muscle isolation type training. Anyone can quickly master the preacher bench curl or seated knee extension, but restoring a squat pattern is hard work. Repetition drives the neural retraining that produces results.

MINI BAND SQUAT

You will need a mini resistance band. You can purchase them from www.performbetter.com ($2-$3 each).   Place the band just above your knees.   Position the feet shoulder width apart. The toes can point out about 20-30 degrees. Grip the floor with the feet—push the toes into the floor. Reach the arms forward and push the hips back. Descend into a squat and at the same time drive your knee outward into the resistance of the mini band. Hold the bottom position for five seconds and then return to the starting position. You should feel the gluteal muscles working while in the bottom part of the squat.

Pick an easy resistance level. Do not start with a heavy blue or black band. Only travel to a squat depth you can move through and remain comfortable and pain-free. You do not have to squat to the floor. As your motor control improves, you will be able to travel into a fuller movement pattern.

Perform five repetitions and then rest. Work up to four sets of five repetitions.

-Mike O’Hara, P.T., OCS, CSCS

To view a video demonstration of Mini Band Squats, click on the link below:

 

The knee meniscus is a cartilage structure located on the top of the tibia, the bottom bone of the knee. Most of us are unaware of our meniscus until it becomes damaged. At present, we can only repair or remove a meniscus, leaving a less than optimal operational environment for the knee joint. Melinda Beck wrote an interesting article in the May 4, 2015 edition of The Wall Street Journal on breakthroughs with meniscus replacements. The research looks promising, and hopefully, it will soon be available to the aging baby boomer population. In the meantime, what steps can we take to keep our knees healthy and pain-free.

Maintain a normal body weight

Larger loads on your legs produce more wear and tear forces on your joints.

Think first

This becomes more important as you get older. A single ill-conceived activity can produce a lifetime of knee trouble. That box jump workout of the day? Maybe not. Spartan, warrior, electric shock, mud hole, death run? Bad idea. Trampoline with the grandchildren? What were you thinking? We hear this in the clinic every day.

Reduce the number of lower extremity impact events in your fitness program

The current trend in fitness is toward a greater number of high speed deceleration events in a training session. This increases the opportunity for break down in the joint and a visit to the orthopedic surgeons office. My suggestion is that we devise training programs that produce a strong metabolic and/or strengthening response while managing impact.

Get stronger in lunges, squats, step ups, and hip hinge exercises

Your knee functions with the foot on the ground, in the standing position. The knee joint operates in coordination with the joints above and below the knee. The neurological component of balance and proprioception is involved in every knee activity. Training in a seated, non-weight bearing position with no coordination or balance demands is a waste of valuable training time and often makes knee pain problems worse. Get better at movement patterns that teach the joints and muscles of the lower extremity to work as a team.

Don’t ignore pain

The majority of our brain is devoted to managing movement. The presence of pain neurologically changes brain signals and alters how we move. Left untreated it can permanently alter neurological control, creating aberrant movement patterns that linger long after the pain has resolved. Perform enough cycles of inefficient movement and you develop early breakdown of essential joint structures. “Training through the pain” can take a graceful athlete and turn him or her into a lifelong speed limper.

Get a Functional Movement Screen (FMS)

To make the fitness journey as efficient and productive as possible, you must begin with an evaluation. I advise everyone have a FMS evaluation every six months. It is the fitness equivalent of taking your blood pressure during your annual physical. Find out where you excel and where you struggle in basic movement patterns. Let the FMS help guide your fitness decisions and your road will be smoother and more direct.

To read the article “New Fixes for Worn Knees,” click on the link below:

http://www.wsj.com/articles/new-fixes-for-worn-knees-1430761617

-Michael O’Hara, P.T., OCS, CSCS

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