Pain Free, Happy Knee!

Attached to this post, you’ll find two different client-cases where feet placement can affect biomechanical, physiological and neuromuscular functions. In layman terms, any inadequate set up can be detrimental for either performance goals or daily activities. We also include a chart recommending appropriate footgear and some Training thoughts about Abductions and Adduction. Questions and constructive feedback are very welcome. Cheers. Will

CASE ONE: ATG Squats

 Performance training should not be limited to the "chosen-ones". For instance, Only a bunch of gifted people can run the under 10 seconds a la Usain Bolt. That doesnt mean we should stop training to become good runners. In other words, for the rest of us, the majority , there alternatives and strategies that can be tailored to train and get better.

Performance training should not be limited to the "chosen-ones". For instance, Only a bunch of gifted people can run the under 10 seconds a la Usain Bolt. That doesnt mean we should stop training to become good runners. In other words, for the rest of us, the majority , there alternatives and strategies that can be tailored to train and get better.

The first case is a 30y.o. Male, former  runner who doesn’t present structural or functional impingements, except by lack of mobility in his ankle joints. As a result, this client is not able to perform fundamental movements like the deep squats because the range of motion of his ankles doesn't match the mobility of the hips or the stability of his knees and lumbar spine, a weak link that used to stop him to stop proficiently or according to his performing potential. However, cases like this one don’t necessarily mean that a performer should stop training. If it was like that, 99% should give it up, as just a bunch of “chosen-ones” are allow to claim “perfection”. For the rest of us, the majority, there are alternatives and strategies that allow us to train and get better.

 

 Above, A client is trying to achieve his deepest squat while keeping the natural curvature of his spine as neutral as possible. Squatting any lower than that would provoke a wink or posterior tilt of his pelvis and ache in his left knee. Both issues can be highly dangerous if the movement is intended with a barbell or any other sort of external resistance.

Above, A client is trying to achieve his deepest squat while keeping the natural curvature of his spine as neutral as possible. Squatting any lower than that would provoke a wink or posterior tilt of his pelvis and ache in his left knee. Both issues can be highly dangerous if the movement is intended with a barbell or any other sort of external resistance.

As you can appreciate in the pictures A and B, The heels were elevated to compensate poor ankle mobility. Now, can you spot the difference about the feet position? While in photo “A” both feet are rather pointing forward, in photo “B”, the feet are rotated slightly outwards (particularly the left one).

As a result, comparing both photos, the performer is able to squat deeper, as a result of our modification, while maintaining a neutral spine. That’s what tailoring exercises is all about. Essentially, not only Coaches and Personal Trainers but, also, self-trained gym goers need to secure that all movement patterns respond to personal characteristics. In this particular case, why should limit the Range of Motion (ROM) of the hip when the performer can actually squat deeper (AKA “arse-to-grass) while keeping the spine neutral and saving the knees from tracking inwards? 

 After prescribing a slight external rotation of the left foot, the Client is now able to squat a bit deeper while keeping his spine neutral and achieving optimal range of motion of the hips. Proper  lifting shoes were recommended for movements like fron squats and Olympic lifting movements.

After prescribing a slight external rotation of the left foot, the Client is now able to squat a bit deeper while keeping his spine neutral and achieving optimal range of motion of the hips. Proper  lifting shoes were recommended for movements like fron squats and Olympic lifting movements.

Do you see the point? Even “perfection” can be relative. It might not be pretty for the trained eye but, hey! Functional movements don’t have to become a beauty contest. They must be qualified according to the level of efficiency and personal safety. As a result, this client commenced to explore his potential during his performance training sessions while we prescribe specific drills to optimize his ankle mobility and also recommended proper weightlifting shoes, in order to provide hard sole overall support and get rid of the heel-elevators (see our recommendations in the chart below)

 Wearing the right foot gear, or not, is as important as selecting a relevant piece of the equipment. It is an actual part of tailoring the right corrective movement with therapeutic or athletic scenarios.

Wearing the right foot gear, or not, is as important as selecting a relevant piece of the equipment. It is an actual part of tailoring the right corrective movement with therapeutic or athletic scenarios.

CASE TWO: The Crab Walk

Every day is more common to see people on the gym floor performing “Crab walking" (or walking sideways) with a rubber band around the ankles. However, something wrong usually happens: Or the “prescription” has been misinterpreted or the “prescriber” lacks of fundamental knowledge about hip joint function. Or, simply, the performer has forgotten the right way to do it. It is not good enough moving more is we are not moving well. Whatever the reason, let’s clarify.

 Notice the toes pointing diagonally. as a result, hip flexors fatigue was present instead of proper activation of the abductors

Notice the toes pointing diagonally. as a result, hip flexors fatigue was present instead of proper activation of the abductors

The photos “C” and “D” belong to a 70y.o. Male, former athlete at state level and, currently, an enthusiastic golfer. You’ll notice in photo “C” how his toes are pointing outwards. Then, in Photo “D”, our client has internally rotated his feet to perform his “crab walk” movement. How the feet position affects the outcome? Well, after finishing his first set with toes pointing out, the QTX client feedback told us more activation in his hip flexors (Iliac psoas group and rectus femurus –or front-top of his thighs) rather that engagement of the abductor muscles. Therefore, we simply recommended to “keep toes pointing forward”. As a result. We achieved the desired engagement of the gluteus medius.

 Simply by rotating feet internally (toes pointing forward), our client was able to optimise the "work rate" of his gluteus medius rather that presenting compensatory activation of the hip flexors.

Simply by rotating feet internally (toes pointing forward), our client was able to optimise the "work rate" of his gluteus medius rather that presenting compensatory activation of the hip flexors.

Even the fact that our client natural stand tends to look like John Wayne’s  (that is feet pointing sideways like a cowboy), our training prescription includes not only keeping forward during abductors work but, also, as naturally his left knee is slightly rotated outwards, we thought should be also natural to rotate his left foot outwards when preparing his golf swing. As a result, knee pain has disappeared and torso mobility has improved.  Despite “standard” standing position suggested by most golf coaches -which suggest toes pointing forward- that slight variation has been good for Tony’s sport performance and health.

 

(TO BE CONTIUED)

Machines littering gyms .jpg

heck out our next post in regards to training thoughts about Abductors and Adductors. Sneak peek? Se why we don't exactly prefer adductor machines: