Isolation training really doesn’t exist, whether it’s in bodybuilding or in rehab. The concept of isolating a muscle has long been associated with bodybuilding purposes to increase the size of the different major muscle groups individually. This has led the whole fitness industry to follow stupid training principles for years, and even today if you step foot in a commercial gym, 90% of people, including most personal trainers, use bodybuilding concepts (working every muscle separately, using body part splits, etc). But I digress.
Even Spiderman is following the trend
You can also notice a certain muscle isolation mindset in most rehab protocols. One of the most popular ones is the isolation of the VMO in knee pain and injuries. How many times have we heard “he has knee pain because his VMO is weaker than his vastus lateralis”. In an effort to cure every knee problem imaginable, we started isolating the VMO…or should I say “trying” to isolate the VMO.
Because of our understanding of the fascial system and how muscle interact together at this point, we now know that isolating the VMO is a flawed concept. But somehow we’ve managed to keep trying to isolate small muscles in the hope that it would cure our shoulder, low back or hip problem.
This guy clearly needs some VMO activation exercises
As Charlie Weingroff recently said: “If you don’t believe in isolating the VMO, why are you trying to isolate the serratus anterior?” To me this is a quote that makes plenty of sense. It’s just how your body works, you can’t isolate just one muscle, whether it’s your VMO, your biceps brachii, the serratus anterior or the lower trap. Isolation just doesn’t exist.
Does it mean that you can’t reinforce a certain movement pattern that will facilitate the recruitment of certain muscles? No. But you shouldn’t think about “isolating one muscle” and think more in terms of movements. And in the end, the goal is be able to perform integrated movement patterns with optimal joint centration and the right muscles will do their job- as long as we don’t have movement restrictions.
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After my blog post from last week on the Bench Press Alternatives for Bum Shoulders, I thought it might be a good idea to do the same kind of post on the knees. Let’s face it, the knee is probably one of the most troublesome joints in the body, especially amongst athletes. Before we delve into the squat and lunge alternatives for your bum knees, I’ll mention the same thing I mentioned in my bench press post; before getting started with any of these exercises, if you have pain, you need to consult a qualified professional and get assessed. You need to clear out any underlying issues that might aggravate your problem before getting started. And also makes sure when you try one of these exercises that you can perform them totally pain-free, because as you probably know by now, pain equals irritation, and irritation equals your knee not getting better. Now that we got the boring stuff out of the way, let’s move on to the good stuff!
- Sled Drags and Prowler Push. The sled drag might be one of the most knee-friendly alternatives to heavy squat and lunges. Most knee pains occur at a significant amount of knee flexion (read: when the knee is bent close to 90°). Sled drags and Prowler pushes (with a high grip) involve a lot less knee flexion than any squat variation. The other advantage the Sled drag and Prowler push have is that they don’t have an eccentric action; it’s mostly concentric actions as you keep moving forward and driving your feet into the ground. You really have no forces to decelerate. For some people with knee pain, eccentric contractions may be more painful. And even if it’s not the case, it still put less stress on your joints.
- Deadlift variations. Posterior chain exercises can usually be done pain-free because they involve less knee flexion and they put most of the stress on the posterior chain (hamstring, glutes, lumbar erectors). If you’re going to use deadlift variations, depending on how bad your knees hurt, you might want to start with more straight-legs variations. The first one to try is definitely the SLDL (Stiff-Leg Deadlift) because it involves almost no knee flexion at all:
Then you can move to Rack Pulls, which involve a little more knee flexion (depending on where you set up the pins):
And if your knees allow more flexion without pain, you can try and pull from the floor, either with a straight bar or with a trap bar:
- Box Squat. This is an option for when your knees start to feel better. The box squat is a great option because, even if it’s technically a quad dominant exercise (also means more stressful on the knees), the goal is to sit as far back as possible on the box. The result is that it shifts your weight posteriorly to make it less knee dominant. Charlie Weingroff went into great detail in his DVDs Training = Rehab, Rehab = Training about how the box squat keeps you more in a vertical shin position, and therefore it puts less stress on your knees. Everybody that has been dealing with some sort of knee pain and want to reintroduce the squat in their training should re-learn to squat with (at least somewhat of) a vertical shin:
- Split Squat Isometric Holds. These are not much of a typical strength training option, but it can be a great addition to your training for different reasons; single-leg endurance, conditioning purposes, etc. So if you can tolerate some knee flexion, holding an isometric position for time usually doesn’t irritate the knees.
Split Squat Holds can be very versatile, and if you get creative like Kevin Neeld (seriously, he’s sooo smart) you can use them this way:
Having pain and injuries is probably the most frustrating thing in the world for athletes and weekend warriors alike. The last thing you want is be reminded constantly of the things you can’t do; that’s why it’s important to find alternatives and focus on what the athlete actually CAN do! As my colleague Eric Cressey puts it: ” you want to feel like an athlete, not like a patient”.
It’s been a little while since I’ve done a random thougths post, and since I have a couple interesting things to share with you I figured now would be a good time!
1. All the Endeavor staff is on Eric Cressey’s Show and Go program right now and the progress we’ve all made since starting the program 6 weeks ago has been phenomenal! I hit PRs on the trap bar deadlift and the front squat and I also added 5 pounds of muscle since starting! And all the Endeavor staff has made similar progress. Eric actually gave us some love in his blog this past Tuesday in that regard; CHECK IT OUT HERE. Eric has done an incredible job with Show and Go and the results speak for themselves. If you haven’t already, I strongly suggest you get it. You are provided with 16 weeks of programs to get bigger, stronger all while reducing your risk of injuries and imporving your posture. How much better can it get? Eric also provides you with videos for every single exercise in the Show and Go programs. Get your copy of Show HERE.
2. I really like to learn new exercises and stretches as it adds variety to your training, and most of the time these new exercises and stretches will feel totally different than any other thing you’ve been doing. This is why I like the wall adductor stretch so much…probably my new favorite one!
I will admit that the position is a little suspicious, but the benefits you get from it are totally worth it! Give it a try, and make sure you keep your butt as close to the wall as possible and keep your knees straight.
3. Last week, I celebrated my first Thanksgiving by eating a lot of food and watching football all day! That holiday also marked the return of a couple of our hockey players who took the opportunity to get a couple of training sessions in at Endeavor while they were back home for Thanksgiving. While conditioning the guys on the slideboard with Phil Collins blaring on the stereo, it just reminded me how much of a good time this past summer was.
I can’t wait for next summer!
4. Last week I was talking with one of my friends in Montreal who was telling me about some knee problem he’s had for a while. He also told me that he saw a professional who recommended he gets some orthotics because his feet were the problem. After getting the orthotics, his pain magically disappeared. But within 2 months though, his knee pain came back to bother him. I was trying to explain to him that his feet probably weren’t the problem and that someone needed to look at him with a more global perspective than just looking at the feet. He agreed to go see anyone I would refer him to, but he also insisted on the fact that the professional he saw put him through different tests for his feet and that there was clearly a problem there. And he also said something like: “the guy’s gotta know his stuff he’s worked with professional sport teams in the past”. As I’ve said before, and as I’ll say again, I don’t care if you work with pro athletes, you still can suck at what you do. That doesn’t mean you’re good; it only means you have good contacts and you’re good at selling yourself. But I digress. After contacting an athletic trainer I used to work with in Montreal and explaining her the situation without letting her know what I thought about the situation, here was her reply:”Orthotics might help in the acute phase, but in the long run they are crutches most of the time and they probably won’t correct your real problem. You need to look at the global picture and not focus only on the knees and feet, and assess everything from the hips down.” I couldn’t have agreed more. It’s really great to see people in the field who really get it. And more than anything else, it also highlights the importance of having a good network of professionals around you.
This is called a Monster Mini-Band Walk, and it might just be my new favorite injury prevention exercise:
The Monster Mini-Band Walk is designed to activate your glute muscles, and more specifically your gluteus medius. Your gluteus medius is a small (usually weak in most people) muscle that creates hip abduction and external rotation. Another important function of the glute medius is stabilize the femoral head in the hip joint.
A strong glute medius is particularly important to prevent the knee to buckle in during different type of activities, which will help you stay away from knee pain. This is especially important for basketball and soccer players who make a lot of jumps/landings, changes of direction and transitions during their sport practice; and these are all actions that put your knees at risk of buckling in. Women in general would also benefit stronger glute medius since they have wider hips and their knees are more at risk of buckling in, whatever they do.
Execution:
Wrap a mini-band around your ankles
Take a wide stance (slightly wider than shoulder width appart)
Slightly bend your knees
Take backward steps and make sure you keep your knees out the whole time
You can incorporate the Monster Mini-Band Walks in your warm-ups or even in between your sets of sprints, plyos or lifting.
Even Spiderman is following the trend
This guy clearly needs some VMO activation exercises
