Common Exercise Corrections: Pain in The Knee During Lunging
Installment numero three-o in the common exercise fix series. To recap: 99% of the time it's not the exercise, it's the execution that's causing issues.
So, let's say you're doing a split squat, step back lunge, forward/walking lunge or some other lunging variation that I forgot to mention and, oh bugger, your knee hurts.
If you have pain in the front knee...
- Check your shin angle. If it's not perpendicular to the floor... then you probably are experiencing pain in the front of your knee.
Look at that shin!
- Check your variation. Some folks just can't do forward-moving lunges. Switch to a reverse lunge (above) or split squat variation, thus minimizing the sheer force on the knee (also, of course, maintaining that vertical shin).
- Still having problems? Check how you're applying force through your foot. (Sorry, that was an awkward sentence) Are you pushing through the ball of your foot to stand up or your heel? Pushing through your heel will put the stress of standing up on your glute (instead of the quad) and your glutes are a LOT better at producing hip extension than your quads. Matter of fact, think about pulling yourself upright through your heel as you stand up. (This applies to step-ups too.)
If you have pain in the back knee...
- Check your back leg's placement. Are you in line or is the back leg at a goofy angle? You want to stand about hip-width apart and make sure that your knee is going straight down (instead of in or out at an angle). How does one create such a delightfully descending back knee? Squeeze your butt. It should straighten out any wild knees.
- Check your variation. Maybe switch to a lunge exercise that doesn't require the back leg to work as hard, a Bulgarian split squat, might work as you're not supposed to use the back leg as much.
Note* this has an ISO hold at the beginning of the set.
- Still hurting the back knee? Perhaps try a different single leg exercise such as a bowler squat, a single leg squat progression or single leg RDL. Those will help train the posterior chain (which might be the source of your knee pain, weak glutes or hamstrings) as well as your hip stabilizers (adductors, glute medii, quadratus lumborum) as it might be an instability in your hips that are causing the knee pain.
If, after trying all these fixers, your knees still hurt, well, don't do lunges (you're in the percentage of folks that just need to stay away from them). There are plenty of other single-leg exercises out there that are just as awesome!
Common Exercise Corrections
I'm starting an on-going series of common fixes to common pains that arise during exercises. Most of the time, it's not the exercise that's causing pain, it's the execution that's the problem
It's not the appratus, it's the application.
*Note* These are general solutions that fit about 90% of the population and for those who don't have any injury that would cause pain inherently.
First up: Anterior shoulder pain or elbow pain during push ups.
Solution(s):
1. Pull your elbows in to 45 degrees from the body (as opposed to 90 degrees from the body). The smaller angle of elbow-to-body allows for the shoulder blade to glide correctly along the rib cage. When the elbows flare, the shoulder blade tends to slide up towards the neck and can pinch things within the ball-and-socket part of the shoulder. It also places a fair amount of torque on the glenohumeral joint (the shoulder) and inhibits the scapula's ability to glide correctly.
2. Speaking of gliding shoulder blades, if the blade doesn't glide = big ouchie. Watch for scapular "winging." See below video.
Check out Mount Everest arising on the athlete's back. That's the scapula sticking up and not sticking down close to the rib cage as it should. This winging (or Mt. Everest-ing) results in pain in the shoulder and possibly the elbow too as the stress of the push-up is transferred down the chain. In a push up we want scapular retraction (think of pinching a pencil between your blades). Like thus:
How does one go from "winging" to "retracting" and thus from push up fail to push up success? There are two cues I generally give. One is to "pull yourself to the floor." Don't let gravity take over; be in charge and lower yourself on your own terms, not gravity's. The second is, "pretend your hands are on two peanut butter jars and you need to open the lids." Essentially, you're trying to twist your hands out (but don't actually move them). Both these cues activate the scapula retraction muscles (example: serratus anterior and lower trapezius).
Typically, those are the two cues that "fix" shoulder and/or elbow pain during a push up. (to say nothing of squeezing the butt and abs... different tale for a different day.)
Linear Periodization (Yawn...?)
Grab a cup of coffee and get comfortable. I'm about to talk programming and, more specifically, my personal experiences with linear periodization: My go-to programming style is, and always will be, the conjugate sequence system. The reasons are many, but to simplify, I just plain consider it the most effective and safest way to improve strength, power, and athletic performance in most advanced athletes while ensuring that serious CNS fatigue stays at bay.
Plus, because the BULK of my programming experience has been for sports where the goal, from a S&C perspective, is to allow the athlete to perform close to their best for upwards of 2-months in many competitions that are all equally important. The constant cycling of compound lift variations and set/rep schemes lends itself quite well to these types of sport.
So, when I began working with track and field, who are only interested in peaking twice a year, the seeming simplicity was almost too much to bear. I found myself working with coaches who implemented their own linear periodization on the track and wanted the weight room sessions to mirror in terms of both volume and intensity.
This meant *gasp* that I would have to resort to programming bench pressing and squatting at repetitions that sometimes exceeded sets of 10. I know that sounds kind of silly, but for women who squat in the 300's and men who hover around 450, a 4x8 back squat session can get pretty out of control.
My first year with track and field I spent many painful hours trying to unravel the mysteries of linear periodization (mountain out of a mole-hill? I'd say so). I even went so far as to get a USATF Level 1 coaching certification in an effort to find some solid footing.
Well, fast forward a couple years, and we've won our conference the last three years and had numerous successes on the road to nationals each season.
Despite this success, I still had a problem. I couldn't accurately identify with the athletes as they trudged through what I believed to be an extremely intense training program.
I've always prided myself on personally experiencing virtually components of every program I've ever implemented. This is critically important because it helps me communicate and relate to the athletes better than if I have no experience with what they're going through.
Why had I never done this with the track program? I've actually got a couple good reasons: Baby #1 followed by Baby #2. But, no longer being in the pregnancy cycle, I figured I could probably manage my way through the sprinters and jumpers weight training program. That or I'd hurt myself trying.
In my next post I will dive into the details of this training plan and how I've been progressing.
Here are a couple teasers: 1. I haven't experienced this much muscle soreness in at least 5 years. 2. I'm amazed the team hasn't attempted a full blown mutiny given what they do on the track is followed immediately by my program. Remember, the programs mirror each other in volume and intensity. 3. My lift today really almost made me throw up. Happily, my iron stomach once again proved to have the upper hand. 4. I'm getting much stronger very quickly.
Until next time...
SMR: Self-Myofacial Release, Magic Without a Wand
For us Muggles, a foam roller is more effective than a wand.
Yes, SMR is more important than a wand is to Harry Potter. Why? The short answer is we have a lot of gunky junk in our muscles that are impeding movements and causing aches and pains. And who wants to feel like a bag of junk?
Those in the fitness-know-how have probably heard of self-myofacial release (SMR) or at least have seen foam rollers lying around a lot of gyms (or, if you're us, lying around the house). A little rolling here and there does magical things for the body! One can instantly feel the difference even after only one time on that foam roller. What is this witchcraft? Let us delve into the magical world of SMR.
What SMR does NOT do:
- Lengthen tissue/muscle- you'll hear this occasionally and SMR does NOT lengthen the tissues because a) the joint position doesn't change b) the SMR modality (aka foam roller) applies compression at a 90 degree angle to the muscle. Unless force is applied more along the length of the muscle, no lengthening will occur.
- Allow more fluid to the muscle- what? SMR is not open a flood gate of fluid to rush into the muscle.
SMR does not equal flood of Isengard
What SMR DOES do:
- Releases tension in the muscles. How does it do that? Let's say there is a knot in the muscle (ball of fail, junk, gunk... pick you favorite term) and you sit on a foam roller or lacrosse ball and apply pressure to the knot.This provokes the ball-of-fail enough to cause it to release the tension. Kinda like a pesky little brother, he pokes you in the shoulder (SMR modality) until you finally explode out of annoyance (release tension).
How does that happen?
Our muscles are encapsulated in a tissued called fascia (there are SO many trails and tangents I could go on regarding fascia, but we'll stick with this for now). The fascia has little receptors (rufini corpuscles and pacini receptors for those who want to know stuff like that, they sound like Italian food.) that generate and relieve tension in a slow, deliberate pace.
*Side note* Our muscles also have similar receptors, the golgi tendon apparatus and muscle spindles, that react much more quickly to changes in length and tension in the muscle. For example, when the doc tests your reflexes by tapping on your knee, what he's doing is stretching the tendon quickly, which causes the muscle spindles in the quad to react, a signal is sent to the brain and the quad contracts (thus extending the knee a bit). It's actually really cool.
Anyway, these slower receptors also have neural components that govern them. What foam rolling does is short-circuit the neural components and the fascia-imbedded receptors (usually) freak out, shut down and take the tension with them.
Since they're slow-acting receptors then we need to foam roll/use a lax ball s-l-o-w-l-y. Hang out on those junky spots and you should feel them release a bit, then you can move one. Check back on Friday for Part 2 and I'll have some videos of how to roll the various body parts.
Until then, just sit on a lacrosse ball. Your glutes will thank me.
Deadlifts: Is It One Size Fits All?
The other day I found myself in discussion with a buddy of mine (he trains at a gym/training chain that shall remain unnamed), and the topic naturally steered toward moving heavy objects around. His tone of voice became quickly disgruntled as he told me:
"Yeah, I hate deadlifting. I love squatting though! But I utterly DESPISE deadlifts."
This obviously perked my interest, so I asked him to elaborate.
Friend: "Well, I just can't get down there and grab in a good position. It doesn't feel comfortable and my back always hurts when I do the lift. The instructors are yelling at me 'Hey, do this, do that, get your back flat' and I'm thinking to myself 'I know, I know!' but I physically can't do it since I'm so tall." (he's well over six feet tall)
Me: Ah, yeah, I know what you mean. I'm guessing you're pulling conventional style, with your feet roughly shoulder-width apart?"
Friend: "Yep."
Me: "Well, did the instructor ever have you try using a SUMO stance for your deadlifts?"
Friend: "......What's that?"
Me: "Where you put your feet out pretty wide, and then grip the bar with your hands inside your legs, as opposed to outside your legs. I find it's a bit easier for people with your type of build to get into a good deadlift position that way"
Friend: "Oh, no, they won't allow us to use any stance other than conventional. We're all forced to use the same stance."
Me: "Excuse me? I thought I just heard you say that they force you to pull conventional, and then they murder innocent little kittens."
Friend: "Yeah, that's 'cuz that is what I said."
Me: "So you have no other option? What about elevating the bar a bit to help you get into a more neutral spine position?"
Friend: "No. They don't let me do that. I have to pull from the floor. Conventional. And it hurts my back like crazy, especially when I have to perform 10 freaking reps for multiple rounds in a row."
I think it goes without saying that hearing this made me completely incensed. What's next, are we going to take young, beginner lifters and throw them under a 400lb barbell, telling them to 'just squat it'? Or do something else as equally useful as handing out free tickets to an all-you-can-eat poop buffet?
And this is why you continue to hear people spouting off that deadlifts are bad for your back. Of course deadlifts are bad for your back. If you're an idiot with them.
The very beauty of deadlifts is you can fit them to the individual, no matter the person!
Here's just the tip of the iceberg with options we have at our disposal, starting with the variation that initiated this entire discussion:
Conventional Deadlift
While conventional pulling arguably looksthe coolest, these require the most ankle mobility, thoracic (upper back) mobility, and hip flexion range of motion (ability to bend at the hips without compensating at the low back)in order to get into position safely. Conventional pulling should typically be reserved for those who've had fairly extensive practice with how to achieve and maintain a neutral spine under load, as this variation places the most sheer stress on the spine (bar is positioned furthest away from the body's center of gravity, compared to other deadlift variations).
SUMO Deadlift
Taller individuals (such as our friend from the conversation above), and those with longer torsos are going to find this variation easier to utilize, as less mobility is required to execute the pull with a neutral spine. In addition, the total range of motion of the lift is decreased, meaning the distance the bar has to travel from start to finish is shortened.
SUMO pulling is the most common variation we will progress our athletes to after they have learned to deadlift with the trap bar.
(Note: The only caveat I'll note with SUMO pulling is that it can really beat up your hips if you use a super wide stance, and if you fail to intermittently cycle them in and out of your training.)
Trap Bar Deadlift
This variation is usually the easiest to for all people to "sit into" while keeping a safe and sound position. The high handle setting makes it so you don't have to dip down so low to grab the bar (thus less mobility is required), and the fact that you're positioned INSIDE the bar typically makes the lift easier to execute, given that the weights are lined up with your center of gravity.
This is usually the first barbell deadlift variation we use to teach our athletes and clientele at SAPT. After they have developed proficiency with the trap bar, we'll move on to the appropriate straight bar variation, depending on their body type and other morphological concerns.
Conventional Deadlift with Barbell Elevated
The beauty of this set-up is that you can adjust the height the barbell is elevated - using mats, bumper plates, or whatever - so that the lifter can utilize the straight bar but at a height that is appropriate for them as an individual.
Oftentimes, I find that someone may know what they're supposed to be doing (such as our friend above), and kinesthetically aware of where their body is in space, but they just can't physically get into a solid position when the barbell is on the ground. No worries! Elevate the bar just as high as necessary to get them into a neutral spine position (and no compensations elsewhere), and, as their mobility and stability improves, they can lower the height of the bar over time.
Kettlebell Deadlift: Conventional and SUMO
With our younger athletes, and sometimes with our adult clientele, we'll have them initiate the process of learning the deadlift by using kettlebells, as they may not ready to use a 45lb barbell, even with the luxury of 10lb bumper plates in order to get the bar at a proper height yet keeping the weight down.
These can be done either conventional or SUMO style, and the weight of the kettlebell will obviously be chosen depending on the person.
Stop Trying to Force Square Pegs Into Round Holes
As you can see, we virtually have an endless supply of deadlift variations to fit the lift to the individual, not the other way around. If someone can't pull conventional from the floor, why force it??? They can simply use another variation (or elevate the bar a bit) until their necessary qualities improve in order for them to pull from the ground safely.
Conventional deadlifting from the ground looks awesome and is "hard core," I get that. But I also don't see what's hard core about forcing someone into a position that perhaps they're just not ready for yet.
All deadlift variations are going to hammer the glutes, hamstrings, upper back; "pull" people into better posture, improve the structural integrity of their bone and soft tissue (Wolff's Law and Davis' Law), all the while teaching them to resist sheer forces and elevating their superhero status. Try not to get so caught up in what "all the cool kids do" and instead focus on the larger, and more important, picture at hand.
How to Fix Anterior Humeral Glide During Horizontal Pressing
One of the first articles I wrote was on Anterior Humeral Glide during horizontal rowing which you can find here. I won’t spend a great deal of time going over what AHG is as that would just be overkill and I’ll leave the area of redundancy up to the creators of American Idol.
In the following video I’ll take you through how to prevent AHG during horizontal pressing, namely during the bench press and pushup. Thanks to our intern Jarrett for volunteering for the video even though I kinda through him under the bus; sorry man! Also for another great cue to boost your bench and to stay out of AHG check out Stevo’s article, Quick Tip to Improve Your Bench Press: The other 50%+ of the Equation
