My Favorite Exercise Combinations: Installment 12 – The Hip Bone is Connected to The Knee Bone

Before I begin, I just want to comment and mention that many individuals want to begin talking about pathoanatomy and all of the complex items that happen in the body, but not many even master the basics and fundamentals before moving onto said items!

In fact, Tony Gentilcore had a funny quip to a tweet I had ranting about this very item.Tony G Tweet

With that under your belts, let’s dive into my newest and most favoritest exercise combination!

The Hip Bone is Connected to the Knee Bone

One common theme that happens quite a bit in many populations that I come across involves the knees exhibiting genu valgus. This is a fancy schmancy word meaning the knees cave in – this could be due to a few things:

1. Increased q-angle, in which a line is drawn from the anterior superior iliac spine (ASIS) to the center of the patella, and another line is drawn from the center of the patella to the middle of the femur.

qangle

2. Over-pronation of the medial arch of the foot, in which the arch of the foot is rolled inwards. If the foot collapses, the tibias could lose integrity and also fall in height as well, thus causing the patellas to fall towards one another.

Arch vs No Arch

3. Lack of hip internal rotation, which could be due to several factors, such as:

  • Lack of abdominal contribution in controlling the motion of the pelvis during gait
  • Lack of strength in glute medius
  • Lack of space in the posterior portion of your hip capsule due to congenital (or you were born with it) reasons
  • The individual does not know how to control the range of motion given to them

…among many others such as contact and non-contact injuries.

Look here for more information on hip internal rotation.

Observations vs Pragmatic Actions

So the mere observation of said information does not help us, rather we (you and I) can intervene in a few ways:

  1. Perform rehab like exercises in order to improve what we are looking at.
  2. Improve gait patterns (over-pronation, reduce postural swinging during gait, etc.)
  3. Improve the individual’s ability to control their body during athletic movements

Today I’ll be going over how to improve option three, in which I introduce the single leg hop where the landing is “stuck,” paired with a single leg squat, or bowler squat, with a subsequent medial band pull.

The single leg hop is a great regression or even beginning assessment tool to see how an individual interprets how to accelerate away from the ground, along with how they decelerate and negotiate gravity.

When an individual lands, a few incorrect items may occur:

  1. Lack of sticking landing (hopping instead of absorbing force)
  2. Overpronation
  3. Knee collapse
  4. Landing too “tall” or high, as opposed to a lowered position

Long story short, I am looking for alignment of the foot, knee, and hip.

Knee Alignment - Sagittal
Left: Good alignment when landing from a vertical hop. Right: Bad alignment when landing from a single leg vertical hop

Further, starting and ending with a lowered position allows an individual to react appropriately with respect to athletic endeavors – if the athlete lands in a higher position, there is less ability to decelerate using the posterior chain/glutes, and more likelihood the person will have to lower themselves in order to get faster, which takes time they could have saved if they just landed lower to begin with.

The bowler squat with a medial band pull requires the individual to maintain all of these alignment items, along with maintaining a lowered center of gravity.

Single Leg Medial Band Pull
The band is pulling the outside knee into valgus/collapse. The brain will recognize this and fight back, hopefully.

I’d also increase the demands by requiring the athlete to pause for 2 seconds at the bottom position, which will take any momentum out of the equation, and challenge their core integrity.

Note: When you have the band pulling on the leg, make sure your most outside leg has the band pulling them inwards toward the midlineotherwise you are assisting your knee in maintaining appropriate alignment. The purpose is to challenge the vestibular and nervous system by pushing the body out of alignment!

How Can I Program This?

I believe this can be a great precursor towards improving frontal plane development, or even single leg forward hops or bounds. For this reason using this as a “reminder” in the warm-ups may be the best bet.

A1. Single Leg Hop (Stick Landing) – 3×5/s

A2. Bowler Squat with Medial Band Pull with 2 Sec Pause – 3×4/s

Make sure to use a slightly less challenging band, because a very strong, or one inch or thicker band, may be too difficult and might hurt more than help!

As always,

Keep it funky.

MAsymbollogo

My Favorite Exercise Combinations: Installment 8

After performing a large handful of assessments with our athletes at Cressey Sports Performance, one thing is very apparent: there is a trend of unilateral instability that is present.

How do I know? Well, I’ve been keeping track of these items in a fancy schmancy Excel sheet, and these things keep popping up! How these individuals arrived at a unilateral instability is also important, but from my point of view I am using the assessment process as a way to deliver high quality fitness and exercise selections.

Essentially, athletes (and general population as well!) are coming in with a predominantly strong pattern for favoring one side or the other.

A Few Thangs to Consider

1. As a strength coach and personal trainer, my responsibility is not aimed at ridding them of dysfunctional movement patterns – some of these dysfunctional movement patterns happen because of broken bones or surgeries, and it would be facetious for me think I can fix a bone! Rather, I’m all about improving upon their current fitness levels and referring out if necessary.

2. A lack of unilateral stability can mean: they need stability in a unilateral (or single leg/single arm fashion), or they need mobility in one area in order to stabilize in another area (providing more ability to move in an ankle or hip or even neck can clear up these issues).

3. If someone cannot perform single leg exercises in a dynamic fashion very well (Reverse Lunges, 1-Leg RDLs, etc.), I have to ask one question: why can you not perform this fundamental movement?

RFESS
Rear Foot Elevated Pains in the Ass

1. Lack of Ability to Split Pelvis in Efficient Manner

  • If someone is extended, their pelvis may be tipped forward (think anterior pelvic tilt).
  • If someone’s pelvis is tipped forward, forward and backward control of their pelvis may not be present.
  • If forward/backward control is not present when standing, how much more will be present when asked to control ONE pelvis in opposition of the other pelvis moving in the other direction?

Pelvis - Weight Shift

2. Lack of Reflexive Control (or Stability) via Abdominals

  • If someone is extended, this lack of forward/backward motion may be attributed to lack of abdominal control.
  • Obliques attach on PSIS and ASIS of pelvis.

Abdominal Obliquables

If abdominals cannot control a pelvis, and pelvis is not used to controlling motion one hip at a time, well then that leads us down a path of a few exercises that keeps all of those items in mind!

Inability to control pelvis, or inability to control abdominals?
Inability to control pelvis, or inability to control abdominals?

With all this in mind, I find myself falling back on this exercise combination that will help initial trainees reintegrate training in a single leg and single arm fashion.

 With the initial half kneeling exercise, you are getting a couple of great items:

1. A hip flexor stretch.
2. Ankle dorsiflexion on the back and down leg.
3. Requisite stability of the lower half of the body while moving your upper body.
4. Scapular motion (protraction/retraction) on the arm that is performing the rowing motion.
5. A static (or non-moving) neuromuscular pattern where you have to stabilize one pelvis in hip flexion and the other in hip extension, along with maintain abdominals and torso that requires stabilizing while rowing.

Why is this a better option than other rowing exercises?

Do you like chocolate? Feels good when you have some, right? Well performing rows (like barbell rows) are like chocolate. It’s good, but this is like adding in Graham crackers and smores. It adds in a little bit of nom, and a little bit of delish to the mix.

PopTart Smores
PhotoCredit: Cakespy.com

Long story short, this exercise allows you to perform a single leg static hold, while performing a rowing variation.

Why the variation for a side bridge?

Well this is a single variation, and you can perform this other variations to get a few more benefits:

1. Feet Elevated Side Bridge

2. Feet Elevated Side Bridge with Hip Abduction

3. Side Bridge versus Bands

4. Side Bridge with PNF Pattern

With that said, the side bridge (or side plank) variation will allow you to work on the abdominals, obliques, and hip stabilizers as well to improve unilateral stability by simply activating them!

How can you program these?

I’m so glad you asked. I usually perform these as a secondary exercise selection, so if you’re following along in the home program, these can be done as a B1/B2 exercise selection.

The movement is a secondary exercise, or accessory, or however else you want to call it. It can also be done as a warm-up, or even added into a circuit if you want to get a little crazy.

Sets and reps are variable as well, and rowing variations can usually be performed for 8 to 12 repetitions. Side plank variations can go anywhere from 20 to 30 seconds, or 5 to 8 respiratory cycles (inhales/exhales).

As always,

Keep it funky.

MAsymbollogo

My Favorite Exercise Combinations: Installment 6

As many of our athletes have returned from their high school and collegiate seasons (and go on to play summer baseball as well), there have been many individuals who, for several reasons, have only just returned to lifting on a more regular schedule.

When it comes down to it, there are only so many general preparatory exercises that need maintenance on a day to day basis.

  1. Hip Hinge
  2. Squat
  3. Lunge
  4. Push
  5. Pull
  6. Anti-Extension, -Rotation, -Flexion

The loads, implements, and other items will change from day to day, but the movements will largely remain the same.

As a rule of thumb with many of our youth athletes, the rotational demands that they have experienced for all of the season during their school year will need to be restored, maintained, and improved upon in order to prepare their body for the upcoming fall semester of play.

If an athlete is returning and they have only give or take 2 months (8 weeks) of hard training, not including any weeks off for vacations (so only 6.5 to 7 weeks in reality).

The drills indicated by the baseball edition of the combination days hopefully serve as an index for restoring movement that may have been as a cause of degradation during the season.

During the off-season, the athlete can now restore mobility, improve power and strength qualities that may have been lost for absolute speed qualities that were improved upon during games.

With all of this in mind, two drills (with a bonus third) I find myself using after the dynamic warm-up involve utilizing a rotational medicine ball drill, and a very simple half kneeling mobility drill.

A1. Hot Feet Recoiled Shotput – 4×4/side

A2. Half Kneeling Windmill – 3×8/side

The “hot feet” version of the recoiled shot-put involves understanding what it means to shift weight appropriately from foot to foot, and from hip to hip. As you move back and forth with intention, the movement will require adequate mobility through the hips, thoracic spine, and scapulae as you throw the ball.

Often times the movement may incorporate simply too much movement from the upper body, and not enough in the hips or even the feet.

What is hopefully accomplished with the pairing involves understanding how the Half Kneeling Windmill works – there is movement that aims to free up the scapula, requires co-contraction of specific lower body musculature, along with maintaining abdominal integrity as you rotate.

This coordination of the lower portion of the body with the upper body is necessary towards developing low levels of motor control – a quality that is also necessary for doing Moonwalks.

Perhaps this third exercise can be introduced to solidify the dissociation and association necessary for more body awareness for our athletes!

As always,

Keep it funky.

MAsymbollogo