Training Matters: Prevent non-contact knee injuries from hampering your habits
By Ed Stiles on September 10, 2020.
Non-contact knee injuries have always been a part of sport but trends have been increasing over the last decade. Greater training demands, earlier specialization, and year- round competitive play have all been cited as contributors especially when coupled with a lack of physical readiness and imbalances in the musculoskeletal system. Thankfully, this trend has sparked a surge in research and suggested approaches towards prevention. Now with the gap in sports participation that COVID has “provided,” the corresponding decrease in movement in general, and the occasional extra pound being packed on as we all hunkered down it’s even more important to implement some of these knee injury prevention strategies ASAP. From the outset it is important to accept that the human movement system is all connected, meaning knee pain can stem from a tight hip or ankle, dysfunctional lower back, or a weak core. Even a sore toe can cause compensations that will affect the way the knee is used. So, prevention of knee injury starts with sound movement mechanics from head to toe. The sooner all athletes embrace good posture and prioritize sound movement mechanics the better we will be. A quick web search turns up some great suggestions for exercises, warm-up routines, and stretches but without an underlying emphasis on proper execution we truly are missing the boat. In a perfect world we would all access a movement mechanic for a thorough look see, but a simple squat assessment can reveal some predisposing problems: Three mechanical issues found in a squat assessment that are easy to see and easy to fix: Stand with a mirror or camera positioned so you can observe from the front and side of the body. 1. Duck feet – as you descend into a squat the whole foot turns out. This demonstrates a lack of ankle mobility. Normal gait mechanics require the ankle to flex without the ducky toes so the knee can align properly. Some focused calf stretching and ankle mobilization along with the simple awareness to avoid walking, running or squatting like a duck can make a huge difference. 2. Caving Knees – At any portion of the squat the knees cave inwards toward the midline. This is a fault seen in many Anterior Cruciate Ligament injuries where the muscles are not being asked to fire properly to keep those knees tracking in line with the ankles and hips. This is often seen in adolescent athletes as they go through their growth spurt. Again the quick fix is awareness, No Cavy Knees! Placing a band around both thighs and pushing knees out into it as you squat can wake the proper muscles up and break that old motor pattern as well. 3. Knee dominant squat – Ideally we share the load of our squat between the quads and the glutes (biggest muscles in the body for a reason). When a squat begins with the knees moving forward well past the toes we put all the pressure across the knee cap. Simply by making the first movement “a sitting back into the hips” rather than leaning over the knees we help share that load and fire up the glutes. With those 3 elements as a foundation feel free to apply those sound mechanics to any of the prevention protocols out there like the FIFA 11, or any warm up, cool down and stretch protocol you see. Then turn up the speed and apply it to controlled running, jumping, cutting and so on so that the body is ready for the uncontrolled reality of sport. Enjoy. Ed Stiles BPE Certified Exercise Physiologist is a member of the Alberta Sport Development Centre’s Performance Enhancement Team and is the Fitness Coordinator at the Family Leisure Centre, he can be reached via email at asdc@mhc.ab.ca or ed1sti@medicinehat.ca. Also enjoy the Stiles and Giles Wellness Podcast on Apple and Spotify for more fitness tips. 11-10
