The Knee: Top Trends in Training - Exercise ETCexerciseetc.com/file/knee-top-trends.pdf · The...
Transcript of The Knee: Top Trends in Training - Exercise ETCexerciseetc.com/file/knee-top-trends.pdf · The...
Webinars on Demand 2017
(C) 2016 by Exercise ETC Inc. All rights
reserved. 1
The Knee: Top
Trends in Training
Laura Abbott, MS, LMT • Master’s Degree, Sports
Medicine
• Licensed Massage Therapist
• Undergraduate degree in Exercise Science
• Instructor of Kinesiology, Georgia State University
• ACE Certified Personal Trainer
• Guest speaker at Atlanta area massage schools and at the Georgia State University Physical Therapy department.
• Owner of Premier Performance, Atlanta, GA
How to Get Your CE Certificates
• View the complete webinar • Make sure your printer is “on” • Log on to our website: www.exerciseetc.com • Click on “Administration” • Click on “Webinar on Demand Certificates” • Complete all required fields & click “submit” • Your CE certificate will appear on the screen; you
may either save or print your certificate; even if you do not have a working printer, make sure to complete this form
• Remember: The WebEx program records when you log on and off; logging off early or fast forwarding to the end of the meeting may result in denial of your CEs.
Webinars on Demand 2017
(C) 2016 by Exercise ETC Inc. All rights
reserved. 2
Learning Objectives (5)
• After viewing this webinar you will be able
to:
– Identify knee anatomy and proper range of
motion
– Explain how to assess ankle range of motion
– Describe correct knee positioning during
squats
– Provide proper instructions for jumps and
landing techniques
– List the components of efficient running
REMINDER:
Obtain medical clearance and physician’s release
prior to beginning
an exercise program
for clients with medical or
orthopedic concerns.
Knee Anatomy & Mechanics
• Bones
– Femur, tibia,
fibula, patella
• Ligaments
– Acl, pcl, lcl, mcl
• Meniscus
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Series Elastic Components
• Quadriceps
• Quad tendon
• Patella tendon
• IT band
• Gluteus medius/
maximus
• Hamstrings
• Gastrocnemius
Range of Motion
• Functional
– 0° to 120 ° flexion
• Active/Passive
– 0° to 135° flexion
– 10° hyperextension
is common
Bulletproofing Your Knees
• Stretch quadriceps
• Do mobility and
proprioception drills
for ankles and hips
• Strengthen glutes,
quads and hamstrings
• Learn to squat, lunge,
jump, and run
efficiently
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Band Assisted Quad & IT Band
Stretches
Joint-by-Joint Approach
• Poor hip and/or
ankle mobility
increases the
mobility
demands on the
knee
Ankle Range of Motion
• 10-30° of Dorsiflexion
w/ knee extended
• Assessment
– Stand with foot 6”
from wall
– Without lifting heal
attempt to touch
the wall with the
knee
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Hip Range of Motion
• Hip flexion
• Hip extension
• Hip external rotation
– In flexion
– In extension
• Hip internal rotation
– In flexion
– In extension
Improving Dorsiflexion
• Self-myofascial or
active release
stretching
– Plantar fascia
– Gastroc/soleus
• Tools
– Racket ball
– Tennis ball
– Golf ball
Strengthen Dorsiflexion
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Strengthen the Glutes in all
Planes of Motion
• Weak hip
abductors &
external rotators
common in knee
pain
• Use multi-vector
and loading to
optimize strength
of the hip muscles
Barbell Hip Thrust
• Arguably the
best direct
“glute”
strengthening
exercise
Crab Walk with Elastic Ring
• Perform 1st as a
side-step walk
laterally
• Progress to linear
walking
• Maintain foot, knee
and hip alignment
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Swiss Ball Leg Curl: Mimics actions that occur during gait
Single Leg Eccentric Leg Curls
• Contra-lateral
resistance
encourages free
limb/hip to maintain
alignment
• ROM restricted by
hip extension on
free hip
Single Leg Reach / RDL
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Nordic Hamstring Curl
• Begin with negatives
• Try single leg variations
• Use bands for
assistance
• Use dbs, bands, weight
vest for resistance
• Glute-hamstring bench
Functional Exercises
for Strong Knees
• Squats
• Lunges
• Step-ups
• Jump training
Squat for Strong Knees
• A body weight squat
below “parallel” is a
great example of
balanced strength &
flexibility at the knee
• Depth for strength
training and mobility
are different
• Parallel squat under
load is advisable
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Correcting Knee Position
• Center of the patella
should track over the 2nd
/ 3rd toe with weight
balanced evenly between
ball of foot and heel
• Use RNT - reactive
neuromuscular training
techniques
Additional Tips for Squatting
• Descend slowly
– Quick, forceful
contraction of quads
during descent can
stress patellar tendon
• Glute activation drills
before squats
• Hamstring curls before
squats
The Goblet Squat
• Can be performed
with one dumbbell
held under the chin
• Allows for more
upright torso while
learning the basic
movement
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Sit to Box – Box Squat
Split Squat
Step Down – Facing Step
• Descend under control
• Avoid using the non-
working limb to push-
off
• Start with a 6-8 inch
step height
• Avoid progressing to a
high step too soon
– Generates high PF
compression forces
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Forward vs. Reverse Lunge
• Emphasis on the
Glute
• Spine MUST remain
neutral throughout
• Loads the front leg
more effectively and
prevents back-leg
loading
• Front knee does not
cross ball of the foot
Walking Lunge
• Back-loaded barbell,
low bar position on
traps
• Long stride with slight
knee flexion on back
leg, stretching the
psoas & rectus femoris
– Increases pre-
stretch opposite
hamstring/glute
Lateral Lunging
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The Clock Lunge Try it with a ball toss, increase speed, hit a balloon
Jumps & Landing Mechanics
• Implicated in most forms of
knee pain and injury
• Teach client to land on ball of
foot with chest directly above
and back extended
• Immediately upon ground
contact… “sit back” and drop
to the heels
• Client should squat slightly to
absorb the ground reaction
forces
Jump Training Basics
• Requires coordination
– Sustain posture
– Immediately flex knees
after ground contact
– Dynamic muscle control
– Eccentric strength
• Flexibility
• Conditioning
– Role of fatigue
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Training Change of Direction
• Forward to
backward
• Side-to-side
• Forward-to-back,
right to left
• Jump to run
–Add directional
change
Multi-directional Resisted
Agility Training
Learn to Run Efficiently
• Run efficiently
– Use gravity
• Neutral spine
– Land on the mid-foot
• Front of the heal
– 90-96 strides per min
– Use the hamstrings
• Pick up your foot
Webinars on Demand 2017
(C) 2016 by Exercise ETC Inc. All rights
reserved. 14
How to Get Your CE Certificates
• View the complete webinar • Make sure your printer is “on” • Log on to our website: www.exerciseetc.com • Click on “Administration” • Click on “Webinar on Demand Certificates” • Complete all required fields & click “submit” • Your CE certificate will appear on the screen; you
may either save or print your certificate; even if you do not have a working printer, make sure to complete this form
• Remember: The WebEx program records when you log on and off; logging off early or fast forwarding to the end of the meeting may result in denial of your CEs.
Post-course Learning Assessment This assessment must be completed if you are certified by BOC, CSCS
or NSCA
Question 1
What is considered to be functional range of
motion for knee flexion?
Question 2
When assessing ankle range of motion for
dorsiflexn, how far away should the client
stand from the wall?
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Question 3
When squatting correctly, the patella should
track over the _____ toe.
Question 4
True or False
When landing after a jump, the client should
land on the balls of the feet with the chest
located directly above the feet.
Question 5
The proper amount of strides per minute in
order to run efficiently should be ______.
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Correct Your Work:
Answer Key
1. 0-120 degrees
2. 6 inches
3. 2nd or 3rd
4. True
5. 90-96/min
Make sure to keep this assessment with your other
recertification documents for 4 years. Questions about
any answer? Email us at: [email protected]
PLEASE NOTE:
• Remember to complete this
webinar and print the certificate
by December 31 of this year.
• Certificates with next year’s
date may not be accepted by
your credentialing organization.