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Tag: injury prevention

The Poliquin Step-up for Knee Injury Prevention and Rehabilitation

January 11, 2022
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| Health and Wellness, Workouts

Knee pain is a common orthopedic pain complaint as well as joint injury. There are many reasons for this such as, muscle and flexibility imbalances, trauma (accident, fall, etc.) overuse, muscle adhesions restricting proper tracking of the patella, etc. Before I jump into this post it is important that if you are experiencing knee or any other orthopedic pain you should seek the diagnosis and advice of the proper medical professional. That being said, the goal of this post is to explain and demonstrate a step-up variation that many colleagues and myself have used to help successfully reduce knee pain, rehabilitate common knee injuries and strengthen specific muscle groups to help prevent knee injuries. 

The exercise I will be discussing with you today is called the Poliquin Step-up. This exercise was taught to me by the world-renowned strength coach, my long-term mentor, and friend Charles Poliquin. May he rest in peace. 

The difference between this version of a step-up exercise and the traditional version is based on the foot and knee position. Although you cannot singularly isolate the VMO muscle, by adjusting the foot position and knee angle you can greatly enhance the recruitment of this muscle during the range of motion.

So why is this important? What is believed to be one of the most common causes of knee pain and injury is a strength imbalance between the vastus medialis muscle and the vastus lateralis and possibly the tensor fascia latae muscles of the quadriceps. This imbalance can oftentimes lead to the vastus lateralis becoming stronger than the vastus medialis muscle. This increases the pull of the patella tendon laterally (to the outside of the knee). When this occurs the patella tendon cannot track properly when you bend and extend your knee and over time can lead to inflammation of the patella tendon and other knee structures and injuries.  

(Side note: I have also found it common that adhesions can develop between the vastus lateralis muscle and the Illiotibial band IT Band which can also cause improper knee tracking, pain, and injury.

In this case, a soft tissue, physical, or massage therapist can help release this adhesion and regain proper function) 

The picture below shows the different muscles of the anterior (front) thigh and where they are located in relation to each other to give you a clearer picture. 

The VMO is most active in the last 15-20 degrees of knee extension therefore this exercise is set up to place greater emphasis on this range of motion. Another important note is that to best innervate (recruit) the VMO muscle it is important to make sure that you are placing most of the pressure on the ball of the foot throughout the motion. Lastly, since this is a very short range of motion it is important to focus on a higher number of repetitions between 12 and 30. This will help assure the proper training effect and that the VMO muscle is being trained optimally. 

In the video below I demonstrate the proper way to perform the Poliquin Step-up and its progressions.

Whether you are experiencing knee pain, rehabbing, or trying to prevent knee injuries then this is a great exercise to add to your leg training. 

If you give it shot please let me know how it goes?

If you are interested in more information on treating injuries please check out my past post “Should You Use Ice to Treat Injuries?”. 

Yours’s in health,

Kevin

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Do What You Can Do

November 3, 2021
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| Uncategorized

Do you have any nagging holding you back? A chronically sprained ankle, shoulder pain, back pain, knee pain, etc.? Have these injuries set back your training, activity, and quality of life? If you are lucky enough to not have any health or orthopedic issues now, then enjoy every second of it because sooner or later all of us will suffer from an injury and/or illness. This isn’t being pessimistic. It’s being real. It happens to the best of us, and it will happen again no matter what precautions you take. This doesn’t mean not take precautions. As I said above, it’s just being real. The fortunate thing is that there is a way to not let injury or sickness totally derail your training, fat loss, health, etc. Read on to find out how.

Recently I aggravated a back issue that I have. Bulging disks in my L-3-L5. If you have ever had your “back, go out” then you can relate to how painful and debilitating it can be. I was down for the count for a week and still suffering pain and limited mobility over a week later. I have done a lot of things to my body over the years. Some of it happened from accidents and others happened from doing stupid shit. Either way, it happened and now as a 48-year-old man with a lot of miles on him my body reminds me daily. The important thing to do first is address the injury and get it taken care of by seeing a doctor, chiropractor, therapist, energy worker, self-care etc. (for more information on self-care stay tuned for my next blog post, Self-maintenance). The next thing is to realize that although you cannot do exactly what you were doing before the injury there is always something that you can do. 

Working as a personal trainer and strength coach for 30 years I have seen and heard it all. One of the things I see most is when someone suffers an injury, they just completely quit their training. For example, they have a shoulder injury, and they totally stop training. How about training your core, back, or legs? Maybe they have a knee injury, and they stop training. How about your whole upper body? You get the idea. The answer is do what you CAN do. 

Below are some great ideas to help you continue training when you are injured or sick.

  1. Train the rest of your body that is healthy around your injury.
  2. Train a weak or lagging body part that you have been neglecting and wouldn’t have made the time to train otherwise. This is a perfect time to bring it up to par.
  3. Cross-train. If you can’t run, walk. If you can’t walk, bike. If you can’t bike, use a bike ergometer. Swimming can also be a great alternative especially for lower body injuries. Try to find an activity that doesn’t aggravate the injured area and focus in that for the time being.
  4. Modify or find an alternative exercise that you can do. Using different hand and foot positions can oftentimes help alleviate pain and take pressure off the injured area. Different exercise can also be better than others. For eg.  low step-ups instead of lunges if you have a knee issue. Split squats or step ups holding dumbbells if you have a back injury. You can also try using a partial range of motion that doesn’t cause pain or isometrics.
  5. Do less but do it more often. You can decrease the load you are using and use a lighter weight but perform the workout more often. The same goes for distance. If you normally run 5 miles 3 times per week Try running one or two miles 5x a week if it doesn’t hurt.
  6. Go lighter and use tempo. By performing reps at a slower tempo with a lighter weight you are taking pressure off of the joint or injured muscles, but the slower tempo allows you to create more tension in the muscle being worked giving it a greater stimulus.
  7. Use machines. Machines can be more stable. They are also great if you have a hand or wrist injury and cannot support a barbell, dumbbell, etc.
  8. Do some yoga. Most people, especially weightlifters or people that sit all day for work can use the extra mobility work.

There you have it. Although there are even more ways to train around injuries it is important to be cautious and ideally be supervised by a professional trainer, doctor or therapist to assure that you don’t make the injury worse. Furthermore, once the injury is almost fully healed it is important to make sure that you do the proper rehabilitation and post rehabilitation therapy to make sure the injured area is properly strengthened and balanced so that you decrease the risk of reinjuring it.

Lastly, and possibly the most important thing is to realize that there is always something you can do. It may not be exactly what you want to do now but by continuing to train you can avoid falling into a rut, depression, and regression losing all your previous progress. So, pick yourself up, seek the advice a professional, keep a positive mindset and just do what you can do.

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The Top 5 Exercises for Healthy Shoulders

June 1, 2021
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| Workouts

The shoulder joint is the most mobile joint in the body. Like all things in life there is a give and take. The extra mobility comes at the cost of stability. This is one of the major reasons shoulder injuries are so common. This is also why it is so important to keep the smaller stabilizing muscles of the shoulder healthy and strong.

Unfortunately, most trainees overlook these small muscles in their training programs. This can lead to muscle imbalances, instability and oftentimes injuries. The following program contains 5 great  exercises to help keep your shoulders healthy and strong. They are also great to help rehabilitate shoulder injures or to use post rehab. 

Important Note:

This article is not meant to take the place of proper care by a medical professional. If you are experiencing pain or have a shoulder injury it is important to first have your shoulder evaluated my a medical professional before beginning any treatment or training program. 

The following program should be done twice per week on nonconsecutive days. E.G. Monday and Thursday. The Program can also be done on upper body days. 

  • Perform 2-3 sets of each exercise
  • Perform 10-12 repetitions for each set
  • Us a moderate tempo 3-0-1-0 (3 second eccentric/lowering, 0 seconds pause at bottom, 1 second concentric or raising and 0 seconds pause on top).
  • Rest 60 seconds between sets.
  • Then move on to the second exercise.

If you have never trained the rotator cuff muscles directly it is important to use very light weights to start. E.G.1-5 pounds. Especially if you are recovering form a shoulder injury. 

Side Lying Dumbbell External Rotations

Dumbbell External Rotations With Elbow on Knee

Dumbbell Trap 3 Raise

Band Pull Aparts

Side Lying Dumbbell Supraspinatis Raise

There you have it. Whether you are recovering from a shoulder injury, trying to prevent injury or just improve performance strengthening the rotator cuff is the key. 

Give this work out a try for 8 weeks and see how you feel?

Let me know in the comments. 

Yours in helath.

Kevin

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