Mike Robertson – Bui letProof Knees
Salepage : Mike Robertson – Bui letProof Knees
Having a bad knee stinks, so I devised a foolproof approach to have your knees feeling healthy and operating as well as they possibly can.
Wait! Were you about to use the back button on this article? Perhaps you might go look to see if any new hotties have submitted their photographs elsewhere on the site? Don’t do it. Why? Because you do not want to go through this.
I didn’t believe so. Yes, this is an article on knee health. No, it’s not as appealing as biceps and massive bench presses, but maybe the photo above will terrify you into caring.
I had absolutely healthy knees a year and a half ago, and I was coming off the finest training cycle of my whole life. To cut a long tale short, a ski vacation resulted in an arthroscope and a knee that may never be normal again.
My specialty is repairing knees. I’ve researched their architecture, how they work, cutting-edge research, typical ailments, and what the industry’s best and brightest are doing to heal even the most obstinate knees. I’d want to claim I’m doing it all for you, but there’s certainly some self-interest involved!
This is the article for you if you’ve ever experienced a knee injury. I’m going to get you up to speed on some new principles (while also revisiting some old ones) that will ensure your knees are as healthy as possible.
Have you ever suffered a knee injury? Then this is a great post for you. If you implement the principles presented here, you will be far less likely to have a knee injury in the first place.
18 Ways to Have Bulletproof Knees
1) Get some knee sleeves.
I’ll make the first one simple for you. Purchase some knee sleeves and wear them whenever you exercise your legs.
This might be referred to as quad-dominant day, hip-dominant day, “leg” day, or anything you wish. Simply slip them on before your workout, warm up fully, and enjoy the delight that healthy knees provide.
2) Don’t skip the warm-up!
This concept is wonderful in its simplicity, yet it is frequently overlooked for many reasons such as “I’m in a rush” or “I don’t need to warm-up since I’m 22 and therefore 10 feet tall and impenetrable to injury.” I’d be curious to see what your lack of warm-up is doing to your joints, mate!
Warming up, in addition to increasing your training performance for a variety of reasons, decreases the viscosity of synovial fluid (the fluid that fills the joint area), enabling greater lubrication and overall healthier joints.
3) Do you want healthy knees? Concentrate on ankle and hip mobility!
It may seem contradictory, but where do we put the most of our attention when we have knee problems? Right, the knees? What else is there? That is a significant part of the problem!
The truth is that knee problems are usually the result of problems in other parts of the body, not the knees themselves. Lack of hip mobility in all planes might cause not only knee discomfort but also back pain. Eric Cressey and I covered a billion hip mobility exercises in our Magnificent Mobility DVD, which I strongly recommend.
However, one topic we didn’t go over as much was ankle mobility, which is sometimes overlooked, or worse, not addressed at all! After watching Mike Boyle’s Functional Strength Coach DVD series, I observed how many athletes had inadequate sagittal plane ankle mobility. Here are some drills to get you started:
In the first exercise, you will simply stand next to a wall with your feet a few inches away from it (you may even want to start with your toes touching the wall at first). Rest your hands on the wall, put all of your weight on your heels, and then stand tall while attempting to “shoot” your knees over your toes.
In this second exercise, you will lay a little board between your toes to create a dorsiflexed position. This board is best placed in front of a wall so you can support yourself with your hands.
You’ll aim to “shoot” your knees over your toes while remaining tall. Don’t worry if you don’t have a lot of range of motion at first; it will increase as you practice.
4) Engage your glutes.
This is another region that far too few of us are targeting, since most people with patello-femoral discomfort are primarily concerned with isolating the vastus medialis obliquus (VMO).
Ireland et al. (1) discovered that athletes suffering from patello-femoral discomfort had considerably lower strength in both hip abduction and hip external rotation. How substantial is the amount? These patients had 26% less hip abduction and 36% less hip external rotation!
What muscles are most affected now that we know what motions to train? We’re talking about getting your gluteus maximus and gluteus medius posterior fibers to fire. So, before we perform any low-body training, we need do some activation work to ensure that those muscles are aroused and ready to go. Here, X-Band walks are ideal.
The setup is a little strange, as you can see in the video, so perhaps seeing it will be simpler than hearing me explain it! Turning the toes out slightly and bracing the core are important things to remember here. This will prevent you from doing the “Weeble-Wooble” replacement pattern, which is common in hip abduction motions. Stay tight, tall, and engage your glutes, and you’ll be alright.
I may only perform one set before training during maintenance stages (when I’m working on max strength). I may execute three or even four sets of these exercises before training when motor control and recruitment are a priority (for example, in the early off-season or during a transition phase).
5) Ignore the VMO isolation!
Many athletes and lifters, particularly those suffering from patello-femoral (PF) discomfort, are eager to get the VMO to fire. In many situations, anterior knee discomfort results from soft-tissue imbalances between the stronger/tighter lateral knee tissues and the weaker/inhibited medial knee structures (the VMO). This muscular imbalance causes the patella to draw lateral (outside) into the femoral condyle, resulting in knee discomfort.
The apparent remedy would be to isolate and then strengthen the VMO, but this does not appear to be possible. In reality, no actual VMO “isolation” exercises appear to exist. Terminal knee extensions (TKEs) do affect the VMO, but it is not “isolated.”
Malone et al. (2) write flatly in an article regarding muscle control of the patella, “The concept of VMO isolation by particular training should no longer be part of our language.”
Instead, I believe a more comprehensive strategy is required. A complete patello-femoral pain program, for example, might include any (or all) of the following:
The lateral structures’ foam rolling (primarily the vastus lateralis and iliotibial band)
Direct soft tissue work for the lateral tissues (e.g., massage/ART) (all of the above plus the lateral retinaculum)
Increasing overall quad strength (via quad sets, leg extensions etc.) TKEs might certainly be included in the program; however, keep in mind that they are not a real isolation exercise.
Increasing gluteal motor control and strength
Quadriceps and calves stretching
It should be remembered that each knee is unique, necessitating a customized examination and treatment plan. I’m not here to rehab individuals; rather, I’m here to assist them avoid the need for treatment! However, I don’t see the necessity for direct VMO “isolation” exercises in that therapy regimen, given their usage has yet to be supported in studies.
6) Strive for balance in your workouts.
I’m still astounded by how many people break this guideline. They’ll squat, lunge, do leg extensions, and perhaps some hamstring training if they’re not completely exhausted at the conclusion of their exercise.
If you do not follow this guideline, your knees may not hurt right now, but they will in the future! When I say we need to balance your training, I’m not referring to the training day or even the training week. When you plan your workouts, you must consider your body’s long-term health! Do not just plan one cycle, follow it, and then disregard it while planning the next. What you did (or did not do) in this cycle has a direct impact on subsequent cycles.
So, if you did a lot of quad-dominated training in one cycle, you best compensate with some major hamstring and glute dominating work later on. “Time multiplies all programming faults,” as Alwyn Cosgrove always says.
7) Put an end to any behaviors that cause you agony!
This is the most basic advise I can provide, yet for some reason, individuals still fail to listen to their bodies and understand the concept: If it hurts, stop doing it! This includes squatting, lunging, jogging, basketball, and any other painful activity.
The same instruction may be given to you by your second grade PE instructor. Remember that taking an additional day or two off isn’t always a negative thing if it allows you to exercise harder (or pain-free) the following time. There are other instances when you need to take a step back and strive on a complete body makeover. If your body has been performing inefficiently for a long period, it may take some time to get things back on track. Make the time to accomplish this sooner rather than later.
Every time you enter into the gym, you need to work on becoming better, and that can’t happen if you’re hurt.
8) Don’t be scared to isolate yourself following a catastrophic accident.
Isolation workouts almost always fail, especially if strength and/or performance are your primary goals. However, regulations may and must alter in a rehabilitative context.
Following my knee scope, I resumed training with simple proprioceptive exercises, focusing on restoring mobility before returning to single-leg activities. My quadriceps, though, were severely underdeveloped. When one muscle is weak, another is compelled to compensate, just as it is with any other. So I was promoting another muscular imbalance by not isolating my quads.
So I reluctantly climbed onto the leg extension machine and struggled with 40 pounds. I’d sooner have a bullet in my head than be seen laboring with 40 pounds on the leg extension, yet it was just what I needed to regain my strength.
Remember this adage: “A muscle that is weak in isolation will be weak in integration.” Do everything it takes to regain strength, even if it involves using machines for a short period. The ultimate objective is to build tissue tolerance and be able to do single-leg activities without compensating.
9) Practice single-leg exercises.
Why perform single-leg work? Here are a few of the reasons I mentioned in my Single Leg Supplements article:
1) Reduce strength disparities between the right and left legs.
2) Changing up the speed of your training
3) Increased proprioception and balance
4) Work on strengthening important knee stabilizers, including the VMO and gluteals.
5) Remove the “light bulb” effect.
Let’s take a quick look at point four. Remember how we said before that those who have knee problems need to strengthen their general quadriceps strength as well as their gluteal strength? Single-leg workouts can help avoid (or rehabilitate) injuries for these reasons alone.
Aside from that, far too many of us limit ourselves to the “major” activities at the gym. I’m all for huge squats, strong mornings, and pulls, but single-leg workouts take us out of the sagittal plane and compel our bodies to acquire frontal plane stabilizing patterns. I am a firm believer that the greater our frontal (and transverse) plane stability, the better we will do in sagittal plane workouts.
In layman’s words, the better you get at single-leg exercises, the better you’ll get at double-leg exercises!
10) Strengthen your glutes and hamstrings!
We already covered how persons with patello-femoral discomfort had much reduced gluteal strength. So, what’s the simplest approach to fix the problem? If you said, “Strengthen their glutes,” you receive a gold star for the day. You’ll be well on your way to healthier knees in the future if you strive to activate the gluteals before your workout and then strengthen them throughout it.
What about the hamstrings, though? Have you ever encountered someone who just cannot sit back when squatting? When they lunge, do they land on their toes? These guys have absolutely no posterior chain strength. It is vital to remember that while we want the glutes to be our primary hip extensor, we must not overlook our other major hip extensors, the hamstrings.
Finally, while many women who suffer ACL tears are genetically predisposed (through a big Q-Angle and broad pelvis), they may do a lot for themselves just by following this suggestion. This genetic propensity leads to poor posture and movement patterns in which the quadriceps and adductors undertake the majority of the effort while the hamstrings and glutes do the least. Combine this incorrect posture with the increasing participation of girls in quad dominating activities such as basketball, soccer, and the like, and you have a prescription for catastrophe!
Every female athlete I deal with will receive a consistent dosage of posterior chain training, including glute-hams, RDLs, deadlifts, reverse hypers, and pull-throughs. It may be tough, but try to focus on increasing overall posterior chain strength while also improving recruitment patterns. Squeezing the glutes at the peak of all motions can help a lot.
Mike’s article now become a lot more fascinating.
11) Acquire the ability to absorb force.
As I write this, I can see people pushing it to the next level and doing depth drops from a ten-foot wall. Let me explain my position a little before we get there.
I’d like all learners to have a fundamental understanding of how to absorb force. If you jump into the air and then land with your knees straight with a loud “thud,” your muscles and tendons are not able to absorb stress. Instead, your joints absorb all of the stress, which isn’t ideal if you value your knee joints (or ankles, hips, or lumbar spine for that matter!)
The vertical leap is an excellent test and workout to use. Jump into the air and attempt to make as little noise as possible as you land. To absorb the power, land with soft knees and soft feet and lower into a half squat. This proposal is not intended to turn you into an outstanding athlete; rather, it is intended to provide you with food for thought. Wouldn’t it be better if you were a little more athletic?
12) Make sure your body is in good alignment!
Have you ever seen an automobile that is out of alignment? Have you noticed how rapidly those tires wear out? Furthermore, the gas mileage is awful. So what if your body is out of whack?
Walking around might be difficult, and I can almost promise that one region of your knee joint is bearing the brunt of the strain. To make matters worse, you’re probably also squatting, deadlifting, and lunging heavy, which is similar to speeding with the same poor alignment. It’ll catch up to you one of these days when your tires explode!
If you need a tune-up, check out the Neanderthal No More series. The benefits of optimal alignment significantly exceed the time and investment required to achieve it.
13) Figure out how to lift!
This may seem obvious, but you’d be surprised how many clients and athletes I deal with tell me, “I can’t perform X exercise because it hurts my (insert body part here).” We’ll presume it hurts their knees because this is a knee article. But here’s the catch: It’s not the workout that’s hurting them; it’s their terrible lifting technique!
I’m shocked at how many individuals can’t complete even the most basic weightlifting exercises, yet they’re certain it’s the activity that’s the problem, not their performance of that exercise. The squat is a good example because it’s been blamed for everything from painful knees to damaged backs.
There have been countless technical articles posted on T-Nation for anything from single-leg workouts to squats and deadlifts, so if you suspect your form is amiss, read through them and double-check your technique. Improving your technique, as well as your strength and physique, is one of the finest things you can do to stay healthy.
14) Watch out for the inflamed rectus femoris!
I used to believe that the psoas was the demon of bad posture and injuries, but now I’m not so sure. Sure, it can be bothersome for a variety of reasons, but for people with knee problems, I’d rather focus on the rectus femoris.
First and foremost, you’re probably thinking, “How can I know whether my rectus is a problem?” To discover out, use the modified Thomas Test:
Sit with your buttocks on the edge of a table or counter. Grab one leg and draw it to your chest while resting back with your head and neck relaxed.
The position of the lower leg in respect to the ground is what you’re searching for here. You’re alright if your lower leg is perpendicular to the ground. If your lower leg is not perpendicular to the floor, you have a short or stiff rectus femoris. The gentleman in the photo below is an excellent example. Notice how his upper thigh is parallel to the ground, but not perpendicular. I’m prepared to wager that more than a few of you will flunk this test horribly!
So, what should you do if this is the case? Instead of stretching your single-joint hip flexors, target your rectus femoris, a two-joint hip flexor that crosses both the hip and the knee. If you failed the last test, try this stretch:
It’s similar to a conventional lunge stretch, but by elevating your rear foot, we bring your hip into extension and your knee into flexion, stretching the rectus femoris on both sides. Maintain your posture throughout. Keeping the chest up, posteriorly tilting the pelvis, and squeezing the stretch-side glutes are all coaching cues.
To get the most bang for your money, do this stretch with some glute activation training to help restore hip balance.
15) Consume anti-inflammatory foods.
When it comes to preserving healthy joints, a balanced diet is crucial. While we don’t yet have all the answers, we are fast discovering that an inflammatory diet is NOT a good thing, whether you are at risk for heart disease, have asthma, or just want to keep your joints healthy.
While we’ve known for a long time that poor biomechanical alignment, being overweight, and ordinary wear-and-tear can all wreak havoc on your joints, we’re now discovering that joint degradation may be systemic as well. Positive dietary adjustments may have a significant impact on your joint health later in life.
Given that this isn’t my area of expertise, I enlisted the help of the experts. Tammy Thomas, MS, RD, CSCS, an autoimmune disease expert, has the following to say on the subject:
“There are too many scientific publications to name addressing joint deterioration and inflammation. Search PubMed for ‘joint destruction’ and ‘inflammation’ to see how many results you get. Inflammation is known to have a significant role in joint deterioration, according to researchers.
Diet, particularly dietary lipids, has a role in inflammation. The lipids we consume, especially fatty acids, have a direct impact on our bodies’ synthesis of eicosanoids (hormone-like compounds) and the ratio of pro-inflammatory to anti-inflammatory prostaglandins. Reduced consumption of saturated fat and even omega-6 fatty acids (arachadonic acid), which are pro-inflammatory, combined with increased consumption of omega-3 fatty acids (alpha-linolenic acid), which are anti-inflammatory, will help to prevent the occurrence and progression of systemic inflammation associated with mild infection, poor diet, and obesity.”
Balancing our fatty acid profile is one of the finest things we can do to improve not just our general health, but also the health of our joints. (If you’d want to learn more about Tammy, please check out her website at www.proactivitysupport.com).
16) Use joint regeneration/protection supplements.
While the judgment is still out on whether specific supplements may preserve and/or repair our joints, I’ll be honest: I’m not prepared to wait!
What if we discovered in 15 or 20 years that glucosamine and chondroitin accomplish exactly what they claim? Wouldn’t you be hating yourself if you hadn’t taken them sooner, when your joints were in much better shape? I’m sure I would be.
But what more is available? To maintain our joints healthy, I believe we need a three-pronged strategy with our supplements:
Glucosamine and chondroitin sulfate (for their possible joint-regenerating effects)
Supplements containing fish oil (to help balance fatty acid profile)
Antioxidants (for healthy connective tissue) (for healthy connective tissue)
Here’s what I take every day:
Glucosamine 1500 mg/1200 mg chondroitin
Vitamin C 500 mg
Vitamin E 200 IU
Selenium 100 mcg
Flameout 4 caps
17) Perform some soft tissue work.
While some of these tactics may be considered unconventional, I am ready to take measured chances, particularly if the returns are as tremendous as some claim. Heavy weight training may appear attractive on the outside, but it has a few disadvantages on the inside (especially concerning the joints). However, adequate supplementation may be an excellent method to mitigate the impact of these disadvantages.
This is another addition to your program that can provide significant long-term benefits.
First and foremost, if you haven’t already acquired a foam roller, what are you waiting for? I’d wager that practically every performance coach worth his salt employs one, so why aren’t you? If you’re not sure how to use one, see our Feel Better for $10 post.
We didn’t include modifying the length of the muscle while training it in the foam rolling article. This allows you to train different muscle groups and obtain a greater reaction. For example, try the following for your rectus femoris and quads: Roll these regions normally, then continue rolling while bending your knee. You may not see a difference at the bottom of your quads, but I believe you will notice a significant difference while rolling the top of your thigh!
Even if the foam roller is useful, it pales in contrast to precise soft-tissue therapy conducted by an expert. If you’ve never had soft-tissue treatment done before, I’d recommend starting with a reputable ART therapist, who will be able to remove adhesions and scar tissue that have formed over the course of your training career.
Following that, a more general deep tissue massage can assist restore your tissue tone and help you achieve improved movement quality. This is difficult to put into words, but you’ll know the sensation when you smoothly descend into a deep squat for the first time!
Stretch your quadriceps and calves!
I have discovered an intriguing prospective research on patello-femoral discomfort. While most studies are retrospective in nature (that is, they evaluate an issue after it has occurred), relatively few look at it in the reverse way.
This prospective study (3) looked at 282 players who were enrolled in physical education programs and put them through a battery of tests to ascertain their baseline statistics. They followed up two years later, and 24 of the 282 had acquired patellofemoral discomfort. Researchers discovered that athletes who got PF discomfort had much tighter quadriceps and gastrocnemi than their healthy counterparts after conducting statistical studies on these patients. So, what’s the takeaway from this story? Stretch your calves and quads!
It’s also worth noting that the gastrocnemius can cause problems on both sides of the joint. Because the gastrocnemius is the “calf” muscle that spans your knee joint, it can also contribute to posterior knee discomfort. All the more incentive to stretch those pups, in my opinion!
Conclusion
You now have all of the information you need to maintain your knees healthy and happy. All you have to do now is put the information to good use! I’m looking forward to hearing some excellent success tales!
Author Biography
In Indianapolis, Indiana, Mike Robertson, M.S., C.S.C.S., U.S.A.W., is the Director of Custom Athletics and President of Robertson Training Systems. Mike holds a Masters in Sports Biomechanics from Ball State University’s Human Performance Lab and has been a competitive powerlifter for the last 5 years. Visit robertsontrainingsystems.com to contact Mike or sign up for his FREE newsletter.
