Hip Flexion

  • By Gergely Kaposvari
  • •
  • 10 May, 2017
  • •

A lovely way of self-torture

As we started to progress in Sprint Interval Training and our Athletic Training, most of our athletes were reporting some sort of knee pain during-after their sprints.

The problem is two-fold, really:

  • First, most of us accepted these pains as a necessary effect of athletic movement
  • Second, most of us got used to it so much that we don’t consider them anomalies anymore.

And so what we, coaches see is a bunch of athletes, massaging their kneecap or stand-stretching their quads (sic!) in a faint hope to get rid of the pain.

Luckily, these guys have coaches with them who know better!

In my private PT practice, with those clients who experience knee problems, we usually discover that they come from two major sources;

  • Faulty movement mechanics
  • Muscular imbalances

Much worse, these two go hand-in-hand. Most of the cases, even if we educate the person about the correct form, s/he will be unable to execute it due to some mobility restriction; which is really just a nice way of saying ‘tight’. This statement would imply that the ultimate solution is stretching, right?

Not really.

Stretching actually don’t do a thing here; we did a little experiment on our Saturday Running training session in Sliema; and we established this.
Most of the cases stretching only makes things worse; the athlete simply pulls on the healthy tissue around the knotted-up tissue. In return s/e irritates the already irritated part even more - at least it hurts so it must be good, right? - without resolving the problem.

But going back to the knees;

Covering the joint there is the kneecap - the patella. It’s a little, floating bone with magical power; what you feel around it is going to give you a hint of might the cause of the problem actually be.

See; with knee (and elbow) pain, the problem is almost never with the joint that hurts. Almost never, I say… because injuries and defected joints are a reality too. So the very basic way of finding what might be wrong would be this;

  • If the athlete reports pain above or on the top part of the kneecap, we look around the quads, hips, hamstrings, glutes, etc.
  • If the pain appears below, then we seek help from the calves, ankles and feet.

Basically, the exact location of the painful spot can tell a lot about where to reach; our experience shows that once we found around which tendon the hurt is, we can identify the causing muscle/s.

Then if we throw a general smashing party on the area and free up the movement on the surrounding joints, folk become much happier.

Very basic method would be this:

Athlete A

has some major pain on the top part of the knee and some lower back discomfort - with the expected atnerior pelvic tilt… the painful spot is the insertion of the vastus medialis. And hey, what a surprise, rolling into the bottom part of the quads causes some noticeable face distortion. Logic dictates, that once we manage to relax this muscle, our clients life will be a lot happier - and logic is right here. So we have two things to choose from;
  • A smashing party for the entire quadriceps and hamstrings. Get out a lacrosse ball and foam roller out, cover the face and roll slowly from the hips down towards the knees (called pressure wave). Relax the muscles as much as possible and once we hit a painful spot, try either contracting and relaxing, or flexing and extending under bearable pressure. Also, oscillate; move in and out of the stretch; movement range will slowly increase.
  • A good, brutal overall stretch-based mob for the entire quadriceps, like a cOUCH stretch, a lunge hip extension or a banded hip extension. With the latter, we need a band to pull the leg at the back forward, hooked right under the butt, where the glute meets the hamstring. One thing though; the athlete must not extend the lower back as it will compensate for the missing range or hip flexion and will turn into an otherwise beautiful mob into a brutal, back-wrecking monster. Bend the back forward, tense the abs and push the hip into flexion with the power of the core instead just shoving the chest towards the sky. The difference will be obvious.
the athlete must not extend the lower back as it will compensate for the missing range or hip flexion and will turn into an otherwise beautiful mob into a brutal, back-wrecking monster.

Athlete B

is hurting at the bottom of her knee. This is a little tricky… the red spot is the tendon of the extensor digitorum longus. So smashing party on the side of the lower leg? Almost; but muscular imbalances can be quite interesting beasts. Usually what ends up happening is some ugliness under the calves gets the front part to overreact; that’s going to create some tension and inflammation at the insertion of the tortured muscle. So the sure bet;
  • Overall smashing party for the calves. Starting from the knee end, seesaw through the complex with a lacrosse ball (beware; this is ugly), then move to the side and repeat. Move the ankle around a god bit a boom! The relief is instant with almost everyone.

Conclusion

Of course, this article is not meant to replace any profession medical help. But - big part of joint pain stems from these ugly muscle imbalances. And, the problem is almost never in the joint itself. If we can find a way to properly mobilise the surrounding joints, restore some sliding tissues and get the connecting muscles to relax; we are golden. The suffering will reduce or go.

To pain-free strength,
TheG

Runners Coahing Malta

Practice makes perfect.

By Gergely Kaposvari • May 18, 2017

No. It doesn't.

Practice makes permanent. Practice with bad form; bad form will be permanent. Practice with good form; good form will be permanent.

But practice with improving form; improvement will be permanent.

Let this sink in a little.

Yes, this is an ultimate truth. And one we constantly have to get our clients to understand and remember.

One of our guys suffered a little injury - he had a broken window and he decided to clean the shards from the frame. You can guess what happened - one of the pieces fell from the top and the guy had to get a good few stitches. 

Ouch.

Now, besides that he did make a mistake - he misjudged the risk-reward ratio - all I can say is  shit happens.


But he had an injury; he knows when it happened and why.

Same with running. If you injure yourself, you know when, how and why. Do you?

If you don't you have to improve... all the pains, aches, and a huge part of the injuries happen due to poor form. Which is a shame; you could have avoided it altogether since form is coachable.

Of course, much like to the guy above, accidents happen... but still! Accidents are one thing, but running with a weak body and bad form is like cooking the frog...

Have you ever heard about that? If you cook a frog, it won't jump out of the water because it accumulates to the gradual rise of temperature. Now, I am not sure; I never boiled a frog myself. But even if it's not true, it's a damn good analogy!

Much like you - if you keep breaking yourself down you will slowly get used to the symptoms until...

Either something snaps or someone gets you symptom free again.

The choice is yours.

And no, simply running more is not enough...

practice makes permanent, you remember?

The G

Long or Short? ... distance matters.

By Gergely Kaposvari • May 5, 2017
Training methods for runners and Marathon Athletes