Is Your Knee Pain Something Else

Knee pain can suck.  Much like low back pain, it can be debilitating and knock you out from doing things you love, like training, or playing, or just simply walking up stairs.  When we experience any kind of pain, our minds usually run to the worst case scenario, and with knee, the mind turns to the ligaments and menisci and what kinds of damage is there.

But if there’s one thing to keep in mind, it’s that body is all connected.

Look Above & Below

There have been countless times with clients where they have complained of knee pain while doing “insert exercise.”  And more likely than not, it usually has nothing to do with the knee at all.  It’s usually coming from somewhere else.

When it comes to pain, my thought process is to look above and below for the root cause.  In most cases, the pain we’re feeling is coming from another source.  It just manifests itself in a vulnerable area.  In this case, strength, mobility or stability issues at the hip or ankle can cause pain at the knee.  The hips and ankles are meant to be mobile.  If this is an issue, the body will compensate and find that moblity elsewhere.  *cough, cough, the knee, cough*.

Remember, the victim is rarely the culprit.  Search for clues as to why the knee hurts.  Avoid automatically assuming something is wrong with the knee.

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Assess and Test”

The Ankle

The first place we recognize knee pain is when we go to squat to do something, or when we go up stairs.  However, in order to perform both of those movements, it’s important to have optimal range of motion in the ankle, specifically dorsiflexion (pointing your toes/foot to you shin).  If this happens to be restricted in some way, then the knee has to take on some of the force.

One way to test to see if you have a good amount of dorsiflexion is the “Knee to Wall” Test.  In this, you’ll set up in a half kneeling position with your front foot 3-5 inches from the wall.  Push your knee towards the wall while trying to keep the heel down on the ground.  If you can do this with no issues, then rock on.  If not, then we may have to do some work with regaining dorsiflexion.

This can be accomplished through different corrective exercises utilizing some banded distraction, stretching and SMR for the calves.

The Hip

Weakness and/or tension in the hips can cause the knee to get a little cranky as it contains many big strong muscles of the hips, but also equally important stabilizing muscles.  Most of us sit a fair amount of time, and this can cause many of the muscles in the hips to tense up and not have access to as much mobility.  When this is the case, the link between the foot/ankle and the hip doesn’t work as well.  And what ends up happening is the knee gets treated like Cinderella by her two evil step sisters.

In order to combat this, we’re going to start off with SMR using a lacrosse ball or foam roller on the glutes, TFL, and the quads.  I’d throw in IT Band as well, although when you foam roll your IT Band, you’re really only affecting the lateral part of the quad at best. But it does feel “nice,” so go for it.

Follow this up with strength based movements like squats (if you can tolerate it) and various hip hinging exercises like deadlifts and hip thrusts. You can also incorporate isolated exercises like hamstring curls, and corrective/activation exercises like band walks, monster walks and posture ups to help strengthen some of the smaller stabilizing muscles.  With those banded exercises, make sure the movement actually comes from the glutes.  It is very common for the hip flexors and TFL to take over.

Band walks happen to be a particular favorite as they target a little muscle called Glute Medius, which can control the hips from shifting side to side, which can lead to knee problems down the line, especially for runners.

Lastly, you can add in stretching exercises like the pigeon stretch.  I’d recommend doing it off a bench as it is easier to control the depth and intensity of the stretch.

 

Pain sucks and our typical reaction is to address the site of pain.  But if we take the time to find the root cause of the pain, we can often take care of it for good.  When it comes to knee pain, look towards the ankle and hip for clues on what to do.


How to Structure Your Training

You Need to Workout Every Single Day

When it comes to training, the tendency is to think that more is better, that we should train every single day.  While that might be a great sentiment, it is a 100% unrealistic schedule to adhere to.  What you should do is figure how many days you can, with 100% confidence, dedicate to training.  This means taking an honest look at what your life is like, what your schedule can allow, and what you can keep up with.

This is where many people make mistakes, thinking that they want to or should train 4-5 days a week.  But their life is a stressful mess, and when they say 4-5 days, its really more like 2-3.  This can set someone up for failure.  Think about it.  If you told yourself you were going to go to the gym to train 4-5 days a week, then you wind up only going twice, how would you feel?  You’d likely feel like a failure, that you didn’t live up to expectations of yourself.

So instead of shooting for this lofty, unrealistic schedule, make a realistic one.  A schedule you can adhere to with 100% confidence.

How To Structure

Depending on how many days you decided you could confidently get to train, there are multiple ways to structure your program.  Side note: I’d recommend at least 3 days of strength training per week, but if that’s not your ideal fit, then no worries.  I would add that no more than five is a good max, as recovery time is an important part of making progress and gains.  Remember it’s not about how much you can exercise, it’s about how well you can recover from your workout and get to the next one.

Here’s your breakdown:

  • Body Part Split
  • Push/Pull
  • Upper/Lower
  • Full Body

Each one has its strengths and its drawbacks.  Some will be better suited for whichever amount of time you’re committing to.

 

Body Part Split

Back in my younger days when I first started lifting, this was the routine I went for.  Mostly because I had the time to do such workouts.  What a body part split essentially is, is breaking you into parts, and solely focusing on that one group for that day. There was a day for chest, back, legs (sometimes), a day for shoulders and a day for just arms.  Cause you gotta get swole!

This ended up creating a high amount of volume for each body part, and it does produce results.  The one drawback is that it’s incredibly inefficient and time consuming as you wouldn’t get back to that muscle group until a week later.  Plus it required at least 4-5 days of training hard and that limits recovery ability as well.  So if that doesn’t fit your scheduling availability, then you’re probably going to have to move on to a different style of programming.

Upper/Lower

With this style of programming, two days per week are devoted to lower body lifts and two days for upper body lifts.  Makes sense?  Your lower body days will consist of squatting, hinging, and some single leg exercises.  You could break this down further into a squat focused lower body day and a hinge focused day.

As far as the upper body day, you could look at doing vertical movements one day, say pull-ups and overhead press for example.  Then on the second upper body day, perform horizontal movements like the bench and row.  The choice is yours.  Ideally this works when you have 4 days to train, but you can get away with 3 if you’re creative with your exercise choices.

Push/Pull

Setting up your program in a push/pull fashion takes attention away from body parts and focuses more on the body’s movement patterns. Two days are devoted to pulling movements, meaning you may see exercises like deadlifts or RDL’s but also pull-ups, and different row variations.

The other days will see pushing movements like bench, overhead press, squats, and maybe even some step-ups for fun.  This type of set up typically works when you have 4 days to train, and can promote balance between training the front and back sides of the body.

Full Body

Short on time or days in which you can train?  This may be the perfect way to schedule your weight training. With this comes the important need to employ solid recovery strategies after each workout and in between each session.  Because you’re using and taxing every muscle in the body on any given day, recovery is vital so you can have your muscles firing on all cylinders.

This style trains the body as a whole which can be more efficient if you don’t have many days in which to lift.  It can be altered to fit 2, 3, or 4 days a week, plus its a great way for beginners to get familiar with the gym and with certain exercises.

Upper/Lower/Full

One last option is going with a schedule where you will do an upper/lower split with a third day being a full body workout.  This actually is successful with many of my clients that train three times a week.  What ends up happening is devoting two days towards strength workouts and then a third day that is more of a full body conditioning/strength session.  This allows them to utilize the strength that they are building from the first two days.

 

Takeaway

Your weight lifting schedule is largely going to depend on two things.  What your goal is and how much time you can commit to your training.  You have to have a clear definition of your goal in order to see what schedule may work best for you, but ultimately time is going to be your biggest factor as well.

 

Remember, the best weight training schedule is the one you can stick to with and consistently see results.

 


Creating a Training Program for Goals

 

We’re all a little different.  From our anatomy to our goals to things we like to do.  ow we utilize them is completely different.  Just go to the gym and you’ll see what I’m talking about.  Some people are hitting the treadmill; some are in the corner only doing crunches, while others are lifting some weight.

Each person is going to have his or her own workout that they love to do, but what they do may not work for you.  You’re different.  In order to get a training program that works for you, you need to decide on a goal. And not something that’s generic like lose weight or tone up.  Get down to specifics, and preferably something tangible and measurable.  Then its time for some soul searching.

  • Why do you want that goal?
  • What will attaining that goal look like?
  • How will your life be different once you achieve it?

Up next…how much time do you have to dedicate to that goal and to your training program?  There is no right or wrong answer here, but its more of an honest assessment of what you can 100% without a doubt dedicate.  It could be 30 minutes, 4 days a week and that’s ok.  It is what you can REALISTICALLY accomplish.  Consistency is the name of the game here, so if you say 5 days a week and you skip days, you missed the point.

Next up is picking out how much time you have to dedicate to your workout routine.  Some people only have 30 minutes while others have a lot more time to put into their training.  Neither is wrong or bad, it’s just a fact of life.  Some people have more time.  In addition to the amount of time spent per day on training, it’s important to narrow down how often you want to train per week.

Take an honest assessment of how your body moves and how it feels.  Take a look at what you do on a daily basis in terms of positions you are in the most, how much sitting you do, how your body feels throughout the day.  This can go a long way towards determining what movements will work best for you, what movements you should avoid for now and where you should start.

Corrective Exercise:

This can include exercises to activate certain muscles, exercises that can fix a weakness, or exercises that can help bring more mobility to a certain movement.   These are going to be up to you based on where you think your body’s weaknesses are.  Mobility, not to be confused with flexibility, which is largely neurological, is being able to move while keeping stability.  Most people can use some mobility work in certain areas, while others don’t need much at all.  This can be solved with some gentle stretching, foam rolling and other SMR techniques to help you move better.

Strength/Main Lift

Now in my opinion, everyone should start with a routine that emphasized learning proper mechanics followed by strength training once those mechanics are nailed down.

Building strength is a matter of intensity in terms of weight lifted and staying within a rep scheme of 1-6 reps.  Go too light with the intensity of your lift and you risk blending into our next adaptation of hypertrophy.  Now in the beginning, strength gains are going to be a neurological adaptation as your body adapts to a new stimulus.  However once that beginner period ends, your muscles will start to get stronger.

You’re going to want to place your strength based exercises at the beginning of your program because they are going to require the most attention, both muscularly and neurologically.  You’ll want to avoid putting them later as you want to be fresh for them.

Assistance Exercises

Assistance exercises are those that are meant to enhance your main lift, but they can also touch on other areas of the body in order to get a full body workout.  These assistance exercises can be programmed in different ways depending on what the goal of the program is.  They can be used for hypertrophy, muscular endurance, and as conditioning using something like density sets.

Hypertrophy:

Building muscle requires a specific stimulus in order for them to grow.  Much like using a low rep range for building strength, hypertrophy will use a more moderate rep range of 6-12 or 15 depending on who you ask.  The key is using a load that challenges that rep range.  Picking up a 5lb dumbbell and doing 12 reps of bicep curls isn’t going to do anything if your bicep can handle 20lbs at 12 reps.  Be smart with your choice of exercise but also your choice of intensity.

Additionally, this is the range you’ll want to challenge yourself in, if you want to properly develop your muscles as well.  What’s even better is that the strength you built from the above section can later translate into a greater load you can use during your muscle building or hypertrophy exercises.  Talk about gains!

Muscular Endurance

As you’ve seen, strength and hypertrophy training requires keeping intensity at specific rep ranges.  Endurance on the other hand will be anything over 15 reps.  This can include the corrective exercises we discussed earlier.

Metabolic Conditioning:

Because we all want to believe we worked hard, so we do things that will make us sweat or breathe heavy, conditioning exercises are a great way to wrap up your workout routine.  Conditioning circuits or even individual exercises like sprints can burn fat and increase work capacity in short, intense bursts.  Just make sure you pick exercises that you can do safely at a high intensity.

Exercise Choice:

What exercises should you use?  Well, there are countless exercises you can use to accomplish your goals.  However it comes down to a few specific movement patterns, seven to be exact.  I don’t want to go into too much detail, otherwise this article will never end, but pick exercises that belong to these movement patterns and you can’t go wrong.

  • Push
  • Pull
  • Hinge
  • Squat
  • Rotation or Anti-Rotation
  • Single Leg/Gait
  • Lunge

 

Takeaway

Strength exercises can be hypertrophy exercises which can also be muscular endurance exercises.  It really depends on the intensity at which you work.

Another important thing to note when setting up your workout routine is to find exercises you enjoy.  Simply because if you don’t enjoy doing them, you’re likely to stop exercising all together and give up.  Now this doesn’t mean pick easy exercises, you need to challenge yourself; it just means pick ones that will keep you compliant with the routine.  Hating exercises and struggling with exercises are two different things.  If you struggle with an exercise, it means you have to work a little harder at it. Try to avoid giving up on it because it’s hard.  If you hate it because it causes pain etc, that’s a different story.

Remember there isn’t one best workout routine.  There are only guidelines on how to create a routine.  The best routine is the one you will do.


Mindset Matters

Mindset matters most when it comes to making a change in your life.  When you starting doing something new, the important question that will shape your thinking is “why.”

  • Why do you exercise?
  • Why do you go to the gym?
  • Why do you do the things you do for your health and fitness?

Take a second to think about why you do all these things.  Why is it that you go to the gym to train, lift some weights, maybe do some cardio and break a sweat.

Is it because of that piece of cake you ate last night?

Or is it because you just love the feeling of your body moving?

There is confusion as to why we actually exercise, or why we should exercise.  If you take a peek into most gyms on any given day, you’ll see people punishing their bodies because they hate how they look or hate how they feel, or they feel they need to make up for what they ate the previous day(s).

The Negative Mindset

Mindset matters.  The prevalence is that we, as a society, have a mindset that Exercise = Punishment.  And it sets us up for negative results.  It’s born out of the need to better ourselves and the only way to better ourselves is to deprive ourselves of things we love (food) and punish ourselves with exercise.

If you polled a bunch of people and asked why they started a healthier lifestyle or exercise program, what percentage would say its because they love movement or they love exercise.  I’d be willing to bet most say they start because exercise is a necessary “evil” in the battle against the scale.  Essentially starting something positive for negative reasons.

This cycle of self-punishment should be avoided at all costs.  It will not set you up for success.  The more you look at it like punishment, the more you put a negative connotation on it, the more and more you are going to hate exercise.  When you hate something, you’re not going to do it, you’re not going to see the benefits from it, and in the end, you might as well not do it.

The Positive Mindset

Change the mindset to Exercise = Movement.

Make the switch from “I HAVE to work out,” to “I GET to work out or “I WANT to work out.”  “Have” implies that you have zero choice in the matter, that it’s forced upon you.  “Get” or “want” is associated with choice.

See that positive spin right there!

Don’t take for granted that you have the ability to move, as some people would kill to be able to move.  Avoid looking at exercise as a means to burn calories, or lose weight.  That is completely secondary to the real reason we exercise.  Exercise because you love moving, because you love the feeling of being able to move your body through space, because you love that feeling of lifting something off the ground with no effort, because you love the feeling of being strong.

I want to leave this with a quote:

“Most people are focused on the result, I look at the results as a bonus.  Sure I have specific goals that I’m working towards but I think the process of getting there is much more important than the end result.  It’s the work that transcends, the work builds character and sharpens you.  The work teaches you humility & aggression.  The work strengthens you physically and mentally.  The process is really what it is all about.  The results…they will take care of themselves.”
-Adam DiBella


Build Your Deadlift

Deadlift

When it comes to deadlifting, the image that most commonly comes to mind is that guy or girl in your gym ripping a loaded barbell off the ground.  And for some, that is their end goal.  To pull as much weight as possible off the ground.  But for others, that’s not their goal.  They just want to look and feel awesome in their everyday life.  Deadlifting from the floor may not be for you, but hinging in some capacity will build strength around one of the fundamental movements we do every singe day.  The barbell deadlift is one variation of a hinge, and one that may not be the right fit for you, but you’re in luck.  There are countless other ways to hinge, we just have to explore your movement capabilities to find the one that is the best fit.  Like Cinderellas shoe…or the porridge in Goldilocks.

Fear

What if you avoid the deadlift because you already hate the very idea because of all the horror stories you’ve heard from friends, neighbors, or that one guy who couldn’t move for a week after picking something off the floor.  If the very idea of deadlifting sends your spinal discs running, then maybe you should read on about building from the ground up.  With a properly executed deadlift or hip hinge you can do wonders for creating a resilient back.

“What’s In a Name”

How did the deadlift get its name?  Without a doubt it came from picking up the dead during the plague.  100% true story.  Probably.  Maybe not.  But here’s a Monty Python clip anyway.

 

Deadlift From the Ground Up

When it comes to executing a solid hinge/deadlift, this is the thought process that I go through, especially if we’re working on building back from an injury, like something in the low back.  We start from the ground up.

Patterning Drills

These two patterning drills teach us what constitutes a good hinge vs a sub optimal hinge vs a squat.  The quickest and easiest way to execute this is to start from a kneeling position, then progress to standing.

Tall Kneeling Hinge– This is a great place to start as there is no risk of injury in this pattern, and it takes some of the miscues at the ankles and knees out of the equation.  What we get is a solid patterning drill to set us up for success when we move to a standing position.

 

Band Assisted Patterning– This drill is good for two things, teaching a solid bar path, and the band creating some reflexive tension in the lats and core.

Band Pullthrough– While the above drill was great for bar positioning, and teaching lat tension, the pullthrough utilizes a band to actually pull you into that hip hinge position we’re looking for.

Let’s Add Some Load

Kettlebell Deadlift– A great intro into a loaded hinge, the kettlebell keeps the weight centrally located between your legs.  This eliminates any problems that mobility restrictions may play in not being able to do it.  What you can also do to create an easier transition into loaded hinges is elevate the kettlebell so that there is less movement required.

The one drawback to the kettlebell is that you can only load so much before it becomes easy.  At AMP, our heaviest bell is 48kg or about 105lbs.  So there is a bit of a ceiling.  You could extend that by using two bells, but at a certain point we may need to progress to a new lift.

 

Hex Bar–  The Hex Bar is a great progression and can be a good starting point mostly because of the way it’s designed.  Since the weight is on the outside of your body, it’s easier to maintain an upright position, which means a lot less stress on the back.  That can ease a lot of people fear right off the bat.

 

Elevated Surface– This is our first barbell lift.  It is important to note that you may never get to this point, and that’s ok.  Not everyone is built to use a barbell.  With the Hex Bar, the load was on the outside, the barbell creates a new challenge with the bar/load in front of you. This presents a slightly different approach, as if there are mobility restrictions, you may not get to the bar without compensations.

Before you lift from the floor, lets see how you do with an elevated surface.  Now this can be off of blocks as shown in the video, but you can also perform rack pulls if your gym allows it.  Either way, the elevated surface will create an exercise requiring less range of motion.  The decrease in requisite range of motion makes for an “easier” exercise.

 

The deadlift can have a tendency to make people cringe.  It’s probably the one exercise that is met with the most fear and trepidation because it has the reputation for being injurious to the back.  However, when you go through the progressions laid out before you, there should be no need for concern.