#kneeextension

[thegaitguys]

What do the hip flexors have to do with the knee extensors ?

What do the hip flexors have to do with the knee extensors ?

"It is not about your test, it is what your client displays in your test that matters. They will try to find a way. The load has to go somewhere, and they will find a place to put it, they always do. Finding out how your client cheats, compensates, recruits and fails is the value of the assessment."

This is just a small example of how I approach a client through small assessment window.

As best as I am able, knowing the absolute limitations of a supine examinations translation to vertical loading, I will approach a client's ability to stabilize in all 3 planes of movement. Today, i will micro-dissect a thought process.

The straight leg resistance test (SLR):

just a few incomplete thoughts on a SAGITTAL perspective (so as to avoid writing a book).

I will do it looking at **pelvis posture (anterior, posterior, oblique), lumbar spine posture (incr/decr lordosis), if they can keep their knee locked in a position, does the pelvis rotate, do they want to deviate into internal or external rotation at the hip, do they plantar or dorsiflex their ankle or toes. Lots to see here in how a client will recruit, and this is just a small snapshot of things they might do. Yes, head position, arm position were left out , again, to avoid a longer post today.

I will add consistent (as best as possible) resistance in the SLR test , with full locked knee, at hip 30, 45 and then full straight leg SLR (at the client's hamstring tension limit), then again at 45 degree knee lock with partial hip flexion, 90 degree hip and knee. I am changing loading vectors frequently to see if their is a directional loading failure. I am looking for their ability to provide ample resistance, and how they might cheat (see above).

But here is how my mind works through the test on the most basic level, which will give me insight on the above cheats** the client may employ.

* In the MOST SIMPLEST thought of the assessment, can they EFFECTIVELY stabilize the pelvis to the lumbar spine, can they stabilize the femur into the pelvis, can they stabilize the tibia onto the femur? It is how they choose to engage the system that matters, and that might be partly why their "Screen" shows up shoddy and may be a window into their pain.

The question is, if they fail, where are they failing and what tissues are overburdened or over protecting ? Where is the load, and where NOT is the load, going ?

"It is not about your test, it is what your client displays in your test that matters. They will try to find a way. The load has to go somewhere, and they will find a place to put it, they always do. Finding out how your client cheats, compensates, recruits and fails is the value of the assessment. This is how you need to be thinking when you perform many of the mostly useless orthopedic tests in the textbooks.

This is key,

a SLR screen will not show you any of this, it will just show you their range of motion, nothing more, not how they did it, what parts worked harder than other parts, and which parts are weak, injured or inhibited, for example. It is not what a client does, it is how they go about it that has the most value to you in helping them.

Today's article below is what spurred my rant today. It gives light that most already know, that everything is connected. And perhaps we can translate it into deeper thoughts for our clients, namely, what part is not doing its job, and where are they not connecting the parts, and where are they putting the loads ?

From the Ema study:

"Our findings indicate that hip flexion training results in substantial neuromuscular adaptations during knee extensions similar to those induced by knee extension training."-Ema et al.

We need a stable and strong core-spine-pelvis connection to display powerful knee extension, and, we need a stable and strong femur-pelvis connection as well. So, where is your client doing more or less of the work, and is it related to their hip, low back or knee pain? Or are they tossing it into the ankle perhaps? This is the beauty of the game we all play every day, if we are actually paying attention.

Now, remember my discussion last week about "adding strength to dysfunction" ? Where is your client going to put the load?, the answer, where they can/able. And that doesn't exactly mean where they should be putting it. Mindless prescription of corrective exercises is a real problem in my opinion.

Shawn Allen, the other gait guy.

#gait, #gaitproblems, #gaitanalysis, #correctiveexercises, #running, #hipflexors, #kneeextension, #SLR, #corestrength, #thegaitguys

Scand J Med Sci Sports. 2018 Mar;28(3):947-960. doi: 10.1111/sms.13008. Epub 2017 Nov 22.

Neuromuscular adaptations induced by adjacent joint training.

Ema R1,2, Saito I3, Akagi R1,3.

[adaptable-polarity]

Movement, Muscles & Meridians: the knee (comparison post with new anterior meridians) This is interesting, to me at least. If we observe the three meridians: anterior, lateral and posterior (all superficial and Yang Chinese meridians), and compare and contrast them, what do we find? I’ll post my thoughts in the comments. Movement (anterior): Knee extension Muscles (anterior): quadriceps Meridians (anterior): superficial front line fascia and Stomach channel #muscles #movement #meridians #fascia #fascial #myofascia #myofascial #myofascialmeridians #anatomytrains #stomachmeridian #knees #kneemobility #knee #kneepain #kneeextension #superficialfrontline #energyhealers #bodymechanics #adaptablepolarity #anatomytrains #tcm #artexploration #anatomyart #anatomystudy #anatomy #humananatomy #kneeanatomy (at Bonny Doon, California) https://www.instagram.com/p/CfosbB0LVOU/?igshid=NGJjMDIxMWI=

[renubakshi]

To learn how to do Knees Extension Exercise visit my YouTube channel. Link is given in profile. #kneeextension #kneeexercises #kneestrengthening #kneehab #kneestraightening #kneepain #kneerehab #kneestraight #kneestrengtheningexercises!;!!; https://www.instagram.com/p/B-SE5uWnlf_/?igshid=1prwli1aq823t

[ascenttoaesthetics]

....humpday Sunday featuring Bulgarian squats, going back to the dumbbells for today, 30kg/66lbs each....just because the balance is a little bit easier, although you can't throw up as much weight as with the barbell, the legs still beg for mercy 😅🔥... all black because @itsbulkingseason . . . . . . . . #happyhumpday #legdayfunday #legdayfeels #legdaygrind #bulgariansquats #bodygoals #treetrunklegs #quadriceps #quadlife #glueusmaximus #kneeextension #styrketræning #beintraining #glutegains #glutesthatsalute #thickthighs #squats #unilaterallegtraining #focusonthegains #legdaygains #ascendtoaesthetics #ascenttoaesthetics https://www.instagram.com/p/BvzwheIlKLr/?utm_source=ig_tumblr_share&igshid=n3tyrrgwjd81

[physiofood]

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A post shared by Physical Therapy & Nutrition (@physiofood)

Could your knee pain be coming from a weakness in your thigh muscle? Time to strengthen up those Quads! Tag a friend to save their knees and wake up those leg muscles. –––––––––––––––––––––––– Medical Disclaimer All information, content, and material of this video is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. –––––––––––––––––––––––– Summer Vibe by Pold https://soundcloud.com/pold-music Creative Commons — Attribution-ShareAlike 3.0 Unported — CC BY-SA 3.0 Free Download: http://bit.ly/SummerVibe-Pold Music promoted by Audio Library https://youtu.be/f6cHKrOdxss _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ #physiofood #physiotherapy #physiotherapytips #physicaltherapy #physicaltherapytips #kneepain #saq #shortarcquads #quadstrength #kneepainexercises #kneerehab #exercisetips #exercisehelp #kneeprehab #fixkneepain #ptmotivation #kneeextension #kneeinjury # #bodybuilding #legworkout #legdayworkout #legday #howtoexercise #homeworkout #kneepaintreatment #physicaltherapyforkneepain #ptforkneepain #kneepainrelief #stronglegs (at Washington D.C.) https://www.instagram.com/p/CCBfbboH7xP/?igshid=1dij81g24kfyx

[gagankohli]

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A post shared by 1 Space Fitness | Gagan Kohlii (@1spacefitness)

Seated Knee Extension with Resistance bands This exercise is similar to the Leg extension machine at Gym. But since the gyms are closed thought to give this exercise a try at home. Resistance bands can be a powerful tools to train at home. People come up with various excuses as the gyms are closed and they can't workout. Not brag but I have Worked out since the last 2 months. I took this opportunity to train myself even harder and push my limits. If your fitness is only defined by going to gym then speaking honestly you have never truly understood the true meaning of fitness. Work out each day. Hustle 💪💪. Make fitness a part of your life. #kneeextension #legextension #resistancebands #sundayafternoon #motivation #hustle #gyms #athomefitness #elitetraining #elitetrainer #1spacefitness (at Delhi, India) https://www.instagram.com/p/CBIFjhHg73p/?igshid=11bmgcn8ftupo

[tumbleveryday]

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A post shared by joy karfield (@tnemgarf)

its ALIVE!! le #vmo's slowly wakin up.. mai koon liao zo gang liao week 12 liao 😹 #aclreconstruction #quadset #knee #vastusmedialisoblique #kneeextension #sgig #instasg

[ksquaredfitness-blog]

Using the Knee Extension machine is an excellent way to develop your quadriceps. Using a nice and slow movement throughout the exercise will give you a nice "burn", squeezing your quads at the full extension is key. If you have knee problems stop at 30 degrees instead of a full extension. #1Tim4:8 #2Tim2:5 #2Tim4:7&8 #healthylifestyle #lifestylechange #fitness #exercise #workout #weightloss #healthy #trainer #fitspo #fitfam #trainer #gym #gymrat #gymlife #diet #focus #desire #motivation #excellence #dedication #determination #kneeextension #quads #adductors

[ascenttoaesthetics]

...good session on the leg press today, hitting sets of 15reps with 200kg/440lbs felt like victory....the trouble with training however, is that no matter how many battles you may win, the war is never over, the war is never won. the fight must go on...if your goal is perfection, you must seek it forever, but you will never attain it, but the joys of the journey are glorious... . . . . . . . . #legpress #legdayfeels #legdayworkout #legs #quadriceps #rectusfemoris #vastuslateralis #vastusmedialis #vastusintermedius #gluteusmaximus #hammiesandglutes #glutesandquads #quadsandglutes #glutebands #glutesthatsalute #kneeextension #neverskiplegday #dontskiplegday #ascenttoaesthetics #ascendtoaesthetics #blackbeardedmen #progressnotperfection https://www.instagram.com/p/BvSXYATliwx/?utm_source=ig_tumblr_share&igshid=7eyciae0jea0

[ascenttoaesthetics]

....smooth motion...dumbbell Bulgarian split squats....eyes forward, chest up. sink the hips. could increase the ROM in the future to increase utilisation of the gluteus maximus. quads feeling the burn here. I like the comfort of the angle of an incline bench for supporting the rear foot, although this does result in a reduced ROM...will have to find a way to mitigate this...possibly standing on a step...anybody else had this problem? . . . . . . . . . . . . #bulgariansquats #bulgariansplitsquats #rearfootelevatedsplitsquat #unilateraltraining #legdayfunday #leggains #lifting #traindirtyeatclean #quadriceps #quadzilla #glutesandhams #glutesthatsalute #splitsquats #focusiskey #kneeextension #hipextension #weekendworkout #weekendtraining #instafitspo #instainspo #buildingtreetrunks #treetrunklegs #legdaybestday #neverskiplegday #dontskiplegday #styrketræning #træning #beintraining #ascendtoaesthetics #ascenttoathletics #ascenttoaesthetics https://www.instagram.com/p/Bv7mEDDFn6S/?utm_source=ig_tumblr_share&igshid=1h6urv53nlawh

[tumbleveryday]

View this post on Instagram

A post shared by joy karfield (@tnemgarf)

for the record, when i see you again #prehab #rehab #rom #knee #kneeexercises #kneeextension #kneeflexion #quads #hamstrings #quadset #hamstringsset #sgig #instasg

[thegaitguys]

Loss of terminal knee extension: How quickly can you process the facts ?

Some quick thoughts that must go through your mind on your examination. These thoughts must be ingrained, so that you can quickly juggle the other issues you client is coming in with that may very likely be related to the loss of left knee terminal extension.

more knee flexion may likely mean more ankle dorsiflexion , and that means more more anterior shin compartment strength is necessary to stop a quick progression to the forefoot (consider their clinical symptoms), this may mean pronation occurs more quickly (consider their clinical symptoms), it may mean more abrupt quadriceps loading since the loading does not start in more reasonable knee extension which means the quad is short now and that means increased patellofemoral compression possibilities (consider their clinical symptoms), this may mean more hip flexion on initiation of stance phase (consider their clinical symptoms), this may lead to more anterior pelvis tilt posturing and thus increased lordosis (consider their clinical symptoms), this flexed knee means that the leg is shorter which will through off pelvis symmetry (consider their clinical symptoms), this may mean more work for the contralateral hip abductors (consider their clinical symptoms), this may mean more frontal plane pelvis drift to the short leg side (consider their clinical symptoms), it will also mean 2 different step lengths which means 2 different hip extension patterns which means 2 different heel rises, and it will likely mean altered arm swing on both sides which can create changes into thoracic rotation (and of course the cervical spine sits on top of that) etc etc etc, so consider their clinical symptoms . . .

just wanted to quickly rattle off how fast your brain must juggle things, otherwise your exam is going to be knee-centered and tunnel visioned. Keep in mind, your client may not even have knee complaints, perhaps one or more of the above. But this is a perfect example of why you must examine the WHOLE client.

Perhaps this gives you even deeper understanding (combined with yesterdays "parallax binocular vision 2D post" as to why we will not give online corrective homework or consultations. There is just no way all of these things can be considered over video, Skype, Zoom or anything of the sort. Gait analysis must be done in person and encompass a hands on exam, if you do not want to miss something possible critically important, in our opinion, for what that is worth.

Shawn Allen, the other gait guy

#kneeextension, #gait, #gaitanalysis, #gaitproblems, #gaitanalysis, #gaitcompensations, #correctiveexercises, #thegaitguys

[thegaitguys]

What do the hip flexors have to do with the knee extensors ?

"It is not about your test, it is what your client displays in your test that matters. They will try to find a way. The load has to go somewhere, and they will find a place to put it, they always do. Finding out how your client cheats, compensates, recruits and fails is the value of the assessment."

This is just a small example of how I approach a client through small assessment window. As best as I am able, knowing the absolute limitations of a supine examinations translation to vertical loading, I will approach a client's ability to stabilize in all 3 planes of movement. Today, i will micro-dissect a thought process.

The straight leg resistance test (SLR): just a few incomplete thoughts on a SAGITTAL perspective (so as to avoid writing a book). I will do it looking at **pelvis posture (anterior, posterior, oblique), lumbar spine posture (incr/decr lordosis), if they can keep their knee locked in a position, does the pelvis rotate, do they want to deviate into internal or external rotation at the hip, do they plantar or dorsiflex their ankle or toes. Lots to see here in how a client will recruit, and this is just a small snapshot of things they might do. Yes, head position, arm position were left out , again, to avoid a longer post today. I will add consistent (as best as possible) resistance in the SLR test , with full locked knee, at hip 30, 45 and then full straight leg SLR (at the client's hamstring tension limit), then again at 45 degree knee lock with partial hip flexion, 90 degree hip and knee. I am changing loading vectors frequently to see if their is a directional loading failure. I am looking for their ability to provide ample resistance, and how they might cheat (see above). But here is how my mind works through the test on the most basic level, which will give me insight on the above cheats** the client may employ. * In the MOST SIMPLEST thought of the assessment, can they EFFECTIVELY stabilize the pelvis to the lumbar spine, can they stabilize the femur into the pelvis, can they stabilize the tibia onto the femur? It is how they choose to engage the system that matters, and that might be partly why their "Screen" shows up shoddy and may be a window into their pain. The question is, if they fail, where are they failing and what tissues are overburdened or over protecting ? Where is the load, and where NOT is the load, going ?

"It is not about your test, it is what your client displays in your test that matters. They will try to find a way. The load has to go somewhere, and they will find a place to put it, they always do. Finding out how your client cheats, compensates, recruits and fails is the value of the assessment. This is how you need to be thinking when you perform many of the mostly useless orthopedic tests in the textbooks.

This is key, a SLR screen will not show you any of this, it will just show you their range of motion, nothing more, not how they did it, what parts worked harder than other parts, and which parts are weak, injured or inhibited, for example. It is not what a client does, it is how they go about it that has the most value to you in helping them.

Today's article below is what spurred my rant today. It gives light that most already know, that everything is connected. And perhaps we can translate it into deeper thoughts for our clients, namely, what part is not doing its job, and where are they not connecting the parts, and where are they putting the loads ?

From the Ema study: "Our findings indicate that hip flexion training results in substantial neuromuscular adaptations during knee extensions similar to those induced by knee extension training."-Ema et al.

We need a stable and strong core-spine-pelvis connection to display powerful knee extension, and, we need a stable and strong femur-pelvis connection as well. So, where is your client doing more or less of the work, and is it related to their hip, low back or knee pain? Or are they tossing it into the ankle perhaps? This is the beauty of the game we all play every day, if we are actually paying attention.

Now, remember my discussion last week about "adding strength to dysfunction" ? Where is your client going to put the load?, the answer, where they can/able. And that doesn't exactly mean where they should be putting it. Mindless prescription of corrective exercises is a real problem in my opinion.

Shawn Allen, the other gait guy.

#gait, #gaitproblems, #gaitanalysis, #correctiveexercises, #running, #hipflexors, #kneeextension, #SLR, #corestrength, #thegaitguys

Scand J Med Sci Sports. 2018 Mar;28(3):947-960. doi: 10.1111/sms.13008. Epub 2017 Nov 22. Neuromuscular adaptations induced by adjacent joint training. Ema R1,2, Saito I3, Akagi R1,3.