In the previous installments of this series, we discussed the evolution of mobility and stability screening and assessment in the field of strength training and how utilizing it as a tool has become a major piece of the puzzle in developing more well-rounded programming for athletes. In this edition we will begin by examining the two joints that are subjected to the most abuse in athletics: the knees and the shoulders and the training approach we have used to make them more resilient.
When we apply Cook and Boyle’s Joint-by-Joint Approach, we understand that the knee is a “stable” joint. To begin our assessment, we need to look at the joints above and below the knee—the “mobile” joints of the ankle and the hip—to ensure that the athlete has quality range of motion (ROM) in both joints. This ROM is necessary when squatting deep and allowing for proper tracking of the knees as they move forward over the toes. To assess this, we will have the athlete perform a Snatch grip overhead squat with a PVC pipe bar. From this assessment we have a visual point of reference of the athlete’s range of motion (dorsi-flexion) in the ankle, hip flexion, and correct tracking of the knees in alignment with the feet (no valgus). A bonus to this evaluation technique is being able to also assess thoracic spine (T-Spine) mobility in addition to the previously mentioned areas of the ankle and hip.
After assessing the double leg movement, we will next evaluate single leg mobility and the athlete’s coordination by having an athlete perform three successive alternating Lunge Walks. This will allow us to view ROM and coordination/balance through an alternating single leg movement pattern. The movement-related issues most often observed during these two tests are:
- Knee valgus (medial knee cave)
- Limitations in ankle mobility (dorsiflexion)
- Hip flexor tightness/weakness
- A lack of thoracic spine and shoulder mobility with tightness in the lats.
The above issues are either directly or indirectly results of kids sitting at a desk for 7-8 hours per day with limited movement, followed by an overall lack of physical activity and free play. After completion of the assessment, training begins with the necessary corrective mobility/stability/activation exercises, followed by ground-based multi-joint exercises to develop the musculature surrounding the knee, including the quadriceps, hamstrings of the upper leg, and the gastrocs of the lower leg.
Addressing the Problem and Preparing for Training
Let us first look at the knee valgus (medial knee cave). This issue usually is a result of a weak or improperly firing gluteus medius muscle. According to Dr. Aaron Horschig of Squat University, this muscle also aids in the glide of the ball of the hip within the joint socket. To strengthen the Gluteus Medius the exercises I like to employ are combinations of 2-3 of the following prior to any multi-joint leg/glute movements:
- Multidirectional Banded Walks, specifically the lateral walk
- Banded Clam Shells
- Hip Bridge
- Single Leg Hip Bridge
These are performed as a part of our mobility/stability/technical refinement/CNS activation circuit prior to beginning the major lifts of the day’s workout.
Each day begins with Multidirectional Banded Walks. We walk 10 yards each forward, backward, lateral left, and lateral right. Following the banded walks, we will begin the actual strength session with our circuit. Working in a team setting we use the Rack Performance timing program to organize our workouts. The workout is set up into rotations of four person groups with each performing a selected exercise. After the set is complete, the athletes will rotate to the next movement station until the prescribed number of sets for the rotation has been completed, at which time the next rotation will begin. The movements or exercises selected will depend on the major strength training emphasis slated for that day’s session. For example, when our first primary exercise is a Clean variation, the four-exercise circuit rotation will be as follows:
- Muscle Clean + Front Squat performed with an empty bar (movement pattern refinement)
- Banded Hip Flexor ISOs (strength/mobility)
- Banded Clam Shells (activation exercise)
- T-Spine Mobility Twist (mobility)
We will rotate through two sets of 10-12 reps of each movement (the Muscle Clean + Front Squat will be 5 reps of each per set) in circuit fashion. On a day when the primary movement is a Squat variation, the circuit will be as follows:
- Either a deep Goblet Squat with a 2-count pause in the bottom or a deep Overhead Squat with a 2-count pause in the bottom (mobility)
- Banded Hip Bridge or Single Leg Hip Bridge with a 2-count pause at the top (activation exercise)
- Body weight Reverse Lunge (activation exercise/mobility)
- T-Spine Mobility Twist (mobility)
Again, we will rotate through two sets of 10-12 reps of each movement in circuit fashion. We use the T-Spine Mobility Twist on both circuits to mobilize the thoracic spine, which allows for better shoulder flexion on Front Squat Rack position, as well as aiding in the correction of posture issues.
In the case that the lack of ankle mobility is limiting the ROM in the Squat variation of the bottom receiving position of the clean and we are not getting enough mobilization from exercises in the current circuits, we will prescribe some banded ankle mobilization on an individual basis.
After completing the Mobility, Stability, Technical Refinement, and CNS Activation circuit, we will move into the next rotation. The primary exercises in a rotation are prioritized by the emphasis or strength focus of the day.
Most issues concerning the shoulder arise from the fact that although, like the hip joint, it is considered a ball-and-socket joint and has an extremely wide range of motion anatomically, it is not nearly as stable as the hip. This is because, unlike the ball of the hip, the shoulder is not completely encapsulated within the socket. As described by Dr. Aaron Horschig of Squat University, the shoulder is more like a golf ball sitting on a tee (sideways) resting loosely within the glenohumeral joint. Therefore, the musculature and strength around the shoulder must be increased to help stabilize the joint. This is especially true in the case of sports where the joint endures violent, high-speed impacts like football, rugby, and soccer, as well as the sports of baseball, volleyball, and softball, where repeated movements from a position of maximum
external rotation are rapidly transitioned to extremely high velocity internal rotations. Such extreme forces as these will quickly and literally “knock the ball off of the tee” (joint subluxation) or cause joint capsule damage if the muscles supporting it are not strong enough to stabilize the joint and decelerate the high internal rotation forces.
Although the shoulder is the most mobile joint in the body, issues still arise usually because of limited overhead movement and/or external rotation. This limited movement is primarily caused by tight lats (latissimus dorsi muscles) of the back and/or thoracic spine mobility limitations resulting from poor posture. As I have mentioned in previous blogs one of the biggest negatives of our technological advances of today’s world is that people, especially kids, are becoming more sedentary. This is a result of a combination of the removal of recess and a reduction of physical education classes from the school day and kids replacing after school free play with endless hours hunched over their phones and laptops texting and staring at social media. The result is rounded and hunched over shoulders (scapular protraction). Then the muscles that are responsible for pulling the shoulders back (scapular retraction) and aiding in good posture—the middle and lower trapezius and rhomboids—are also often underemphasized or completely ignored in strength training programs. Add in the fact that external rotation of the shoulders is negatively impacted due to lack of emphasis on training the external rotator cuff muscles, the Infraspinatus, and the Teres Minor, and we have a train wreck in the making.
Just as we prepared for the primary Olympic or leg movement with specific Mobility, Stability, Technical Refinement, and CNS Activation movements, we will do the same prior to performing the upper body strength exercise of focus for the day. The exercises will be done during the Olympic lift variation rotation. The following exercises will be used to correct posture issues in the thoracic spine and to activate and strengthen the muscles of the posterior rotator cuff:
- Over & Backs with band (activation and stability)
- Band Pull Apart (either at chest, throat, or forehead) (activation and stability)
- Push-ups (mobility and stability)
- Prone Ys & Ts (activation and stability)
In the Rotator Cuff Complex station, we will perform two sets of 10-12 reps of Banded Over & Backs alternated with two sets of Band Pull Aparts. Coaching points on Band Pull Aparts are to keep tension on the band throughout the movement, pause and hold in an isometric action for a two-count at the midpoint of the movement, and then slowly return to the starting point. We will follow this station with strict sets of 12-15 reps of Push-ups with a 2-count lockout pause at the top of each rep. The final exercises will be two sets of 12 reps each on the Prone Ys and Ts, with a 2-count isometric pause and hold at the top of each rep.
At the conclusion of the Olympic variation rotation, the shoulders and posterior rotator cuffs are primed, and the shoulders are ready to move to the primary upper body pressing exercise for the day in the next rotation.
In the next edition of this series, we will discuss our exercise selection to train for muscular balance, our program layout, and our volume used for our supplemental exercises throughout the remainder of programming.