In the previous few editions of this series, we have discussed identifying mobility and stability issues through the use of a functional movement assessment and screening process, common physical and postural deficiencies facing today’s young athletes, and corrective exercises we use to address and correct these deficiencies. In this edition we will examine how we progress from the use of specific corrective exercises to utilizing combinations of our core multi-joint exercises and supplemental body part movements in developing overall joint stability through muscular balance.
As we have discussed throughout the series, one of the keys to safe training, aiding in injury prevention/reduction, and achieving success in your sport is through efficient movement. Although efficient movement starts with body weight movements and coordination, the progression must continue into strength training exercises. Inefficient movement patterns of the strength training exercises performed in a program do not produce the desired training adaptations or optimal risk-to-reward results. Consequently, a key component to achieving the desired outcome from our strength training program is teaching and refining sound technique and setting an expectation that exercises are consistently performed with immaculate technique.
Technical refinement exercises such as the Muscle Clean + Front Squat, Muscle Snatch + Overhead Squat, Goblet Squat and hinging movements like the Romanian Deadlift (RDL) act to breakdown key components of complex exercises, refine movement patterns, and prime the muscles in complex movements prior to performing them in the actual workout with increased weight.
Training for Lower Body Muscle Balance
Training for muscular balance is critical to aiding in joint stability of the knee. The knee is considered a hinge joint although it rotates slightly. Using the Joint-by-Joint concept discussed in Part 1 of this series and looking from the bottom up, we know the ankle is mobile, the knee is stable, and the hip is mobile. The knee joint is supported by four ligaments: the Anterior Cruciate Ligament (ACL), the Posterior Cruciate Ligament (PCL), the Medial Collateral Ligament (MCL), and the Lateral Collateral Ligament (LCL). The ACL acts to stabilize the knee during rotational movements such as cutting or pivoting. It also is a secondary means of support to prevent hyperextension of the knee. The PCL helps to maintain proper alignment of the upper leg bone (femur) and the primary lower leg bone (tibia). The MCL and LCL act as primary medial and lateral stabilizers for the knee joint, respectively. The responsibilities of all four ligaments overlap to aid as secondary help to the others.
Ligaments, unlike muscles, are not elastic in nature. Where a muscle can be stretched and then return to its resting length, a ligament, once stretched, does not return to its original length. Consequently, once a ligament is stressed (stretched) beyond its capability, the tissue tears, and the result is laxity in the joint. This occurrence is referenced as a joint sprain. Sprains are graded according to their severity on a scale of 1 to 3. According to physiopedia.com, a 1st degree sprain is considered mild with minimal ligament damage. A 2nd degree sprain is a partial or significant tearing of the ligament, and a 3rd degree sprain is a complete tear of the ligament. In most cases surgical repair is not necessary for a 1st or 2nd degree tear of the ACL or any level tear for the other ligaments. However, 3rd degree ACL tears almost always require surgical repair.
The generally prescribed non-surgical approach to rehabilitate joint sprains of the knee is through physical therapy in which the primary emphasis is strengthening the muscles that support and stabilize the injured joint. In the case of the knee, the quadriceps muscles of the thigh, the hamstrings of the posterior thigh, and the gastrocs muscles of the lower leg are strengthened to develop the needed support to aid joint stability. As strength coaches our approach in programming should be to train in such a way as to develop muscular balance and eliminate existing imbalances, especially in musculature surrounding joints. Doing so from the start can potentially reduce likelihood of serious injury in the future.
My approach is to overemphasize the development of the posterior chain muscles since they are at a strength deficit to their anterior counterparts from the get-go. As I discussed in Training the Young Athlete- Part 4, because they are already at a deficit, we program posterior chain movements at as much as 3:1 volume ratio over exercises that emphasize the anterior muscle groups. A program will be sequenced as follows:
With our more advanced athletes, as shown above, we follow a concurrent training program throughout the year. Based on our assessed needs following the season, we will begin the off-season with a 4-day program split and transition to a 3-day total body routine for the remainder of training within 4 to 6 weeks. Regardless, our primary lower body Max Effort (ME) Plus Day workout will contain a ground-based multi-joint movement of focus (i.e. Back Squat), a Dynamic Effort (DE) on a Pull (i.e. Clean Pull), Volume (V) on a Single Leg exercise (i.e. Overhead Lunge Walk) and a Posterior Chain exercise (Glute-Ham Raise). With our younger athletes, we will follow a linear periodization protocol and will not include Dynamic Effort movement except for our Olympic exercises.
From the graphic you see that our Squat will get 25-30 reps and exercises that are more posterior chain and single-leg dominant—such as the Clean Pull (20 reps), Overhead Lunge Walk (40 reps), Glute-Ham Raise (36 reps), and Backward Sled Pull (60 yards)—give us a greater than 3:1 ratio of Posterior Chain to Squats. My data is anecdotal and not scientific research; however, since using this programming out of hundreds of athletes since 2005, we have had fewer than five ACL injuries that required surgical repair.
Training for Upper Body Muscle Balance
In the graphic of the program above, you see that although it is a Max Effort Back Squat day, it is also a volume day for the upper body focus, which is shoulders. And just as with the lower body, we overemphasize the volume of the posterior muscles of the back and posterior deltoids to increase muscle balance around the shoulder girdle.
In Part-3 of this series, we explained the gleno-humeral joint of the shoulder is the most mobile joint in the body. However, it is not overly stable and therefore is extremely susceptible to injuries such as joint subluxation that damage the ligaments and the labrum. This is especially true for athletes competing in contact sports (football, soccer, rugby) and sports involving overhead movements with high-velocity internal rotation (baseball, softball, volleyball, football quarterbacks), as well as those who perform high-force-producing lifts like the Bench Press and Shoulder Press.
To counter the already present muscular strength imbalance of the internal rotators and anterior musculature of the chest and deltoids, we will employ the same philosophy we do to develop the posterior chain of the lower body with the external rotators, scapular stabilizers, and posterior muscles of the upper back.
In the graphic you see that we still get our thoracic spine mobility, external rotator activation, dynamic shoulder stabilization (Lockout Push-ups), and scapular stabilizing exercises in preparation for performing our Max Effort pressing movement of the day. We will perform between 100-105 reps of pressing movements (Push-ups, Bench Press, and Standing Alternating DB Press) and perform 190 reps of upper back Posterior Chain (PC) exercises. This gives us 58% more PC reps than anterior pressing reps. Also, this workout (5+ Bench Press) is our highest volume pressing day, which means the percentage of PC reps over anterior pressing will increase slightly in subsequent workouts. As for exercise selection, I like to have a vertical pulling exercise and a horizontal pulling exercise, as well as an external rotation activator in each upper body PC session that is paired with our Max Effort pressing movement. Also, after performing each set of our upper back pulling movements we perform a 45 second set of Prayer Stretch to help keep the lats flexible and mobile which aids our overhead range of motion.
Just as we did a volume shoulder workout on our Max Effort Squat session, we will do a volume leg workout focusing on single-leg and posterior chain exercises after we complete our Max Effort Bench Press rotation. As with ACL injuries, since 2005 we have had very few serious shoulder joint injuries and only two that required surgical repair.
For over three decades, my philosophy and programming of coaching strength and conditioning have been in constant evolution. To remain successful, you must persist in the effort to learn, adapt, evolve, and apply new knowledge and techniques. If you stay the same, you get passed up! NEVER STOP LEARNING AND YOU WILL NEVER STOP GROWING!