Training to prevent knee injuries

Valgus knee

Knee injuries seem to be more and more prevalent in the modern world and it’s something I see a lot of as a fitness coach. I come across many clients who have suffered knee pain, discomfort and ligament tears and strains. These types of injury can have a devastating impact on everyday lives.

One of the most common types of knee injury is an ACL (Anterior cruciate ligament) tear which is most often seen in athletes competing in sports that require rapid deceleration and cutting type movements such as tennis, football and basketball. However with a huge increase in the popularity of “functional training” we see many regular gym goers who are supplementing their training with these types of movement. Lateral movements such as ice skaters, cone hops, side to side shuttle runs, sprint training and board jumps are all exercises can can potentially lead to ACL injuries. Many people are simply not equipped with the necessary strength or motor control at the affected joints to prevent the ACL being overloaded and injured. A sedentary individual who has recently come back into training needs time to develop motor control, coordination and strength before they can safely perform certain movements and exercises.

Knee injury and ligament damage can also come as a result of more basic movements done within the gym as well, particularly when someone has a large disparity in strength across opposing muscle groups. A combination of having strong quadriceps and weaker hamstrings is a common issue that can result in ACL and other knee related injuries. Research has shown that the quadriceps create a strong anterior (frontal) force on the Tibia (Lower leg) that can load the ACL to failure. Conversely, the hamstrings should be co-contracting to help reduce that anterior force but many people have weaker hamstrings and therefore don’t have the necessary tools to prevent the ACL being overloaded. This issue is often further exacerbated by valgus knee. (when the knee collapsed inwards)

By incorporating exercises into a our program that help to strengthen the hamstrings and other muscles in the posterior chain can help to dramatically reduce the risk of ACL injury. Some example exercises could be:

-TRX hamstring curl
-Dead lift/single leg dead lifts
-Kettle bell swings
-Nordic curls
-Swiss ball heel tucks
-long step lunges

An effort can be made to consciously keep the knees aligned when performing flexion and extension (bending the knee) if you’re prone to letting the knees collapse inwards.

In regards to movements that require rapid directional change and declaration we can implement ques and direction into our training and client programs to help these movements become safer. When we look at explosive or plyometric movements we often talk about the acceleration phase, encouraging clients to generate as much ground production force as possible to either jump higher of further but we often forget about the opposing side of this which is ground reduction. This happens during the eccentric (muscles lengthen) phase of a movement. Typically knee injuries occur during the declaration or landing phases of movements. By making an effort to reduce impact by having a “softer” or “quieter” landing whilst also triple flexing (Bending at the hips, knees and ankles) we can significantly reduce risk of knee injury.

Have a look and see whether you might performing movements with valgus knee (you can perform squats in front of a mirror for example) and make sure you are incorporating exercises into your program that will promote hamstring and glute strength.