Most of the people that search out our services come to us with injuries. We consistently track injury rates and injury areas to look at the trends in our clients. 40 percent of the injuries we deal with are lower back, followed by knee, ankle, leg, and then shoulder. This is not a complete list, but is does show the top 90 percent of the injuries that our clients need to address. We do not diagnose injuries, our job is to help our clients return to health and fitness by strengthening and mobilizing the injured area, balancing out the body to prevent future injuries, and trying to find out if problems in their exercise technique or their previous exercise program contributed to the injury.
Incorrect form combined with too much weight are usually significant factors in injuries. However, one of the most common problems that we see is the fact that most individuals do not perform a balanced exercise program. Working the chest without performing equal or more back exercises to balance the muscles pull on the body. Performing quad dominant exercises while ignoring the hamstrings and gluts. These imbalances can contribute to lower back, knee, and shoulder problems due to anterior muscles placing more force on the skeleton without the posterior muscles to balance out the loads.
The term “Functional Fitness” means exercise that challenges the muscles in the same way that the body would work outside of the gym. When you use a prime mover muscle (example: chest) then the opposite muscle (back) must also work to counter balance movements and smooth out the action. Supporting muscles (shoulders) will also be used to assist with the movement. The problems is when the muscles you have focused on consistently (chest) are significantly stronger than your stabilizing and supporting muscles (back and shoulders), you have now greatly increased your risk of injury. The strength of your chest muscles have now lead to your greatest weakness and the area you will most likely injure (lower back or shoulders). An exercise program must work all muscle groups to keep your body moving well, without pain, and moving through the full range of motion. Overworking specific muscle groups and causing imbalances only reduces the “Functionality” of your body.
Research in the Journal of Physical Therapy Science has shown consistently that exercises for the core (think more lower back and oblique’s, not just abs), gluts, and hamstrings significantly reduces lower back and knee pain. Below are 3 tests (and fixes) to see if imbalances are part of your pain problem.
Knees hurt? Check your hips.
The pain you feel in your knees could be tightness or lack of mobility in your hips or ankles. Check the mobility of your hips by lying on your back in a doorway so that the middle of your kneecap is on the threshold. Place your arms at your sides, palms up. Keep your feet together, toes pointed at the ceiling. Pull your toes towards your shins to create a 90-degree angle at the ankle. With one leg straight and staying in contact with the floor, slowly raise the other leg until either your knee bends on your raising leg, or your bottom foot bends or turns out to the side.
If the knobby part of your ankle can make it past the door frame, your hips are mobile—check the ankle test below to see if that’s causing knee issues. If either ankle can’t make it, foam roll your hips and gluts, and then work on this stretch using a belt or strap for more improvement.
Fix it: Lying in the same position as during the test, wrap a strap or belt around one foot and raise it until you just start to feel a stretch, only mild discomfort. Do not stretch to the point of pain. Hold this position for 30 seconds and repeat twice per leg. You should see small improvements in your range of motion weekly.
Hips moving OK? Check your ankles.
If your hips are mobile, or even if they’re not, ankle mobility can also lead to knee pain. To check your ankle mobility, assume a one-knee position facing a wall. Your knees should both form 90-degree angles, and the toe of your planted foot should be about four inches from the wall. In this position, try to glide your knee over your little toe to touch the wall without lifting your heel. If you can reach the wall, your ankle is mobile. If your heel comes up before your knee touches the wall, your calves are too tight and this could cause a problem.
Fix it: Foam roll your calves and work on mobilizing the ankle by working it through the range of motion mentioned above. Trying to slowly push the knee closer to the wall while keeping the heel planted on the ground. Performing this as a drill, you can see as much as half an inch of improvement. If you feel pain during the drill, stop and consult a physician.
Lower-back tightness? Check your hips.
Back discomfort doesn’t always indicate a back problem. If one side of your pelvis is higher than the other, it can result in back pain, hip pain, groin pain, or even knee pain. Unevenness of your hips can pull on your lower back, causing that tightness while sitting all day.
Fix it: If you notice your hips are uneven, try this hip abduction exercise. Lie on your back with knees bent and feet flat on the floor, hip-width apart (the classic sit-up position). Wrap a small resistance band around your knees so that it’s already a little tight while your knees are together. Now press out against the strap to separate your knees until they form a V-shape, holding this position for 5 seconds. This move helps to fix the hip imbalance because “in the lying position, the muscles that are causing the pelvis to be out of alignment are shut off. Repeat for 2 sets of 20 reps, 3 times per week.
An exercise program should make you stronger, help you perform everyday and sport specific activities better, improve your overall health, and do these things without increasing your risk of serious injury. Look at the exercises you perform to ensure that your program is balanced. If you sit most of the day, performing exercise that work your back, gluts, and hamstrings are vital. Foam roll and stretch daily to improve and maintain mobility.
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