One of my favorite parts about coaching and training people is the investigative process that unfolds during the course of getting someone from where they are to where they want to be.
It sounds strange to those who have never done it but that is largely what coaching boils down to in the end.
Clients come to you with a goal or at the very least an idea of where they’d like to be go and where they don’t want to be and your job is to figure out how to help them accomplish it.
Although most times clients have a long storied history of chasing the goal unsuccessfully on their own and you are being called in more than anything to figure out why exactly they have been unable to do it themselves.
This is when you get to dawn your sleuth hat, obtain a history of the case to date, begin making inquiries to identify potential suspects, hone in on a key problem, and solve the case.
And the best part is that the longer you practice and the more people you coach the more patterns begin to develop and the quicker you are to identify problems and execute on solutions.
And one of the recurrent cases I find myself investigating is the curious case of non-specific knee pain, especially in avid runners.
Don’t get me wrong I don’t take myself as someone who was trained to handle pain, pathologies, or diagnosis pathologies, but I do think of myself as a smart, intelligent, competent, and well educated strength coach and trainer who has been forced to become knowledgeable about how to deal with pain as there just aren’t many situations in which a client isn’t going to experience some pain at some point.
Yes I refer out and yes I insist clients seek professional medical advice for pain and injuries.
But the reality is most never follow up whether because of financial challenges, lack of insurance, or plain skepticism about medical professionals.
Thus my hand has been forced to learn how i might bring clients some kind of alleviation from their knee pain and especially for those who seem to develop knee pain or exacerbated knee pan after bouts of walking and running.
Again I don't claim to have the ability to diagnosis anything, but I can recognize patterns and identify some sort of correlation and one pattern I've seen again and again in this situation is a connection between lack of control and stability at the hips in those with knee pain.
I could tell you about all kinds of fancy assessments and tests that I did to identify this problem like a gait analysis or manual muscle testing, but the truth is I simply just took an up stream and downstream approach when working with these individuals.
I know that running and walking requires adequate ranges of motion and control at the toes and ankle. I also know that running and walking require stability at the hips to control the pelvis and leg during the striking phase of the gait.
So all I did was look at those two areas to make sure that those prerequisites where in place in order to rule out whether this was whether a true problem with the knee or perhaps the knee was simply picking up slack for another piece of the kinetic chain and therefore becoming angry about it.
Turned out in most cases when I had someone stand on a single leg to look at hip stability very few people were able to maintain a level pelvis indicating so me that they may have some problems with hip stability and pelvic control when each of their feet struck the ground during their gait.
And while I can't say with 100% confidence that that was indeed the problem most people I've worked with knee pain resolved after drilling exercises to improve their hip stability and control on one leg.
I'd like to share with you one of my favorite drills for working on this.
I particularly like this drill because it places the lower body in a similar position to what is experienced during gait. That is the one leg striking the ground is forming a closed chain during gait therefore we should train and mimic that position to get a better carry over effect from our training.
Open chain hip stability and control drills, such as a clamshell or side lying hip abduction, are great and could be used in conjunction with this exercise, but I don't think their carry over is quite as good.
Thus I introduce to you the Closed Chain Hip Abduction and Adduction Drill.
I know it looks a bit more difficult than it really is. But don't let that freak you out. Give it a try.
And if you struggle with the balance aspect of it simply regress it by using the wall or a squat rack for some support.
If you are someone who occasionally experiences knee pain or just want to improve hip stability please let me know how this exercise works for you or if you get any benefit!
Happy moving and heavy lifting!
Practical, Purposeful, Effective Training