Knee injuries - How can you hope to solve the problem using the stimulus that caused the problem?

As a student of sports training and competition I took up the opportunity to watch the exercise selection from the waiting room at the physical therapists. I was surprised at the amount of quad exercises used over the weeks of my observing.

Later as I lay on a table in the therapy clinic I listened to a young male client answer the question from this physical therapist.

Therapist: Okay what have we done so far?
Patient: Squats.
My mind: That’s one.
Patient: Wall squats.
My mind: That’s two
Patient: Lunges.
My mind: That’s three.
Patient: Walking lunges.
My mind: That’s four.
Patient: Step ups.
My mind: That’s five.

So far, the workout was 100% quad. I shook my head and said a prayer for the patient. Now to be fair I did see one non-quad exercise being done later. But the first five and the overwhelming majority of exercises being used in the rehab program for what I believe was an ACL surgery patient were quad exercises.

I found this ironic, because it was this very profession some 30 years ago that brought me attention to the risks of ‘quad dominance’ in muscle balance and its relationship with gait and joint integrity. And here I was, some three decades later, and they were creating that exact same condition.

I took this quad dominant concern, along with my own observations, quite seriously and spend a decade or so developing and refining before publishing a concept I called ‘Lines of Movement’ in 1998. You might not recognize the concept title I gave it but you will recognize the terminology by virtue of the prolific unreferenced and uncredited publishing by people who knew better.

In relation to the lower body, I developed the concept to ‘hip dominant’ exercises to counter the concern I learnt from my therapist colleagues about ‘quad dominance’. Now, nearly 20 years after I first published this concept, my theories about the risks of quad dominance have become greater and clearer. I rank the muscle imbalance presented by quad dominant training as one of the highest correlates with ACL ruptures and similar.

If I am track, then the question can be asked:

How can you hope to solve the problem (ACL rupture risk) using the same stimulus that contributed to the problem?

Now I understand that there are many reasons why most will disregard this message. Firstly, and most importantly, because the majority of ‘performance’, ‘injury prevention’ and ‘injury rehab’ strength training does just this – create quad dominance. And to accept this and change would take the emotional intelligence to conclude one is off track and needs to redirection one’s training programs. That’s the biggest reason the message will be ignored.

I understand this. I understand others are waiting for ‘evidence’. I say look at the changing injury landscape. This injury was extremely rare in the 1980s, and even after the surgery became available there was not an instant increase in ACL incidence – so the low incidence was not because the surgery was not available. It was just a rare injury. It is not any more. So what changed? Why are so many athletes suffering from this injury now? But this would take again a degree of commitment to excellence and a detachment from ego that few are committed to.

Evidence is, I suggest, another way of saying I will only do it when I see most others doing it, and when I am doing what most others are doing, I feel ‘right’ and ‘safe’.

What I do say is this – not withstanding the frequent medical claims I here quoted by patients all too often about how their graft will be stronger than the one their Maker gave them - 50% of all ACL patients will have repeat knee surgery, and 100% will have premature degenerative changes such as osteoarthritis. I would not wish this on anyone. If it was your child would you want this?

So while the masses wait the quarter to full century it may take for the ‘evidence’ to ‘allow’ them to take note of my conclusions, another generation or more will suffer from life changing injury and surgery such as the ACL.

It does not have to be this way for you and those in your care, however that is up to you.

Physical train wrecks

It does not have to be this way

Every day I speak with athletes who have more injuries than I believe are necessary or acceptable. The list of injuries is getting longer, relative to the decades past. This may be the trend, however no athlete needs to follow the trend. However for them to buck the trend, they will need to think differently, act differently and have different values than those around them. Because too many in the sports circle now accept, embrace and even benefit from this high incidence of injury.

Todays athlete injuries story – shoulder surgery at 17 years of age, multiple shin stress fractures in the next few years, following by multiple ankle joint and ligament strains in the next few years, followed by a dislocated wrist.

The one before – ACL, torn peck, etc etc.

Now I don’t blame the athlete in the first instance, especially when their first injury was in an age when in other aspect of life society does not deem them legally responsible. Noting that the exposure to ‘strength and conditioning’ was about two years prior to the shoulder injury, I confirm another example supporting my hypothesis that if we were to remove all ‘strength and conditioning’ programs globally, the athlete injury rare would halve or more.

In the first instance the sports administrators, coaches, physical coaches, and commercial sellers of goods and services should take a look at their values and competencies. Coaches - if just getting a job gives you a sense of fulfilment, I hope one day you look for more, including best the best you can be for the athlete. However as that is not likely to occur en-mass, the responsibility must come back to the athlete, especially the athlete 18 years or older.

Athletes – it’s time to wake up. You don’t have to be injured. You don’t have to accept this paradigm. But you are going to need to do something about it yourself because no one else is. Its your call. Accept the smorgasbord of injuries like most do – or be different. Find out what you can do to fulfill your potential through injury free training and competing. It is possible. We do it every day.

The rise of the strength sports – and associated training trends

Many have noted the rise of popularity of the strength sports, particularly Olympic and power lifting. A spin off from the training faciliites offering ‘Crossfit’, many suggest, which is a positive for the respective strength sports (and equipment suppliers to these sports!)

What has also become apparent is the trends in training in some circles. Take for example the trend of powerlifting training six days a week, including 3-4 squat sessions a week and at least one three lift day each week.

Training trends far removed from the practice and wisdom of only a few decades ago.

Now as a student of training, I am always open to take a lesson. However as part of being a student I also apply the practice of creating hypothesis for the purpose of testing theories.

So here I go – generally speaking, all things being equal, those adopting these new trends in training in the strength sports will enjoy initial gains (first year). Then they will plateau (within 2 years). And then they will have significant injuries (within 4 years).

Just a hypothesis. I look forward to the study conclusions in the years to come based on adequate samples sizes of at least case studies. Happy however not to be one of the guinea pigs!

Are your single leg training concepts from the 1990s still relevant?

I recently received a email where the writer asked:

“ Dear Ian, I've come across your single leg 2 part routine limping into October online. This I believe is the gold dust I have been looking for. I've been attempting to create something similar to this without realizing it!

Is this something you would still recommend as I notice it was posted online in the late 90's? It still seems very relevant to me.

I feel it’s next to exactly what I'm looking for. A routine to follow for a 3-4 week phase that will help reduce any muscular imbalances I have before I start my pre season conditioning early June.

Any advice on this would be very much appreciated. Kind regards.”
--Tom

This is what I responded with:

“This is a program that changed the way the world trains, and the reason why you were looking to create something similar - because it created a human trend that spread throughout the world. Take the concepts I promoted in the late 1990s about unilateral body weight lower body exercises, lines of movement, speed of movement, control drills prior to strength training and so on, out of those interesting books on ‘functional training’ and books would fall over, and no, despite the complete absence of ethical and professional referencing, that author did not come up with those ideas. What he do however was orchestrate the famous ‘Boston Walkout’….

https://youtu.be/DqNvk12dotE

Is the content of this 1990s program still relevant? I don’t produce trends. I produce concepts that serve forever. So yes, it is still relevant. It will not in itself solve your problems because it only addresses the strength side, and there is so much more to training as an athlete than ’strength and conditioning’, despite the dominant paradigm created by a historical incident of convenience in 1981. Keep in mind also that it is a generic program, not individualised.

On that point, on individualization, it’s ironic that the industry has not only failed to moved towards higher competency in individualization, but the trend based focus is attaches to (and you have been caught up in) has result, I suggest, in a move away from individualization. The art of individualizing training is not taught, and possessed by few. It goes a massive distance further than doing a weekend course with a three digit trademark certification and buying the related testing device.

On the point of relevance I developed these ideas during the late 1980s and early 1990s and published them after over a decade of experimentation and refining in the late 1990s. If you think the ideas may be dated, you are more alone than you may appreciate.

Now it was only about 5 years later, but I nearly fell out my chair and swallowed my protein shaker when I was sent (by a concerned colleague) a video from a 2003 seminar in Nevada where the presenter presented my unique approach to bodyweight exercises and then told the audience the only way to learn more about them was through personal communication with himself or by buying his book (must have had amnesia about the dozen or so resources he learnt them from that he could have recommended, or the actual source of the info…)

https://youtu.be/dbE90Fr_vgc?list=PL502185E23BBDA89F

I was shattered to see virtually the entire contents of my ‘How to Write Strength Training Programs’ book (1998) repackaged verbatim and promoted as an ‘industry bible’, (verbatim and lightly paraphrased), in 2005 and again in 2009, with the ‘authors’ seeking to pass it off as their own works, sold for 3 times the price people would have paid for the original works.

https://youtu.be/E5sQ05aA728?list=PL502185E23BBDA89F

I was ‘intrigued’ when I noted an article by a certain ‘functionalist’ author promoting the benefits of single leg exercises in around 2011, over 10 years since I championed the concept against industry beliefs, and in the same online magazine. I failed to see how you could publish with such ‘revolutionary’ ideas in the same magazine over a decade later! And then there was the national convention in a large island country where the key note speaker proudly presented on the concept of stability exercises etc., and new strength sub-quality that I published about in the early 1990s, nearly 20 years prior!

So if these otherwise ‘highly regarded’ industry experts (although I not sure how you get ‘highly respected’ when the C+V keyboard buttons are your best friend?) find worthiness to promote off these concepts some 10-20 years after they were first published (and up to 30 years after I began developing them conceptually), and the market didn’t react poorly to them (after all, some will only present on content they are confident will be ‘popular’ and ’trendy’) then this may be a hint of their timelessness!

I trust this answers your question.
--Ian King

When buff is 'bad'

I was near the finish line at a high school yesterday watching over 100 thirteen to fourteen year old boys complete a cross country race. As I do everywhere I studied their shape and development.

Apart from the expected changes some were experiencing consistent with entering the early teen age years, there was another noticeable physical sign on many of the boys.

It was apparent to me which of the boys was engaging in body shape changing strength training. Now for most the changes they were making would have been impressive – larger muscles, heavier and potentially stronger than they were or their peers were. This is what would catch the eye of most, and appear impressive.

And I have no doubt in the short term they will experience these benefits and feel rewarded for participating in what is considered normal and appropriate – the application of strength training to young athletes applied with the current paradigms.

However, based on over three decades of stuying the human body’s response to stimuli, and seeking to understand and then be able to predict the relationship between cerain stimuli in training and the incidence and severity of injury, I d did not share that feeling of being impressed.

Quite the opposite actually. I added more numbers to the sample group for the purposes of testing my hypothesis of future injuries patterns for these boys.

What I saw was a potential relationship where over 80% of these boys engaged in what is considered normal practice strength training will suffer injuries during the next few years BECAUSE of their strength training.

The most glaring imbalance I saw in their body was quad dominance, with their quad muscles over-shading lagging hip muscles – hamstrings and glues.

During the 1980s, after identifying muscle imbalance from traditional strength training, I began to develop a concept I called ‘:Lines of movement’. What resulted were six primary divisions or categories of exercise, which I didn’t publish until 1998.

These categories included:

• Hip dominant • Quad dominant • Horizontal push • Horizontal pull • Vertical push • Vertical pull Within a few years this concept was hijacked and published unreferenced by certain ‘writers’ keen to promote their self-interests, rather than the interests of the end-user, for whom it was developed.

Perhaps this is the reason why not only have we failed to fulfill the concept I developed nearly 30 years ago, we are arguably worse off as a society in relation to injuries that I suggest are a direct result of the training we do.

Once I realized the tragic direction the world has been taking in relation to training induced injuries, combined with the unfettered abuse of my concepts for self-serving purposes at the expense of the intended recipients – I have dedicated more time and energy to the purpose of helping people avoid the pitfalls presented by writers who for the most part lack real success in training, yet are ‘teachers’.

I have done a number of seminars throughout the world this year on this subject, and will peak this message at the November 2015 Society for Weight Training Specialists (SWIS) convention in Toronto, Canada – in addition to a number of presentation on this topic in a number of different countries during the remainder of the year.

I can only reach out and seek to warn parents and other care-givers – we need to pull back in the involvement of young athletes in the formal physical preparation program, especially strength training, until training methods and coach competencies are significantly higher.

If you have children in sport, or if you coach young athletes in physical training, I want to say thanks for contributing and look forward to meeting you in a seminar during 2015! The world need you to step up, up-skill and take great pride in ‘first, do no harm!’

Planning a specialisation strength program

One of the great challenges for a person (including the 'professional' coach/consultant) is to design a strength training program around a body part or line of movement specialisation program. This challenge was reflected in this question i received from a KSI client:

Since I no longer train for sporting prowess/performance (basketball and track), but simply for health/fitness (and to keep up with my kids’ play) yet, feeling like a “somewhat” concrete goal might be fun, I’ve been looking at various "symmetry" scales and formulae (McCallum's, as well as Willoughby's in your GBIV), which has quickly made me become aware of a few things: My training/sporting background gave me a solid lower-body foundation (hips/glutes being 3” above “ideal”, thighs 2½” above "ideal", and calves 1"), but to the "detriment" of upper body symmetry.

For example, according to various scales (and, of course, I realize fully this is just for “fun” and to give a general perspective on things), chest size is below by 2”, arms by 1 to 1½ inches, forearms 1 inch, and neck, 1¼ inch!!!!!

In terms of strength, and as one would expect, lower body strength is well above average, and upper body is just around average, except for one glaring exception: shoulder pressing strength is well below (in spite of having reasonable shoulder development?!?). So, this leads me to the following (and was hoping to get your feedback)…

I was considering giving your Great Guns program a go (which I thought would be a great way of emphasizing arm/forearm development), but was wondering how to prioritize (or deprioritize the lower body, as the case may be) other lagging parts (neck, chest, and, then, shoulder pressing strength)?

Should I postpone those other areas to future cycles/phases? Is there any way to work on chest size AND shoulder strength, WHILE still prioritizing arms? Or is this overkill? Your comments, as always, are appreciated.—Éric

To which I responded with:

Eric- a specialization program is just that – specializing in one area. What I taught in my 1998 ‘How to Write’, in my 1999 book ‘Get Buffed!’ and throughout my articles in various magazines (hard copy and online), every singe program creates a priority – by virtue of the sequence, relative volumes and relative load potential of the exercises provided.

You are leaning towards doing the arm specialization program, which is great, but at the same time are wishing you could specialize in a number of other muscle groups. When you specialize by sequence - which is inherent in all program by default – assuming volume to each muscle group or line of movement is equal, you still have prioritization or specialisation.

However when you add prioritization or specialization by volume also, which occurs in specialization programs such as the ‘Great Guns’ program – you are forced then to reduce volume in other muscle groups or lines of movement. What you are being tempted to do is overload your program, which in turn will overload your body. This is common in strength training, and the most common outcome is the conclusion that growth without drugs is impossible.

This is not correct. The best way to answer your own question – and that is the purpose and intent of my educational material, to help you make your own decisions – is to determine the amount of volume (lets use the simple method of number of sets to measure that) to your number one specialization. In this case, you have nominated your arms.

Lets take my general recommended volume range of 8-15 sets per workout (not including abdominal, control or warm up sets) and use the average number of 12. Now lets use my maximum number of workouts per 7 day cycle that I believe suits most and that is four workouts a week. We are left with 60 work sets in total for the week.

Once you have worked out how many sets you want to allocate from these 60 sets to your number one specialization priority (in this case your arms), then allocate volume (total number of sets) to your remaining body.

You can show a secondary priority and a third priority – in fact this will happen by default – and so to some extent you can sequence your priorities, but no other muscle group other than your arms is going to get real prioritisation.

On the flip side the only way you can do a specialization program and get away with it is to put other muscle groups / lines of movement on hold, or in maintenance. This applies to training outside of strength training also, which has direct application for all athletes.

So I know, I have not answered your question in the way you may have been hoping – in the old world ‘I am the guru and the only way you will get anywhere is through me’ approach – but I believe I have answered your question from the ‘you are your own guru’ perspective, or at least nudged you to realize your own ability to answer your questions.—Ian King

Now I'll be the first to agree that the challenge of designing a strength program around a specialisation program is a challenging task. The approach I use and teach my high level coaches at an individual consulting level is one that applies a series of high level decisions and a considerable time to construct the training program, which is a level of excellence and cost that many avoid in the 'hope' that their quicker, less considered decisions are adequate. I am continually amazed at how humans give their motor vehicle more individualised service than their bodies!

To answer the challenges presented by this task i encourage close study of my Get Buffed! educational series and or a program design consultation with one of my high level coaches.

Ian King

PS. The following response was received:

Ian... Contrary to what you might have implied in your last paragraph, this has been IMMENSELY useful. Right in line with your espoused philosophy and educational approach of "teaching a man how to fish" rather than simply "giving him the fish"

As you know, I already own a very extensive library of much of your material but, in some cases, getting a fresh perspective and slightly different angle (with a more specific context) on some of the ideas can help one along in exactly the right way.

This will help guide me with my planned phases. If need be, I'll send you a copy of my written program, for some more specific guidelines, but I feel you've already done more than enough.

As always, I'm grateful for your time, insights and wisdom.

Be well...
-Eric