Flexibility And Mobility For Lifters - Volume 3 (Knees​)

So Volume 3 the knees you know that funny thing in the middle of your leg that goes crack and pops every time you squat down.  We have all dealt with knee pain at some point, and many of our non-lifting peers suffer daily with knee pain this often leads us to look at the knee as a week joint susceptible to injury. While we can pick up injuries and niggles at any point, the knee joint is far from weak and is capable of handling heavy loads. For example to the knee joints deals with up to 3x your body weight when walking and subject to up to 5 x your bodyweight when going downhill let alone jumping off high boxes and sprinting making it pretty robust.


The knee joint functions as a synovial hinge joint which gives a big clue to how it operates much like the hinge of a door although there is some room for rotation as you'll find out later this is often when the knee becomes most susceptible to injuries.



The bones that form the joint are the femur (Thigh), patella (Kneecap), tibia and fibula ( shin ).  All being held together with 4 ligaments which go by the names posterior cruciate ligament (PCL), anterior cruciate ligament (ACL), medial collateral ligament (MCL) and the lateral collateral ligament (LCL). There are also  2 wedge-shaped pieces of cartilage in the joint which are known as your meniscus. The extension and flexion of the knee not only allows us to hoist savage poundages in the squat but also run, jump, sit, stand pretty much any athlete endeavour.

A quick anatomy lesson the muscles


Muscles/Tendons that allow the knee to function:



Prime Mover: Quadriceps - vastus lateralis, vastus medialis, vastus intermedius, rectus femoris - A well-developed set of quads are the sign that someone has spent some time under the barbell.


Synergists: There are no true synergists of knee extension. However, the gluteus maximus and soleus could be viewed as synergists to knee extension during closed chain mechanics.


Antagonists: Biceps Femoris, semimembranosus, semitendinosus, popliteus, gastrocnemius, gracilis, sartorius


Knee Flexion:



Prime Mover: Biceps femoris, semimembranosus, semitendinosus

Synergists: popliteus, gastrocnemius, gracilis, sartorius - Did someone say biceps? Everyone wants jacked leg biceps right?


Antagonists: Quadriceps - vastus lateralis, vastus medialis, vastus intermedius, rectus femoris


A Careful balance between medial and lateral stabilisers of the knee must be maintained to prevent excessive internal or external rotation of the tibia.


Quadricep Tendon - This tendon will continue further down and become the patellar ligament. And for the sake of this article well keep in simple and treat it as a single tendon. This tendon is what your quads pull on to extend the leg.


Lateral Tendon of the biceps femoris and medial tendon of the semimembranosus, semitendinosus - These tendons attach your hamstring to your shin which allows the hamstrings to flex the knee when contracting.


Testing:

To test the range of motion at the knee joint is just as easy as checking your ankles. For this, you will need to lay supine (on your back) on the floor. To test flexion, bring your heel as far as possible to your glutes. Aiming for a 135-140 degree flexion at the knee. Now try the opposite and contract the quadriceps/straighten your leg and your heel should come up slightly. Aiming for 0-15 degree extension.  


( Images of testing )


Hamstrings you should be able to lay back flat on the floor, extend one leg up to 90 degrees while keeping the other leg flat on the floor, this can be performed with a band or a partner.


( Images of testing )


Quadriceps you will stand tall and neutral, flex one leg with the assistance of your arm, you should be able to move your heel to reach your glutes while your knee is pointing straight down to the floor.


( Images of testing )


Again you should log your findings in the test so you can make the necessary changes to fix or to stay the same. Having it recorded will make it easier for you to see what needs to change and give you a boost of motivation when you look at how far you've come with progressing. If you find that you don't pass the tests, then you will either have tight quadriceps or hamstrings depending on the area you struggled with and fix this problem by stretching the restricted regions daily.


Strengthening:

To strengthen the knee joint, you must strengthen the muscles around the knee. The first exercise I would suggest is to squat! This is my number 1 choice because it not only strengthens the prime movers but also strengthens the stabilisers. You may have heard squats are bad for your knees, well this is completely wrong. In fact, squatting is great for knee health, overall leg development and requires proper coordination and forces your muscles to work alongside one another. It’s only when you have crappy form and are putting yourself in a weak position it will become bad. For this, I’d recommend getting a good coach who knows what they are talking about so they can teach you correct and safe form and plan and progress training.


Squatting instructions - Grip the bar with a comfortable distance apart (roughly just outside shoulder width) and engage the back and core to stabilise yourself, feet should be a comfortable distance apart again, I like to go just outside shoulder width with my toes pointing slightly out. Break at the hips and knees, remembering the knees are allowed to track over the toes as long as they stay in line! Controlled descent until the hips pass the knee crease and then power up. Making sure the bar path remains over midfoot for the entire movement and keeping a neutral spine.



Second exercise Id recommend called the Val Slide. Basically just a hamstring curl with your bodyweight.  All you need is the valslide for equipment, a bit of floor space and you are good to go. If you don’t have the valslides at your gym, then you could use a leg curl machine or banded hamstring curls as an alternative to still isolate and focus on the hamstrings.



Valslide instructions - To perform this exercise lay flat on your back with your heels on the valslide and toes pointing up. Now engage the glutes and bridge up so only your upper back in contact with the floor. Now squeeze the hamstrings and bring your heels to your ass and then slowly extend the legs again remaining in the bridged position.


A third exercise I’d suggest to do is reverse prowler drag. It’s simple to do, it’s fun, and it’s easy to set up. Load the prowler up with some 20’s, strap up in the harness or belt and walk backwards dragging the prowler, making sure you keep in a slight quarter squat position, 25-50 metres or as far as you can go. The pump is unreal! An alternative to this exercise is, if you have one, the leg extension machine, or if you don't have the machine, banded leg extensions. Focus on the concentric and slow eccentric phases of the movement, and your legs will just be as pumped!



Reverse Prowler Drag instructions - To perform this exercise, first you must set up the prowler, once set up, get yourself in a harness or belt, sit down in a quarter squat and start walking backwards. Keeping yourself square and walking in a straight line. It’s as easy and straightforward as that.


Stretching & Self Myofascial release



Quad Stretch - Personally the best stretch I think for the quads is the couch stretch, it hits the entire quad, and it hits it deep! Not only does it hit the quads but also the hip flexors, so it's a double win for flexibility gains. To perform this, you will be the half kneeling position with one leg propped up against a chair, bed or table and that knee must be pointing straight down. Now the lead leg must be placed at a 90degree angle, keeping a neutral spine, squeeze the glutes and push the hips through and feel yourself loosen up. Hold for 60's and repeat on the other side.


Quad Self myofascial release - A great way to release the muscle it Is to use a pain-pill, I know a lot of gyms won't necessarily have one, but it's worth it. Place the pain pill at the top of the quads and work your way down and back up, moving slowly, leaving it on a tense spot, moving it side to side. It really helps relieve the tension in the muscle. A good tip is to use it like a rolling pin, just instead of dough, you're rolling it's your leg!





Hamstring Stretch - The banded hamstring stretch is simple and easy to do. All that you need is some floor space and a band that's relatively strong. Hook the band around the base of your foot and pull it towards your face while you lay flat on the floor. You must remember to keep both legs straight, make sure the grounded leg is flat on the floor and try and aim for a 90-degree angle. A stretch while the knee is bent would be good to try out also. Try the posterior chain floss, using a band and a box, wrap the band around your hip and place your foot on a box or something similar to a box (almost be in a lunge position) hold for 30seconds. You can straighten your leg and push the hips back to deepen the stretch further and move in and out this position.


Hamstring Self myofascial release - One of the easiest ways to release the hamstrings is with a foam roller. Place the foam roller under your leg on the meaty part of your hamstring and put as much pressure going down on it as possible. Start moving up and down slowly finding tight and tense areas. Go up and down at least 10 times to really try and work the tension out.



Exercise/Movements Affected:

Having lousy knee health or tight muscles affecting the knee will not only impact your lifting or your sports but will impact daily life. Having an unstable knee restricts your ability to run, jump, land, squat, lunge and increases the risk of injury. If the muscles are tight, you may experience knee pain and think it’s something worse than what it actually is. Keep them healthy and allow yourself to run, jump, squat, basically, anything you fancy without the thought of pain sitting in the back of your mind.

Keeping in mind knees don’t like too much lateral movement, changing direction rapidly in a football game, for example, could cause damage to the LCL and MCL. Also direct blows to the knees from side on collisions also aren't the best for knee stability as my brother has found out the hard way, resulting in meniscus and ligament damage making it an unstable joint and sitting him out off rugby for 2 seasons and a long and slow rehab process in the gym for months.

As with any joint, there are a whole host of injuries that can occur and its best to consult a physiotherapist or physician to help you with any pain.


Dean