ACL injuries for kids have become an epidemic in the States. Adolescent girls suffer the most, in sports that include a lot of unpredictable cutting like soccer, basketball, etc.
My understanding of the literature as to why this is happening, can be distilled down to a lack of structural balance.
One thread seems to be ‘quad-dominant’ athletes, with strong muscles on the front of the thigh, but weak hammies.
Another common thread is overuse with one side of the body…think athlete that kicks a ball hundreds of times with 1 leg, and a couple times with the other.
Lastly, athletes are adding weight and getting bigger muscles, but AREN’T proportionally building up the structures that MOVE those muscles, ie feet, ankles, calves, tibialis, knees, vmo’s.
Every pound added above the waist corresponds to an exponential weight impacted at the knee. We experience 2x the impact at the knee just walking flat ground. So if a 150 pound athlete is dynamically moving, jumping, twisting, stopping…it’s just common sense that the demands that are trying to pull that knee apart are incredibly high!
What can we do though? We can build from the ground up first. We know that any force not taken by the foot and ankle…travels up to the knee. It’s a kinetic chain. So bulletproof the hell out of the foot, ankle, tib…to HELP prevent. Remember, this isn’t a guarantee…but it IS a wise investment.
We can then train to achieve closer to structural balance, relentlessly identifying and pursuing weak links…NOT just continually adding weight to the lifts we like to do.
Lastly, we can train the Nordic exercise. This movement works the tissues that hold the knee together, and fight that pulling-apart action.
This is a cheap and accessible piece of equipment that should be in every gym! I was so focused on my bench and squat numbers when I played my sport. I wish I pursued being able to do even 1 repetition of a Nordic! I can still only do the eccentric portion (downward movement) after about 6 months of trying. Please send me info of any high schooler that can do a strict Nordic! I would be so happy for this kid! I believe that making the Nordic a ‘cool’ exercise would prevent a ton of ACL surgeries.
ACL tears and knee surgeries have come up to epidemic levels for teens in the United States. We don’t have definite causes for this, but we can assume that these young athletes are NOT structurally balanced, and NOT built from the ground up.
To truly bulletproof this area, and protect the best that we can, exercises that directly focus on the knee itself (like the Nordic and the ATG Split Squat) will eventually be more crucial.
However, in the early years (think tweens) we can start that process of building from the ground up with some simple exercises. This will at the very least start building strength and protection below the knee, in the foot, ankle, tibialis, and calf, therefore collecting much of the impact before it gets to the knee.
The 80’s mix is an easy to remember, kid-friendly set of 4 exercises, 20 repetitions each…that are recommended for use before practice, before game, before the trampoline park. Really, they can be used effectively to activate those lower legs before participating in any activity. Hopefully, 80s mix will help your kid stay more protected!
I’m so excited around this time of year. It’s full of closure and renewal…ups and downs. And as long as we can navigate that emotionally, we can accept the exposure, and learn a ton!
Speaking of learning…I found a bunch of good books in 2022 that I want to share with you, and I learned a lot from them. I suppose if I distilled down what I learn when I read, I could name it Perspective (possibly humility too though). Reading presents me with another point of view, broadening my scope and reminding me that the world isn’t just seen through my own eyes. In that sense, it also humbles me. I know that each person I talk to, knows more about something than me. Reading has encouraged me to do that.
As always, I try to keep up on posting my reading list on my website here. I want to sing the praises of a select few that I read this year. Hopefully you’ll find one to enjoy:
Less — by Andrew Sean Greer Pulitzer prize winner right here! I think I read this book in a day or two, and was so pissed when it was over. It follows Arthur Less who is trying to avoid the inevitability of his own life. Sadly, I could relate. It was laugh-out-loud funny, but also seriously threaded through the challenges we all face. Arthur is a failing author, who is invited to the wedding of his ex. So he quickly attempts to set up a book tour to show that can’t possibly RSVP. It’s messy and relatable. Oh…and Pulitzer prizes aren’t just passed out lacklusterly.
City of Girls — by Elizabeth Gilbert Set in the hustle of 1940s New York, Vivian is kicked out of college and is then sent to be with her Aunt who runs Lily Playhouse — a somewhat rundown theater. Vivian tells the story as an old woman in the last years of her life…looking back. It’s full of great characters, the lively theater world, and the romanticism of New York city. It’s beautiful.
The Signature of All Things — by Elizabeth Gilbert After reading City of Girls and realizing Gilbert’s quality, I heard about this. Holy! This one feels more like her magnum opus. It’s grand, spanning, and worldly. Centered in 1800s Philadelphia where a titan, Henry Whitaker establishes his estate. The story follows his daughter Alma, who instills herself in the botanical world. It’s full of family expectations, lineage, love, and death. The full span of it. I laughed and cried with both of these Gilbert pieces.
*The Dutch House* (Audiobook!) — by Ann Patchett The actual book would be just great to pick up and read. However, the audiobook (that I listened to for free in the Hoopla app…connected to your local library) is read by Tom Hanks! His familiar and comforting voice, along with his acting/reading credentials made it so very nice to listen to. I recommend the book however you can get it…but highly recommend the Hanks version of the audiobook. This story uses a house as the focal point for a family tale about a father that achieves incredible wealth through real estate, and then the paradox within the lives of his children. I love how it relates the character of a physical thing (in this case, a house and all of it’s details) and how that can affect us as people. Being a home-body myself I can totally relate, seeing how a home can become part of our identity and how we define ourselves. This story isn’t just homey and happy though. It’s got the full span of life’s challenges too, touching on all of the human condition.
Here are some nonfiction pieces that I loved:
Clear Seeing Place — by Brian Rutenberg Brian is my favorite contemporary painter/artist. I met him at a showing in Cape Cod, and what a guy! On top of his amazing paintings, he has an informative YouTube channel in which he delivers studio visits to describe his work, and educate aspiring painters like myself. This book is a valuable collection of all of his wisdom. I loved it.
How to be an Artist — by Jerry Saltz Staying on the theme of art, Jerry is the only art critic that I’ve found so far, that I would read and listen to. Instead of the typical hoity toity look-down-your-nose-at-me type of writing and critique…Saltz is blue-collar, humble, realistic, seriously knowledgeable, encouraging, and hilarious. In this book, he very directly details the simple path to becoming the artist that you keep wondering about.
The 5am Club and The Monk Who Sold his Ferrari — by Robin Sharma Both of these books are considered ‘Self Help’, which I love. I think that genre gets a bad reputation but sheesh, call it ‘Personal Development’ if that helps you feel better. I respect the hell out of anyone that takes time to read a book that potentially motivates them, and introduces them to new ways of living. Both of Sharma’s books here do that. One of them is focused on mornings and the structure of our day, and the other reminds us of functional ways for us to live more like a monk in today’s world. The x-factor to both of these books though, is the format that Sharma used. In both works, he uses characters and a story-type narrative structure to more effectively illustrate the messages. Both of these books are awesome.
“Don’t let your knees go over your toes,“ they said.
Turns out, training with our knees going forward over our toes… Is EXACTLY what will help lead to us bulletproofing our knees!
The entry-level exercise for this, and the ‘special sauce’ for repairing your knees is…walking backwards. When you take a step backwards, you land on your toes…and your knee is ‘over your toes’. This is a short-range movement that’s low impact (notice how the landing is softer than a forward walking heel strike). It also flexes and works the big toe and foot…an area that all of us could give more TLC to.
Perform this walking backward special sauce for 5-10 minutes a day. Make sure that you have a clear area and a smooth surface to do this on. Your partner can help by holding your hand, being your eyes, and guiding you. Then switch positions. Another great method, especially during these colder months is to get on a treadmill and without turning it on, turn around and spin the treadmill belt yourself by walking backwards on it. This provides a really good resistance to the walking… And helps build up those muscles around the knee.
The absolute best method, is to pull a fitness sled on turf while walking backwards. Maybe your gym has this? If this can’t happen, there are DIY options for making your own sled and pulling it in your driveway or yard as well.
Backwards walking? It sounds kind of silly… But this is the X factor that has brought my knees back to being out of pain. There are certainly other things to be doing along with this… But this is where it all starts. I can help you find a way to be doing this.
Please call me or message me with your knee story… whether it won’t bend, it hurts, or both! I can’t believe the restrictions that I’m hearing that many of us are living with. And dealing with chronic pain is for the fricken birds! Let’s deal with that! I’m confident that I can help.
No cost, no pressure or obligation. I’m passionate about helping, and I get paid by learning through your story.
> Quality of Life < Consider your pain, what you want to be doing, and how you feel right now. Can you stand up and run a quarter mile immediately? Can you get down on the floor to play with your grandkid? Can you get back up? Does it hurt to go down stairs? This is grand scheme…and should weigh heavily into how we consider being fit for life.
> Range of Motion < Full range, partial, and everything in between. Would it be wise to be strong in one particular part of the range but not others? Also, moving our joints through a full range brings synovial fluid in, signaling repair and restore. As most of us can acknowledge with age, our joints work under an approach of ‘use it or lose it’.
> Connective Tissues < Yes we can develop our tendons, ligaments, cartilage etc.! They take longer to adapt, but we must put effort here. If we simply add muscle to the upper body for an athlete, but we don’t focus on joint development in the lower body…we’re basically manufacturing knee surgeries! Another way to think of this is that if we’re carrying around extra weight, but we haven’t built joints and tissues from the ground up, we’re asking for problems.
>Structural Balance< This is about being as strong forward as backward. It’s about being strong in acceleration AND deceleration. ATG considers ‘overuse’, and builds strength in reverse of that action. A baseball pitcher for example, with all of that forward throwing must create structural balance by building strength in reverse with something like an external rotation exercise. Mimi and Grampa who have taken millions of steps forward? They can use backward walking to reverse out damage and build strength into the future.
>Old & New< Tried and true methods are important. The squat. Ideas from successful coaches from the past like Charles Poliquin or Louie Simmons. They gave us methods that will stand forever. In another way, we must continue to push innovation, try new movements, and consider radical ideas. Not to accept every one of them…but to stay relevant and accessible to each individual. Success leaves clues, whether in history, or in your own knee today.