Structural Balance

This concept was popularized in the 1980s by Charles Poliquin. It basically states that in order for our bodies to perform optimally, and with less injury and pain…we should be pursuing a type of harmony within the size, strength, and weight distribution of our body. 

To help illustrate this, let’s look at some examples of how we can be OUT of balance:

The most common and pertinent application for me and what I’m seeing in my work…is bodies that are top-heavy. This means a body is loaded with weight above the belt, without sufficient building of connective tissues and strength below the belt. This is just asking for foot, knee, and hip pain and problems. This is where building from the ground up is crucial. 

Another example would be an athlete who has a very strong posterior chain (calves, hamstrings, glutes, etc.), but is very weak in front (anterior chain) with their tibialis, quads, and hips. This could pose problems for deceleration, approaching a jump, etc. or lead to shin splints and knee pain. We’re basically creating a body here that can’t absorb all of the force created by its own self. 

If we build up a ton of muscle tissue, but don’t develop the tendons and ligaments along the way, we are asking for joint issues, tears, pain, etc. 

It’s been very popular to train what’s called Triple Extension. ‘Triple’ is connected to extending the foot, knees, and hips. Think of being in a squat position and then jumping up into the air. Most athletes tend to train these movements separately. We could use a calf raise, a leg extension machine for the knee, and a squat or good morning for the hips. BUT, what about Triple ‘Flexion’? We rarely hear of athletes focusing on this…or at least focusing on it as much as on Triple extension. Triple flexion would be tibialis raise for the shin area, a nordic curl for the back of the knee and hamstring, and a reverse squat where we pull our knees up to our chest. What if we hooked our feet up to a cable and weight stack, and actually measured how much we could lift by pulling those knees to chest? It’s not to say ‘don’t squat’. It’s simply to say let’s also give incredible focus to reverse squatting. Athletes find when they do this, their legs feel so much lighter, instead of that heavy footed feel. Triple extension AND triple flexion leads to structural balance. 

If we can push really well with chest and triceps, but can’t pull for crap with back and biceps, we aren’t structurally balanced. 

If a softball pitcher or baseball player throws hundreds of times with one arm every week, but can’t effectively and safely slow that arm down with external rotation strength, they aren’t structurally balanced. On top of that, one side of their body is developing differently than the other, which can certainly lead to pain or injury. 

Lastly, I’ll consider another issue with knees because that is my weakness. If we develop the outer quad muscles (vastus lateralis), but don’t address the inner VMO (vastus medialis) muscle, we are manufacturing and asking for knee issues. The VMO is rarely trained, but is most correlated with a stable and more pain-free knee.  Therefore, leaving it out leaves us out of structural balance. 

Well, how do we get structurally balanced then, one might ask?  We seek out the weak links by trying a few exercises. It doesn’t take long at all! Then, we use our bodyweight, and our main lifts to calculate some ‘Standards’ for all of the other lifts. This lets us know where we stand, and what we should be at least pursuing. Without this information, a young athlete may just think more, more, more is the answer, but then blow out his knee or shoulder because of a clear weakness our imbalance in a noticeable area. 

Now…we MUST say that even the most structurally balanced human could go out, play their sport, or do the activities within their day, and STILL get injured. This isn’t perfection that we’re striving for. Life is hard. Sports are dynamic. There are many unpredictables along the way. But a wise investment, putting money in the bank to make ourselves much more resilient, goes a long way in preventing a good amount of pain and suffering. 

If you’re thinking you may be structurally ‘imbalanced’ in some way…if you’re in pain…if it hurts to play your sport…I’d love to have a conversation with you to see if I can provide value and get you on the right track. 

Vmo’s that make you cry

The VMO muscle. It’s the teardrop shaped muscle on inside of knee. Sadly, when I heard about this muscle about a year ago, I couldn’t find it on myself…mine were non existent! 😢

The VMO has an inverse correlation to knee pain. In general, the bigger the VMO, the less knee pain we’ll have.

VMO is the most fast-twitch, and first to contract of the quads.

It is trained most effectively when knees go over toes, OR when knee is fully bent. How ironic that most of us totally AVOID those two positions.

The VMO also helps to efficiently track the patella (kneecap), and therefore helps guide and seat the patella properly. Many of us have weird shifting and floating of the kneecap. This, along with dislocations can feel cruddy and helpless!

You can see that my the VMO on my right knee (the one with 3 surgeries), is smaller than my left. I have work to do there, in effort to become more structurally balanced.

A question to consider especially for an athlete would be, what do we think the cause would be if we built up upper quads, and added mass/weight in the upper body, before or without addressing the VMO?

I actually don’t really care about studies. I care more about what’s working for you or me today. But I know it matters to some so I’ll include a few below that I’ve read. To me, the science matters, but real life application matters more. For example, the third link – study on patellar maltracking concludes that rest, a knee brace, and anti-inflammatory drugs (these break down cartilage) are commonly used non surgical treatments. AND that there are about 100 styles of surgery to TRY to correct this, resulting in NO gold standard amongst medical professionals. Good lord. Fortunately, it does mention range of motion and strengthening of the VMO.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8752958/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609425/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6570735/…

ROKP (Reverse Out Knee Pain)

The lightest form of knees over toes training is walking backwards. If you have knee problems, this is the special sauce to start down the path of recovery. At least 5 minutes per day is what I do and recommend. We call this ROKP (reverse out knee pain).

But walking backwards ALONE, even though good for light recovery, won’t cause the pressure and adaptation that we want. At some point, we need to add some load or resistance. AND, walking backwards outside can be dangerous with obstacles, potholes, uneven terrain, etc. especially for older folks.

At that point, pulling a fitness sled on turf is the best method. Smooth, predictable surface and measurable load. The late, great Louie Simmons (RIP) popularized the sled, with some of the strongest folks in the world. I learned it from Ben Hartford and Brian Christopher. Ben is still coaching Anchor Athletics in Concord, NH. This is a great gym… with great turf for sledding!

If we don’t belong to a gym with this setup. There are many DIY sled options to make at home, but you need a good driveway, yard, or street to pull it on.

Don’t want to do that? Another fine ROKP option is the reverse deadmill. Stand on a treadmill, but turn backwards and push away with your feet. It’s good to have padding between your back and the control panel area for comfort. You can probably find a free treadmill out there. It doesn’t even need to work! Just make sure you can spin the belt and that it provides resistance. Some spin fast and gain momentum. No bueno.

Ok lastly…it’s too cold and uneven out there for backward walking, no sled, and no treadmill? You can do 5 minutes of ‘knee drops’ seen in my video, standing in place. With your hands holding something for stability, and keeping your torso vertical, let your knees go forward out and slightly over your toes. Your heels should slightly come off of the floor. While returning to starting position(straight legs) engage the tibialis and lift with the toes. Keep pulsing down and up. When knees lockout, toes should lift off of ground slightly. It’s NOT the same if you don’t lift the toes! This helps get into a slightly hyperextended position, but engaging the tibialis causes even more blood flow and good vibes. 5 minutes of this for less pain, and incredible pump around the knee.

Please try ROKP in some way, then tell me how the knees feel! It’s done wonders for mine. 5 minutes per day will help get your base back!

ACL epidemic

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.

kia kaha,

Kids Pre-sport movement – 80’s mix

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!