by Jessica Bento, Physical Therapist
It can be really challenging posting about moving better and overcoming common aches/pains. The reality is that pain is far more complex than most people think! There are many variables to consider from structural damage to a joint, muscle/tendon, and soft-tissue issues. Combine that with lifestyle issues like hydration, stress, inflammation, and sleep patterns, when people ask how they solve “x” problem, I typically have to ask many more questions.
Instead of just saying, “do THIS exercise”, I wanted to address many of these variables we should be considering especially with trying to build healthy knees. Of course, I also want to start getting people motivated to work on these concepts, so using these posts to helps to discuss drills you can be implementing right now into your training can definitely be a way to get a big jump start on issues like healthy knees. So, what are the 3 best and most overlooked exercises you can use to solve such issues? These are what I have found to be so productive, yet, are missing from so many programs.
Step-ups & Downs
I’m not a strength coach, I’m first and foremost a physical therapist. That means I’m less concerned how much you can squat and more so how you can take that strength to more functional tasks. “Isn’t squatting functional?” Of course it is, but it is an exercise with diminishing returns over time. There is a well known concept known as “optimal strength” in athletics which basically says getting stronger in an exercise doesn’t mean improvement in a sport. That is why one exercise can’t do everything.
So, why am I more focused on step-ups and downs? You can’t use nearly the weight on these drills as you can squats? Well, for one, they will make every lower body exercise you do better, they are a better measure of leg strength because you can’t really cheat with your low back, and we get functional stability training in the fact you have to produce and resist force at the same time. That means step-ups and downs are not only awesome for building healthy knees, but also great strength builders as well.
Most people overlook these drills because they fail to see all the ways they can be progressed. You have several variables you can use…
-The height of the step (all too often a mistake people make on an arbitrary level)
-Direction of the step (typically never considered in programming)
-How the body is loaded (so many options here to stress specific outcomes)
-Stepping up versus stepping down (the control, strength, and stability of stepping down is much more challenging than stepping up).
I will take a quick pivot to mention one step-up or step down I really do NOT like! That is putting the Ultimate Sandbag on the back. That is because unlike the barbell, there is no “shelf” to put the weight of the USB and this causes undo stress on the neck, often forces people into lumbar extension, and very importantly, negates many of the benefits of the many ways to load the body during the step-up.
Step downs are phenomenal for building strong legs, glutes, and healthy knees. However, most people don’t realize how you can introduce them more successfully to clients when you realize how different tools offer better opportunities. The DVRT Press Out vs a dumbbell raise (both offer counter balance) is much stronger because by gripping and pulling apart, pressing from the stomach, we get a far stronger brace of the core and therefore better stability! Once you get proficient you can use many of the same options as in step-ups!
Arc Press
Wait a minute! How in the world is an upper body push something that can help us with building healthy knees?! That is one of the wonderful aspects of functional fitness versus isolated training, we can attack multiple goals at once. Yes, the Arc Press is a wonderful one arm press that teaches how to press correctly through gripping the USB and the added push/pull you get, but there is something else the Arc Press helps us learn.
When we perform any press, but especially the Arc Press, we have to ground our feet and create stability in the core/pelvis. If there is a break in the chain the Arc Press gets very awkward and we see a lot of movement compensation. Now, this strategy is true of any press we perform, so why is the Arc Press unique?
Well, the fact the weight moves laterally gives us an opportunity to work on resisting lateral motion which is so foundational to many of the muscles of our body and what we really mean by better knee stability. The lateral stability is one, but due to the fact that progressing in load isn’t always possible (because Ultimate Sandbags get bigger as well as heavier) we can alter body position, the surface we are on, and/or adding force vectors like using bands with our Core Strap.
Stepping Hip Hinges
That doesn’t build strength!” Is a criticism we get on occasion when we post movements that look so unfamiliar to people. We get it, people don’t understand what is happening and why it would make you stronger when the weights aren’t what they can use when they are more stable. A great example of true instability training and a powerful way to build better strength and healthy knees are stepping hip hinge patterns.
We have a two legged deadlift, we have a single leg deadlift, yet, people often fail to see that we can hip hinge in many different patterns. When we do so, we are creating stability demands on the entire chains of the body to create efficient and strong movement. The trick is that most fail to have the ability to move in these directions with any control, they can’t decelerate (which is essential of healthy knees and true functional strength of the lower body), and they can’t resist the additional forces trying to alter out body’s position and posture as we move.
As I show above, we have 4 primary patterns we use in our hip hinge matrix. We can perform these from the more classic hip position (the weight held down by our hips) or raise the intensity by going Front Loaded. It is very easy to use only one of these patterns (which I would recommend when introducing them) as well as we can progress to power based movements (as I show below).
My hope is that you are seeing that there is a much bigger world of strength and good movement training than most people ever explore or understand. Many think that to train movement you need circus tricks and others think that doing what they have always seen in the gym is all they need. There is a smart way to do both, but you have to understand how the body functions and the demands of human movement. I hope this inspires you to try to add these 3 categories of exercises to your workouts whether you are trying to overcome problems or just looking to reach higher fitness goals.
Jessica Bento, director of education at DVRT, has been a physical therapist for over 16 years practicing in orthopedics, neuro, and geriatric rehabilitation. Jessica is currently director of education for DVRTFitness.com where she has taught DVRT programs at national conferences and all over the world. You can get 35% off right now on Jessica’s DVRT Rx course with code “kneepain”