Jumpers knee is a common term used to describe an overuse injury to the patellar tendon.  The technical term for this tendon injury is patellar tendinosis or patellar tendinopathy and is estimated to affect 45% of elite volleyball players.

According to the most current literature, patellar tendinosis is largely due to the eccentric load placed on the patellar tendon. That is, the tendon is lengthened under load when lowering for a jump and when bending the knee upon landing. (For an explanation of “eccentric contraction” please refer to our previous post about the prevention of hamstring strain). According to a study published in the British Journal of Sports Medicine, athletes who experienced patellar tendinosis had a tendency to land with a lesser degree of ankle and knee joint flexion on initial impact. That is, they didn’t bend their knees or ankles during landing to the extent of other athletes. The study also found that the rate at which the knee is forced into flexion upon landing may be a risk factor in the development of patellar tendinopathy.

So how do we apply our newest understandings of “Jumper’s Knee” to the athlete at risk? If a coach or trainer notices any of the above findings in one of their athletes they should be urged to try a soft landing technique, bending both the ankles and knees as much as possible to absorb the force of landing. If symptoms are present, frequency and intensity of jumping may need to be reduced. Of course, we always recommended that you consult with a doctor so that your condition can be diagnosed prior to any treatment.

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References

Bisseling RW, Hof AL, Bredeweg SW, Zwerver J, Mulder T. Are the take-off and landing phase dynamics of the volleyball spike jump related to patellar tendinopathy? British Journal of Sports Medicine 2008; 42: 483-489.

Bisseling RW, Hof AL, Bredeweg SW et al. Relationship between landing strategy and patellar tendinopathy in volleyball. British Journal of Sports Medicine 2007; 41: e8.

Disclaimer
The purpose of this blog is to educate our patients and those interested in improving their health and wellbeing. We recommend that you always consult with a qualified health care professional before applying any of the topics or suggestions mentioned on this website. This information is not intended to diagnose or treat your condition. Burlington Sports Therapy, Dr. McIntyre or Dr. McDowall accept no responsibility for any complications arising from the use of any suggestions, exercises or topics of discussion on this site.

Most experienced runners have a preferred brand of running shoe. Mizuno, Asics, New Balance and Saucony seem to be common choices among our patients, but the jury is still out as to which manufacturer truly makes the best shoe. Since there are no objective, scientific guidelines to direct your purchase, it seems to boil down to personal preference. Thanks to some recently published research, lacing up your chosen shoe is a different story…

This past February, an interesting paper was published in the Journal of Sports Sciences which investigated the various lacing patterns in running shoes. Using force plates, pressure transducers and accelerometers attached to the leg, the authors measured how different lacing patterns would influence pronation of the foot, tibial acceleration and pressure distribution in the bottom of the foot. The authors laced the shoes using one, two, three, six or seven eyelets in addition to investigating the tightness of the laces (weak, regular or strong). The interesting results were as follows…

When shoes were laced tighter, using all the eyelets, there was a lower rate of loading and the foot pronated slower (which is a good thing). This lacing pattern also showed the lowest peak pressure under the heel and the outside of the foot.

When a six-eyelet / cross lacing pattern was used, a higher loading rate and higher peak heel pressure was observed when compared to the seven eyelet method. Interestingly, the participants did not report a difference in perceived comfort between these two lacing patterns.

Reduced impact and lower peak pressures were observed under the third and fifth toes when only the lower eyelets of the shoes were used. This interesting finding was explained by the foot sliding within the shoe during the stance phase.

Therefore, the findings of this interesting study suggest that using each of the eyelets in a running shoe (and lacing them up firmly) allows your foot to experience the full benefit of what the shoe was designed for. Under most circumstances, good running shoes are designed to reduce impact and control excessive rear foot pronation. Lace them up properly and they might actually achieve that!

Like what you’ve read? Sign up for our automatic email feed on the right of this page! Questions? Comments? Feel free to post them!

References

Hagen M, Hennig EM. Effects of different shoe-lacing patterns on the biomechanics of running shoes. Journal of Sports Sciences 2009; 27(3):267-275.

Disclaimer
The purpose of this blog is to educate our patients and those interested in improving their health and wellbeing. We recommend that you always consult with a qualified health care professional before applying any of the topics or suggestions mentioned on this website. This information is not intended to diagnose or treat your condition. Burlington Sports Therapy, Dr. McIntyre or Dr. McDowall accept no responsibility for any complications arising from the use of any suggestions, exercises or topics of discussion on this site.

Like the various musicians in a symphony orchestra, athletic movements require different muscles to activate and deactivate in a very co-ordinated fashion. When disrupted, this orchestra of muscular activity can not only affect athletic performance, but can also lead to different injuries.

Functional instability of the ankle is an example of an injury that has been shown to affect muscular activity in other areas of the lower limb. With functional ankle instability, many people have a history of repeated ankle sprains. Although their “bad ankles” are not painful, these athletes feel like their ankles may “give way” at any time. Several studies have shown that these athletes can have hamstring, tensor fascia lata and peroneal deficiency during double leg to single leg jumps. The significance of this can be show through an example…

Imagine a soccer player with a previous ankle sprain who moves from standing on two legs to standing only on their previously injured leg (like when they plant their stabilizing leg to kick a ball). Given the findings mentioned above, these players may not have normal muscle activity in the standing hip because of their ankle dysfunction. As a result, they may injure their lower back (for example) because there wasn’t a co-ordinated muscular response to adequately stabilize the spine. This is a case where an athlete incurred a non contact injury to the lower back because of “bad ankles”. Thankfully, identifying functional ankle instability and prescription of individualized exercises can help to prevent these injuries.  Feel free to contact us!

Questions? Comments? Please post them right on the site or email us directly. Like what you’ve read? Sign up for our complimentary email feed on the right side of this page so that you can receive these posts every two weeks.

References

Solomonow M. Sensory-motor control of ligaments and associated neuromuscular disorders. Journal of Electromyography and Kinesiology 2006; 16: 549-567.

Van Deun S, Staes FF, Stappaerts KH et al. Relationship of chronic ankle instability to muscle activation patterns during the transition from double-leg to single-leg stance. American Journal of Sports Medicine 2007; 35: 274-281.

Zampagni ML, Corazza I, Molgora AP, Marcacci M. Can ankle imbalance be a risk factor for tensor fascia lata muscle weakness? Journal of Electromyography and Kinesiology 2009; 19: 651-659.

Disclaimer
The purpose of this blog is to educate our patients and those interested in improving their health and wellbeing. We recommend that you always consult with a qualified health care professional before applying any of the topics or suggestions mentioned on this website. This information is not intended to diagnose or treat your condition. Burlington Sports Therapy, Dr. McIntyre or Dr. McDowall accept no responsibility for any complications arising from the use of any suggestions, exercises or topics of discussion on this site.

   

 

 

The gluteus medius (pictured on the left) is a gluteal muscle that is best described as being on the “side” of our gluteal area.  It assists in several motions, including abduction movements (moving the thigh away from the midline) and stabilizing the pelvis during activity.  This muscle was definitely most active during side lying abduction. Interestingly, this exercise was approximately twice as effective as side lying clam exercises.  In descending order, other useful exercises were single limb squat, lateral band walk, single leg deadlift and sideways hop.  Other exercises studied but deemed as being in the lower “tier” of effectiveness for this muscle were (in descending order of muscle activation) the transverse hop, transverse lunge, forward hop, forward lunge, clam at 30 degrees, sideways lunge and clam at 60 degrees.  

The gluteus maximus (pictured on the right) is a large gluteal muscle that performs hip extension.  This muscle was found to be most active during the single leg squat and the single leg deadlift.  This finding is in agreement with other research which found that gluteus maximus activity is greatest during exercises that require single leg balance with hip flexion / extension.  Interestingly, the gluteus medius was activated to a similar extent during these exercises, suggesting that they are a great “bang for your buck” in terms of overall gluteal strengthening.

Questions about the exercises?  Comments?  Please post them right on the site or email us directly.   Like what you’ve read?  Sign up for our complimentary email feed on the right side of this page so that you can receive these posts every two weeks. 

References

DiStefano LJ, Blackburn JT, Marshall SW, Padua DA.  Gluteal muscle activation during common therapeutic exercises.  Journal of Orthopaedic & Sports Physical Therapy 2009; 39(7): 532-540. 

Disclaimer

The purpose of this blog is to educate our patients and those interested in improving their health and wellbeing.  We recommend that you always consult with a qualified health care professional before applying any of the topics or suggestions mentioned on this website.  This information is not intended to diagnose or treat your condition.  Burlington Sports Therapy, Dr. McIntyre or Dr. McDowall accept no responsibility for any complications arising from the use of any suggestions, exercises or topics of discussion on this site. 

There is no question that the bench press is a very popular exercise for strengthening the pectorals. Although effective, this exercise can prove painful for many people so attention needs to be given to proper technique.  Here are a few tips that are supported by published research…

Not too low - That burning stretch you feel at the bottom of the bench press is not necessarily the good type of “burn”.  If you lower the bar to touch your chest, you’re likely to be straining the end of the pectoral muscle at the musculotendinous junction instead of targeting the pectoral muscle tissue.  It’s recommended that you keep the bar 4 to 6 centimetres above your chest when performing this exercise.  You can roll up a towel and place it on your chest if you need the reminder!

Not too wide - A grip that is too wide forces your shoulder into excessive external rotation.  This can damage the passive structures in the front of your shoulder joint leading to chronic capsular laxity.  If you’re someone who has dislocated your shoulder in the past or if you are known to have “loose” joints, a wide grip may increase the likelihood for certain types of injury.  The recommended grip width is no wider than 1.5 times your acromial width (the acromions are the bumps on the top of your shoulder).  Worried that this will reduce your strength too much?  According to the literature, you should expect only a 5% deficit in strength with this change.

Keep it flat - When you place the bench on an incline it forces your shoulder into external rotation.  If you’re someone with a structural deficit in the front of the shoulder joint (perhaps due to the aforementioned laxity or a history of dislocation) you’ll find that this increases the likelihood of pain or injury.  Try keeping the bench flat and see if that makes a difference.  Worried about strengthening your upper chest?  According to some literature, inclining the bench does not alter the activity of the upper pectoral.  Instead, it decreases the activation of the sternal portion of the pectoral (in the midline of your chest).

Questions or comments?  Feel free to post a comment on this site or email us directly.  Like what you’ve read?  Sign up for our complimentary email feed to receive these articles every two weeks.

References

Glass SC, Armstrong T. Electromyographical activation of the pectoralis muscle during incline and decline bench press. Journal of Strength and Conditioning Research 1997; 11: 163-167.

Green C, Comfort P. The affect of grip width on bench press performance and risk of injury. Strength and Conditioning Journal 2007; 29 (5): 10-14.

Lantz J, McCrain M. Modifying chest press exercises for athletes with shoulder pathology. Strength and Conditioning Journal 2005; 27 (3): 69-72.

Disclaimer
The purpose of this blog is to educate our patients and those interested in improving their health and wellbeing. We recommend that you always consult with a qualified health care professional before applying any of the topics or suggestions mentioned on this website. This information is not intended to diagnose or treat your condition. Burlington Sports Therapy, Dr. McIntyre or Dr. McDowall accept no responsibility for any complications arising from the use of any suggestions, exercises or topics of discussion on this site.