Overuse Injuries and Knee Braces

About the Author: Eric Cressey

Yesterday morning, Tony Gentilcore and I got out to the local track to do some sprinting work.  After we had wrapped up our 45-minute session, as we walked off the track, we noticed a 20-something year-old female runner on the ground banging out crunches in what we estimated were sets of 800.

What caught my eye even more than her elite training protocol  (insert sarcastic smirk here), though, was a knee brace so large that it looked like a giant octopus had devoured her leg.  Geek that I am, I started pondering things over.

Most people would say that she’s probably got an overuse injury from all the running.  I wouldn’t disagree.

To take it a step further, though I immediately started thinking about why she had a dysfunction/ imbalance that could be predisposing her to pain with all that running.

Think about what happens with a crunch: trunk flexion.

As Mike Robertson and I described in our Building the Efficient Athlete DVD set, in the process, we actually make ourselves more kyphotic (rounded over at the upper back) via a shortening of the rectus abdominus, which pulls the rib cage down toward the pelvis.  Just check out the points of attachment in the image below and you’ll see what I mean:

In most cases, when we round over at the upper back, as a compensation to keep us upright, the lumbar spine tends to become more lordotic – meaning that the natural lumbar arch is exaggerated.  Go to a more lordotic position, and you’ll “trigger” an increased amount of anterior pelvic tilt (associated with shortening/tightness of the hip flexors, including the rectus femoris, psoas, iliacus, tensor fascia latae, among others).

We know that the hip flexors play a very important role in knee health; the rectus femoris actually attaches to the patella, too.   In addition to the pull these muscles have on the leg, they also tend to force one into anterior weight-bearing (already a problem in most females, thanks to evolution and high-heeled shoes).

Just imagine how great that knee would feel if she swapped the thousands of crunches for some foam rolling, lacrosse ball work, and glute activation and hip and ankle mobility drills.  Success in training (and corrective exercise) is all about the opportunity cost of your training time and effort; you just need to select the drills that give you the most bang for your buck while ironing out imbalances that help you to move more efficiently.

Building the Efficient Athlete

Food for thought.  Enjoy the rest of the week, everyone.