What factors impact hip activation and knee stability? How are these altered in clients who are post-rehab for ACL tears? What should we look for as signs that an activity should be changed or adjusted to ensure that the desired training effect occurs?
As it relates to glute/hip activation in relation to knee stability during vertical shin movements like a DB Step-up, Reverse Lunge or Walking Lunge, one clue is the ability or lack of ability to maintain an upright torso when the knee is at or approaching 90 degrees of flexion. Another may be when a client “falls back” out of alignment with the foot on the box during a Step-up. During a Reverse Lunge, this would exhibit as pushing back against a straightened rear leg. The brain is seeking to shift the load away from the front or lead leg.
Cam French is performing DB Step-ups as part of her post-rehab training program. Most days, the 18″ box would be no problem for her. Here, there is a motor control issue during the deceleration phase of the exercise, slightly worse on the left (injured) side.
She had just flown back from Paris (school trip.) 8 hr flight, 4 hours on buses after 2 weeks in Italy/France.
Since we’re trying to reinforce a pattern of hip extension deceleration via glute/quad complex activation, this is less than optimal, to say the least.
If you look closely, you can see where glute/quad controlled deceleration begins to slip and hip flexion starts to occur.
Solution? First, a lower box. Next, to maximize training effect, change the target point of the non-working foot to a few inches further behind the box. This creates a “longer” deceleration and a deeper ROM at the hip and knee.
It allows maximal intensity without compromising motor control or risking losing the intended training effect. It also lets my athlete maximize the “win” factor and remain part of the success process.
There are certainly plenty of glute activation activities that we can use to shore up this pattern. A variety of bridges and single leg movements will help. RDL’s are also valuable for this, but I would lean toward the split stance version or some version of a loaded tilt.
It also helps to know what you are looking for in “diagnosing” the movement defects. Sometimes the signs are big and obvious, like knee valgus or extreme forward torso lean. Often, though, the signs are more subtle.
Look for a “hitch” during deceleration during squats, lunges and step-ups. This indicates a break in that primal pattern. Then, determine whether there is a motor control issue, fatigue issue or mobility issue (or some combo.) Address them in order of simple to complex.
You’ll find your solution. You’ll also be serving your athletes and clients better.
Keep the faith and keep after it!