Forum

Welcome to the Sport Medicine/Rehabilitation SIG forum. The purpose of the Sport Medicine/Rehabilitation SIG is to promote this specialty area to NSCA members who are involved in Sports Medicine/Rehabilitation or individuals interested in related issues. Membership may include, but not limited to, physical therapists, athletic trainers, students of related fields, and other health related professionals (e.g., sports trained physicians and chiropractors). The Sports Medicine/Rehabilitation SIG will serve its members and members of the NSCA, as well as the public and consumers by working within the mission of the NSCA to bridge the gap not only between research and practice, but between traditional rehabilitation concepts and strategies that take advantage of strength and conditioning principles. Please share research, ideas, training techniques, and ask questions. The Sport Medicine/Rehabilitation forum is moderated by the Sport Medicine/Rehabilitation SIG Executive Council. 

I have no idea how to create a topic, but I wanted to weigh in on the article "Are Deep Squats a Safe

and Viable Exercise?" in April 2012 Journal.  

I have bad knees.  They ache.  They predictably ache worse when I squat.  When my knees are bad, If I am sitting in a chair, with my knees bent in a parallel squat angle, getting out of the chair, with no weight, is very painful.  It got to the point that my squat poundages were dropping rapidly because of the pain.  I had Platelet Rich Plasma injections in the knee and a 4 week layoff with bi-weekly physio to let the knees recover but it didn't help much.  MRI then showed the pain was caused by inflamed cartilage behind the patella at the top of the knee joint.  Based on the MRI, and when I experienced the pain worst, the Orthopedic surgeon stated the angle of attack on the knee at parallel was causing massive pressure to the cartilage which was causing the problem.  So, based on his advice I changed from parallel squats to deep knee squats.  That worked.  The Deep Squat took the pressure off the knee at the point when i was changing direction from down to up.  Doing this, my knees have recovered a lot, the're not perfect, but i recently did a PB on back squat of 160Kg so I am not complaining.  It worked for me, so in this particular case, Deep Knee squats were actually a useful knee rehab exercise.  Now I do no other type (Both for front and back squat).  

The article talks about my specific problem, and rather than the compressive force discussed at a deep bend causing me a problem, the Orthopdeic surgeon was concerned about the change in direction as the process of halting and reversing causes significantly increased momentary pressure in the knee.  What I find in practice is a Deep knee squat actually feels more restful on my knee than a parallel squat.

I also found rotating my squat exercise regularly helped (front, back, good morning on six week cycles) as that changes the pressures placed on the knee and allows for better recovery.  I also found TK knee bands helped as well, due not so much to the support they provide, but rather I think to the localized increased heat which they trap at the joint.  But if I do parallel squat even doing these other things does not help enough to make the pain livable or squating viable.  

I would therefore argue that even if the knee is not "Healthy", in certain circumstances Deep Knee squats can be beneficial and that conversely Parallel squats can be harmful to a non "Helathy" knee.  It would need to be assessed on a case by case basis and deep knee squats should not be automatically ruled out just because someone has bad knees.

Sports Medicine/Rehabilitation SIG Meeting  

Friday July 13, 2012                                                                  

8:30-10:00 a.m. 

Meeting Room 555A 

We will also be holding elections for the following Executive Council Positons.

Chair 

Don Reagan, PT, DPT, CSCS

Vice Chair 

Daniel Preusser, MSEd, ATC, CES 

Secretary/Treasurer 

Scot Morrison, CSCS, TPI-CGFI 

At-Large (2) 

Jeff Fields, MS, ATC, CSCS 

Robert J. Butler, PT, PhD 

I am interested in learning more how to identify muscle imbalances, specifically as related to the concept of relatively inactive muscles or "turned off' muscles and exercise regimens to address such problems. Can anyone direct me to articles or books on the subject? I am particularly interested in how to identify muscles that are abnormally lengthened or shortened due to over or under use and any research on how these imbalanced states impact athletic performance.

Hi James,

You might want to check out the work of Shirley Sahrmann on Amazon.com, or check Vladimir Janda's works at OPTP

http://www.optp.com/Vladimir-Janda/Manual-Therapy.aspx

Both authors delve into the intricate relationships between muscle imbalance and motor control processes.

I would consider researching and reading up on the Functional Movement Screening and Movement book by Gray Cook. They've created a standardized movement screening process and patterning procedures that highlight muscle imbalances and asymmetries. They go into great detail on programming progressions that engage the inner-core muscles to safely progress movement patterns to eliminate asymmetries, therefore preventing injury. 

www.functionalmovement.com

http://www.amazon.com/Movement-Functional-Assessment-Corrective-Strategies/dp/1905367333/ref=sr_1_2?ie=UTF8&qid=1351808146&sr=8-2&keywords=movement