Category Archives: Relieve Joint Pain

Step Down for Stronger, Healthier Knees

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Knee pain is something virtually all of us hard-training folks encounter at some point in our life. The cause of the pain can be attributed to many possible problems such as a fallen arch or weak outer hip muscles. However, your vastus medialis muscle is often a major factor because when it’s weak it can’t hold the patella (knee cap) in its proper alignment. Faulty alignment of the patella can irritate the patellar tendon and cause pain below the knee cap.

I prescribe strength exercises for the vastus medialis whenever a client comes to me with knee pain and it always helps. It might not completely rid the person of knee pain because, as mentioned, there can be other factors at work. But sometimes it’s all that’s needed.

Whenever you have joint pain, start with the simplest solution first. Strengthening the vastus medialis muscle should be your first line of attack.

The lowest portion of the vastus medialis, closest to the inside of the patella, is thought to contain fibers that run in a more oblique direction than other parts of the muscle. These vastus medialis obliquus (VMO) fibers are often mentioned in clinical settings as being the ones that are typically weakest and most difficult to recruit. The jury’s still out with regard to the possibility that those VMO fibers even exist because anatomists have had a tough time finding them on cadavers.

In the past, trainers and physical therapists often used the leg extension exercise to strengthen the vastus medialis. On paper, this approach seemed valid. However, in practice it rarely helps and sometimes exacerbates the problem due to the large shear forces that accompany the leg extension movement.

The best exercise I’ve found to increase the strength of the vastus medialis, and maybe the VMO (if those fibers exist), is the step-down. It effectively strengthens the vastus medialis without putting excessive strain forces on the patellar tendon. When you perform the step-down correctly, you’ll feel tension directly on the inside of the knee, in the vastus medialis.

The video below shows the proper technique for the step-down. But before you watch it keep these three points in mind.

1. Perform the exercise slowly: it’s not easy to target the vastus medialis so you must move slowly to develop the mind-muscle link you need to activate the correct fibers. Push through the ball of the foot on your working (elevated) leg throughout the contraction.

2. Hold weights if necessary: if you can easily perform 15 reps without feeling much tension in your vastus medialis, you’ll need some external load. Start light, maybe a pair of 20-pound dumbbells if you’re a strong guy, and work up from there.

3. Stop if the exercise causes more pain: prescribing rehab exercises is rarely simple since your problem might be more complex than one exercise can fix. With the step-down, or any other rehab exercise, if you experience more knee pain after the exercise you should not continue. You should feel less pain and more strength around your knee after each set is finished.

Step-Down: perform 3 sets of 15 reps with each leg, every other day, until the knee pain goes away.

Finally, I’ll be covering all of my best joint rehab exercises in my seminar in Phoenix, AZ on February 2-4. To find out more seminar details, click this link.

Stay Focused,
CW

How to Lift and Live with a Herniated Disc

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Question: Hi Chad, I recently purchased Huge in a Hurry from Amazon, and think its a very well written book. I love the plans and how they’re laid out in the book. I’ve been strength training for a few years, and have had decent trainers along the way, so I honestly feel like I have form pretty locked down.

With that said, I was experimenting with my back arch while doing back squats in June this year, and ended up herniating my L5/S1 disc in my lumbar spine – so completely stupid and a mistake I’ll never make again. I was out for a few months, and did physical therapy for over 2 months. I’m now back in action, and have been cleared to do split squats, single leg squats..basically any squat that is not with both legs. I’m leaning on the cautious side!

My question for you, is how can I do the program and work around the 2 legged squat / deadlift exercises? I suppose I could wait a few more months to get started, but your book got me excited to focus again.

Thanks,
Andrew

CW Answer: Thanks for your support Andrew and I’m stoked that you like Huge in a Hurry.

First off, most avid lifters have some level of disc herniation (bulge). My friend and colleague, Dr. Stuart McGill, works with many NFL players and he constantly sees disc problems. Or put another way, he constantly sees NFL players who play with herniated discs. I don’t have the hard numbers, but I’d guess that the majority of all NFL players probably have some type of disc herniation, even if they’re not symptomatic. You can include me in that category.

In other words, you can have a herniated disc and not even know it. The good news for the small fraction of you who don’t have a disc problem is that this information will still apply to you. I follow the same technique and core activation protocols whether or not a client comes to me with back pain. Prevention is key for those who aren’t injured because it’s very likely that you will herniate a disc unless you get your training parameters right.

There are three important steps to follow when performing any leg exercises, or any strength exercise in general, when you’re experiencing back pain.

Step #1: Improve tissue health and mobility
When your back is aching you can be sure there’s compensation going on in multiple muscles throughout your body. If you have pain in your left low back I’ll bet your left hamstrings and calves are tight as guitar strings. You must loosen the fascia covering those muscles so they can move freely.

That’s why you should start each workout with the golf ball foot roll as popularized by Anatomy Trains author, Thomas Myers. Stand barefoot and roll the bottom of your right foot over a golf ball with as much pressure as you can withstand for 30-60s with each foot. This relaxes the fascia from your calves all the way up to the back of your neck. Focus on the sorest spots since they need it most. Then, foam roll your spinal erectors, quadriceps, IT band, glutes and calves.

Step #2: Activate your core and lats
Before each set of a leg exercise perform the side plank with rotation. This is one of the most beneficial activation exercises you can do to protect your back and remove stress from your aggravated disc. The benefit of this exercise is that it activates the muscles in your quadratus lumborum (QL) and lats, two muscle groups that are essential for spinal stability.

I recommend you perform 3-5 slow, intense reps of the side plank with rotation on each side before every set of leg exercises (squat, deadlift, lunge, etc).

Step #3: Focus on single leg exercises that don’t cause pain
When you’re experiencing radiating pain from a disc herniation, most physical therapists will recommend that you stay away from two-legged exercises such as squats and deadlifts. I agree with that cautious approach.

So, if you’re following the workouts in Huge in a Hurry and have an injured disc, replace all traditional squats and deadlifts with single leg versions of each. A back squat can be replaced with a single leg squat or lunge; a deadlift is replaced by a single leg deadlift. Do your best to stick to the same other parameters for that workout.

For example, if a workout calls for 40 total reps for the back squat with a load you can lift 10-12 times for the first set, simply replace the back squat with a single leg squat or lunge and follow the same protocol.

However, there are two important points to keep in mind. First, just because it’s a single leg exercise doesn’t mean your nagging disc will approve of your choice. Any exercise that causes immediate pain should be avoided or you should reduce the load. Second, I talk a lot about lifting fast in Huge in a Hurry but that advice goes out the window when you’re dealing with an injury. Perform each rep slow and controlled and focus on keeping your core and glutes tight.

Now, what you do outside of the weight room is just as important. In fact, it’s probably more important. There are 168 hours in a week. So if you lift for four hours each week that leaves you 164 hours where you can really aggravate your discs.

That brings me to step 4…

Step #4: Maintain lordosis throughout the week while sitting
I herniated a disc at L5 back in 2001 when I was doing heavy back squats. Since that time I’ve managed to keep it under control, even in the face of nonstop strength training. However, it wasn’t until this last year when I finally fixed the problem.

How did I do it?

I made a point to maintain the inward curvature of my low back (ie, lordosis) whenever I was sitting. I realized the time I sat at my desk or on an airplane or driving to clients was constantly aggravating my decade-old disc injury. The solution is as simple as rolling up a large towel and placing it between your low back and whatever chair you’re sitting in.

Follow these four steps and you’ll allow the disc to heal without losing any significant strength or muscle.

Stay Focused,
CW

An Interview with Eric Cressey Part II

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Eric Cressey is one of the few people I keep in my circle of advisors. He’s been training, studying, lifting and writing with passion and enthusiasm that’s rare in this field. Cressey Performance is definitely a place to check out if you’re in the Massachusetts area. So if you missed part I of my interview with him, be sure to check it out here.

Now we’ll pick up the rest of his interview where Eric discusses his awesome new training manual, Show and Go, for a bigger, stronger, healthier body.

CW: I got a good laugh reading your statement in the introduction of Show and Go. You said, “This book is for people who give a sh*t.” Care to elaborate?

EC: I was actually pretty excited to be able to swear whenever I wanted; I guess that’s the beauty of self-publishing!  Rather than reinvent the wheel, I’ll share a little excerpt from the text that I think will answer the question:

““…you’ll find that the tone of this manual is much less conversational and entertaining, and much more “troubleshooting” and “do this and get diesel.” Fortunately, just as you’re more tolerant to cursing, you’re also more tolerant to training programs that will challenge, educate, and motivate you to all news levels of strength, performance, and health. My feeling is that you didn’t purchase this e-book to be entertained; you purchased it to get direction and results. Continue reading →

Adventures in Juicing Part II

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This summer I decided to go on a vegetable juice fast. I’ve never done any type of fasting (unless you count the hours I’m sleeping) so I didn’t know what to expect. I always thought fasting was for emaciated hippies who weren’t tough enough to eat meat three times per day. But since my vegetable intake could use a healthy boost I gave it a trial run. You can read about my first 36 hours in part I here.

So now I’ll pick up on the night of day 2 of my vegetable juice fast. (I didn’t give you all the details of day 2 in part I.)

The first day, as mentioned, was a little rough. I was as hungry as an angry boar by mid afternoon but I stayed busy enough to fight off the hunger pangs. On day 2, my hungry was more manageable. By evening I decided it was time to replenish my muscles. I was leaner by day 2, for sure, but I felt pretty weak. So at 7pm on day 2 I did a circuit of 10 kettlebell swings, 10 clap push-ups, and 5 pull-ups for 10 rounds. I was weaker than normal but my endurance was up to par, maybe even a little higher. This was a pleasant surprise. Continue reading →

Adventures in Juicing Part I

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Vegetables are the best food on earth. A magical food group, if there ever was one. It doesn’t matter if you want to burn more fat, build muscle, or improve your overall health, consuming more vegetables on a daily basis will make a dramatic difference. How many foods can you say that about?

To stay lean and healthy, I can sum up a lifelong nutritional strategy in one sentence: consume vegetables all day long with some lean protein. Veggies reduce inflammation, fight cancer and every disease, and they’re loaded with nutrients your body needs to keep your good hormones up and bad hormones down.

But there’s a problem: I despise eating vegetables. Sure, I wave a big ol’ veggie flag because my clients’ results depend on eating plenty of them, but in my own life I’ll freely admit that my intake is woefully inadequate. So I recently took it upon myself to change my ways. Continue reading →

Relieve Joint Pain and Prevent Muscle Strain

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Here’s a situation I’ll bet you’ve experienced many times.

You run into an old friend. That friend recently started working out again and he or she is looking more fit. So you ask your friend how things are going with the exercise program and he or she replies, “It was going great. But now I have this shoulder pain that I can’t get rid of.”

Or maybe it’s a neck, knee, or low back problem?

More importantly, maybe that “friend” is you?

The truth is, virtually everyone will eventually suffer with some type of joint pain or physical limitation. And I really mean everyone.

In the spring of 2007, Debbie Siebers, a worldwide fitness expert who’s been featured on The Swan and the creator of the immensely successful Slim in 6, hired me to help her correct some nagging injuries. Her right shoulder and upper back were bugging her, and she suffered with occasional back twinges and zingers that just wouldn’t go away. (Yep, even fitness experts can throw things out of whack.) She tried everything: chiropractic adjustments, physical therapy, massage, and acupuncture, just to name a few. She got some temporary relief, but only for a few hours, or if she was lucky, a day. In the end, nothing ultimately worked.

Debbie heard about the success I’ve had working in Los Angeles with everyone from elite athletes to the average Joe and Jane. Even though I’m known in many circles for helping people build size and strength, joint rehabilitation takes up most of my time these days. Yes, joint problems are more prevalent than ever.

So I put Debbie on a program comprised of movement drills that she could do at home. Within 30 days, she restored mobility, gained strength, and was pain-free. She was so pleased with her results that she asked me to help her bring a training-based joint therapy program to the masses. I, of course, agreed that such a product is long overdue.

Before I go any further, let me explain why the other types of therapy she tried didn’t work.

Most joint pain is due to a lack of mobility, a lack of endurance strength, or both. Mobility is the ability to move freely. So if you’ve ever felt restricted while picking up a bag of groceries or chasing your kids around the park, it’s probably because you lost mobility. Endurance strength is simply defined as your ability to maintain muscle contractions for an extended period of time. I’m sure you’ve felt strain and pain in your low back while hunched over at your computer, or working in your garden, or just standing in line at the movies.

Stretching isn’t enough because it doesn’t restore movement, it just restores passive range of motion. Lifting heavy weights won’t help either. Research has demonstrated that people who lack endurance strength are more likely to experience low back pain. Even if you’re strong enough to lift the back-end of a minivan, you could still suffer from back pain. Why? Because heavy weight training doesn’t build endurance strength. Plus, you need a balance of strength around your joints, not just on one side.

Getting cracked by a chiropractor, poked by an acupuncturist, or rubbed by a masseuse is akin to putting a band-aid on the problem. You must restore mobility and enhance endurance strength to solve the problem. Up to this point, no one has effectively tackled both of those limitations with one, simple, do-it-yourself system.

To take control of your life and restore knee, low back, shoulder, or neck health without training gadgets just click HERE

Stay focused,
CW