Pylon Pain - The Health Evolution
Knees are the pylons of a bridge. There’s no point in building up the muscle of a bridge without putting time and effort into the correct positioning and function of a bridges pylon. Crossfitting is no different. Start with learning the functional basics. Dodge, duck, dip, dive, and dodge, then air squat, back squat and front squat, until you’ve got diddly-squat strength left in your legs to get off the couch.
Focus on the coaching elements of an optimal lower back position, with the pelvis in neutral and the lumbar back as straight as a chin up bar with no lumbar lordosis or kyphosis. Not just because we want you to continue training or stop you from whinging about your pain to work colleagues but because an optimal lower back and pelvic position, activates your core abdominal muscles. Transverse abdomonis and the pelvic floor make up the majority of the core abdominal muscles and are in charge of looking after our back and pelvis. Rectus abdomonis our ‘six pack muscle’ and our obliques are a bit like the packaging of your coconut water, they only keep the contents of your stomach from spilling all over the gym floor.
Were we talking about knees or backs? Well... if you remember back to our childhood, your back bone is connected to your pelvic bone, is connected to your hip bone, which is connected to your knee bone. Poor back and pelvic position will cause a below average knee position during a squat. Knees need to stay exactly where they begin during a squat, moving slightly to the outside to formulate strength and activate our hip stabilising muscles. If the knees travel forward over our toes, sharks with laser beams attached to their heads will be let loose in the box.
The chest is up and the head relaxed and facing forward. The combination of the above three main points will result in a good squat position and activate the appropriate muscles of the knee. Avoid these pointers and wither in self pity at your dysfunctioning quadriceps muscles.
When we as health professionals assess a dysfunctional knee, in reality they are a simple as a bridge pylon. They can break down if one side of the pylon has concrete that was mixed properly together and the other was put together by several apprentices on an early Monday morning.
Knee pain that has progressed over time is usually one of two issues. Firstly and less common, is patella tendinopathy pain, essentially aggravation of the patella tendon as it attaches to the tibia. Constant box jumps for example on a knee not conditioned to these exercises, can irritate the tendon and develop inflammation at the front of the knee inferior to the patella.
Secondly and most common of all is knee patellofemoral pain. We believe that a huge majority of the population will suffer from this knee dysfunction at some stage in their life. Those individuals that pick it up earlier and look after it, preventing the kneecap from sitting and rubbing over their knee fat pad will be laughing all the way to the gymnastic rings.
The kneecap needs to sit smoothly over the fat pad, and move medially or towards the inside of your knee before it even thinks about moving laterally. Improved speed of activation and strength of vastus medialis compared to vastus lateralis is a huge component of preventing this type of knee pain, along with preventing the lateral structures of your knee and thigh from tightening up like your stomach before a hero workout.
After all, if the pylons of a bridge start to break down, we have to rebuild the bridge