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Your Gymnast’s Knees

Your Gymnast’s Knees

By Karen Goeller, CSCS

painful-knee-illustration-14526284I’ve spent many years coaching gymnastics and as a CSCS. The CSCS is responsible for effectively training the athlete for sports performance. The CSCS also helps bring the injured athlete back to competition fitness once cleared from their physical therapist or doctor.  That step in-between physical therapy and all-out competitive workouts is often missing. It is the job of the CSCS to fill that void.

Sometimes after a gymnast is “medically cleared”  they continue to have knee pain. It is not that the doctor or physical therapist was not effective. Once cleared, the gymnast often is not aware on how the body should function; it is a lack of awareness.

I was asked by a gymnastics club owner to “go over some knee exercises” with some of her gymnasts who had a previous knee injury and some who were recently cleared by their doctors. I would be willing to bet the owner and coaches had no idea I would be teaching their gymnasts how to properly stand, bend, and straighten their knee, but that is what these gymnasts needed. AWARENESS. Below is a summary of what we did so that you can help your gymnast.

As many of you have seen, a high percentage of gymnasts have over-pronation. That is a rolling inward of the feet. Many have one that is more severe than the other. That causes poor alignment of the ankle, knee, and hip. You see the knees fall in laterally towards one another. With that poor alignment, the gymnast often performs skills adding stress to the joint because of the force involved with skills. The poor alignment is often seen in the take-off for the cartwheel, round-off, side aerial, and front handspring. This poor knee alignment is also seen in the landings of dismounts and jumps. Over the course of time, performing skills and landing can cause severe damage to the body if the gymnast is using incorrect technique and/or has poor alignment.

So here is the report from the quick clinic I gave to this group. Throughout each exercise I reminded these gymnasts how each drill related to the sport, landing mechanics and skill take-offs. When an athlete knows the purpose of a drill they get more benefit.

Out-In-Neutral-Foot
I asked the gymnasts to stand straight with their feet together, simple. (Well, sort of.) Many in this group could not do that without over-pronating. It is very common for gymnasts to have over-pronation. They train barefoot with no arch or heel support several hours each week. (That’s why they need high-quality shoes when not in the gym.)

I asked these gymnasts to gently roll their feet out towards their little toe, then back in towards the arch in their foot, and finally back to straight/neutral so they could feel the difference between the three positions. (It is very important to be sure they do not roll too far in any position. You do not want them causing damage to the ankle or foot.) As they did this slow-motion movement, Out-In-Neutral Drill, I instructed them to look and their knees to see the difference in alignment. Some seemed surprised at the difference foot placement made in the knee.

After that and asked these gymnasts to bring their feet hip-width apart and again to slowly roll their feet out, in, then back to neutral. At this point, they all were able to clearly see the difference in ankle and knee alignment with foot position. I asked the gymnasts to perform this simple Out-In-Neutral Drill several times in order to see and feel their neutral foot position and proper leg alignment.

After the gymnasts performed the Out-In-Neutral Drill on two feet, I asked them to lift one foot off the floor and perform the Out-In-Neutral Drill on one foot.  Again, some seemed surprised at the difference the slight movement of the foot had on the knee alignment. I reminded them that the single leg alignment is important on the one-foot take-off and leap landings.

Once the gymnasts did a few repetitions they seemed to understand the relation between foot alignment and knee alignment really well. Before that moment, these gymnasts never realized that the alignment of the foot had so much effect on the rest of the body.

Side-Side-Neutral

After the Out-In-Neutral Foot Drill we did a simple weight shift drill. I call it the Side-Side-Neutral Drill. Believe it or not, when many gymnasts squat they tend to lean on one side more than the other. This is not something many people notice during the landing of the dismount because it happens so fast and the focus is on sticking the landing. The technique of the landing is imperative to maintain low body health.

I asked the gymnasts to stand hip-width apart and keep their feet in the neutral position. I then asked them to perform a ½ squat position as if they were landing a dismount. As I suspected, many were leaning on one side/leg. Others were bending at the knees with hardly any hip bend.  We made adjustments to proper landing mechanics at that point. (Landing a jump on beam is different than landing from a double back on floor or a dismount from equipment. Since the force is so much greater, it is imperative to teach proper weight distribution when landing.)

Once all were in the correct position, I asked them to perform the Side-Side-Neutral Drill, shift their weight to one leg, neutral/center, and to the other leg.  This was to remind the gymnasts that they must land with their weight centered, evenly distributed between both sides.

Remember, the force on the body when landing from a double-back can be 10-13 times the gymnast’s body weight. With some gymnast’s, one side could be taking more force than the other and in other cases the front of the legs could be taking on more force than the back.  With gymnasts who are primarily bending at the knees, the front of the legs-knees and quads take a much higher percentage of force than the back of the body-glutes and hamstrings. The front-load landing can put enormous force on the knees and over time may cause damage.

Since gymnasts dismount daily, it is imperative they line up their knees with their ankles and hips, but they must also evenly distribute their weight from side to side and from front to back.  Sometimes it is just as important to teach awareness as it is to physically strengthen the body.

SONY DSCWe took this a few steps further and added a medicine ball with more complex movements.  We carefully performed the chop exercise in order to simulate a landing but to also involve the core and upper body. We did this with both legs and then single leg. Adding the medicine ball made the movements challenging, but they were able to safely perform. This exercise is a great value because it forces the gymnast to focus on landing mechanics while building a little added upper body strength for bars.

Finally, during this session, we did include some traditional knee rehab exercises. Many gymnasts with knee pain have weak gluteal muscles.

I assigned the physical therapy bridge.  I call it a hip lift. The gymnasts lied on their backs, bent their knees and lifted their buttocks off the floor a number of times. In the hip lift position we also did the marching exercise, but I only allowed the gymnasts to lift one foot 2 inches off the floor in order to keep their hips up.

Next, I assigned the clamshell exercise. I instructed the gymnasts to lie on their side and bend their knees, keeping their heels in line with their spine. Once in position, I instructed them to keep their heels together, but lift the top knee towards the ceiling, opening their legs.  We did both sides.

Another exercise we did that day was the side plank. Added to the side plank hold we did plank hip dips. In the side plank position, I instructed the gymnasts to lower their hip to the floor and lift it back up. We did a number of receptions on each side.

And we did plank leg extensions and small kicks. In the plank leg-extension, I asked the gymnasts to lower their knees to the floor then bring them back up to a straight position.  We did single leg plank leg extension too. With that one the gymnast kept one foot 2 inches off the floor as they worked on the supporting leg, lowering and lifting the knee.  That leg extension is simple, but a great quad strengthener and form drill. And for the small plank low back kicks I asked the gymnasts to lift one foot 2 inches off the floor. I instructed them to keep their foot pointed and lower their toes to the floor and lift the foot 2 inches. I had them alternate these slow, low kicks.

There are so many things you can do to maintain or improve your gymnast’s health. Keep doing much of the conditioning that is well known, but also consult with physical therapists, chiropractors, and CSCS’s for ideas.

Karen Goeller, CSCS

www.BestSportsConditioning.com

www.KarenGoeller.com

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Exercise List to go with Video and Article

  • Out-In-Neutral Foot Drill
  • Side-Neutral-Side Drill
  • Physical Therapy Bridge (Hip Lift)
  • Clamshell
  • Chops
  • Single Leg Chops
  • Plank-Leg Extensions (Bothe legs and single leg)
  • Plank-Low Back Kicks
  • Side Plank with Hip Dips

 

You can’t cram last-minute for gymnastics competition!

web-trainingad-beam-2011Competition season is around the corner. Strength, speed, power, flexibility can’t be developed overnight. And learning new gymnastics skills takes time.

It’s not like school where you can cram for a test last minute. With sports there is a SAFETY factor. It takes time to become prepared for gymnastics competition each  season.

There is a learning and training process that must be completed for safe and enjoyable competition. Many drills, conditioning exercises, and skill repetitions must be performed long before the new gymnastics skill is used in a routine. And once in the gymnastics routine, the new skill or combination will still need to be refined. It will take time for the gymnast to comfortably perform the new gymnastics skill within the routine.

Do not wait until the last minute to call for help! Your gymnast’s safety will be at risk if you expect them to skip steps in the training process. If a gymnast is uncomfortable with a new skill they may lack focus. That lack of focus can easily lead to injuries, small and catastrophic.

Going from a new gymnastics skill to a competition-ready routine should be an enjoyable journey, not a season filled with fear, stress, and risk of injury.

Let me know how I can help your gymnast.

www.bestgymnasticstraining.com

www.bestsportsconditioning.com

#gymnastics #sports #training #gymnast #strength #usag #usaigc #ncaa #joga #highschool #newjersey

Stress Fractures in Gymnasts

Another gymnast with stress fractures… So sad!

This is the third gymnast that I have seen with stress fractures within the past few months. And I am sure there are many more out there.

I wish these coaches would learn when to push and when to slow things down. Some only know how to push their athletes hard, but do not know when to slow it down. Many are great coaches, but many really do not know how to communicate with gymnasts regarding injuries. As a result, the pain and injuries become worse and healing time becomes longer. No one is happy by that point.

And unfortunately, some coaches see gymnasts as a commodity, NOT as children! They see them as something that will bring in more business when they win at competitions or go off to a great college on scholarship. The competitive gymnasts often make the reputation for the program.

I owned a gymnastics club for ten years, have been coaching since 1978, and have NEVER had a gymnast with a stress fracture. (I’ve been hired in the past to help gyms REDUCE injuries.) My level 6-10 gymnasts trained 24 hours a week and it was nonstop movement in the gym with the exception of water breaks. They progressed rapidly and remained healthy. If I was capable of producing healthy gymnasts so is EVERY other coach out there.

The rule that can be followed is if 3 out of 10 gymnasts, 30%, have pain the the same general area of the body (ankles/feet, wrists/hands, back) the program must be changed. It may be something simple such as a few less push ups or adding a sting mat. Or something drastic may need to be done such as buying new spring beams or more resilient mats. Coaches MUST be more aware and conscientious when training gymnasts. Again, there are so many amazing coaches out there, but there are still too many that are not in tune with what is happening to their gymnasts.

Coaches, please… listen to your gymnasts when they mention pain and discuss it with their parents. It’s better to deal with an injury BEFORE it becomes serious. And it’s better to deal with it completely than to force the gymnast to return to full training too soon.

I am a CSCS AND a gymnastics coach. Parents call me to help their children (gymnasts) regain strength and return to competition after the injures. If you are a parent or coach and need help please reach out to me, 908-278-3756. We all want what is best for the gymnast!

Some reading on stress fractures…

Bony stress reactions and stress fractures are very common in Sports Medicine.  They are considered overuse injuries and usually occur when the amount or intensity of an activity is increased too rapidly.  Initially the involved muscles become fatigued and lose the ability to absorb shock.  This subsequently transfers the load of stress onto the bones, causing injury within their internal structure.https://www.rothmaninstitute.com/specialties/conditions/stress-fractures7

Stress fractures often result from increasing the amount or intensity of an activity too quickly.” http://www.mayoclinic.org/diseases-conditions/stress-fractures/symptoms-causes/dxc-20232156

A stress fracture is an overuse injury. It occurs when muscles become fatigued and are unable to absorb added shock. Eventually, the fatigued muscle transfers the overload of stress to the bone causing a tiny crack called a stress fracture.” http://orthoinfo.aaos.org/topic.cfm?topic=a00112

They also affect people with weak bones or nutritional deficiencies, and can happen in the foot, leg, spine, arm, ribs, and other bony locations.” http://kidshealth.org/en/teens/stress-fractures.html

http://www.webmd.com/fitness-exercise/stress-fractures-the-basics

 

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