T Nation

Cressey Prime Time: 8/29 and 9/1


#1

I'll be on tonight and Thursday. What's on your mind?


#2

coach if you notice a sharp pain in your hip after dl session that goes away but reappears when you do sudden moves should you back off deadlifts? BTW that's all I do DL's and bunch of overhead presses. Thanks!


#3

are there any "limb ratios" you can offer to determine body type? I am rather short and stumpy all over and thought I have never trained exclusively for powerlifting, I feel like my low back is my weakest link while squating and perhaps it is a leverage issue.


#4

I was curious about this myself. It may seem obvious but some numbers would be nice.


#5

I hurt my knee in December of 2003 while doing leg press. I went to several doctors and some said they werent sure or it was chondromalachia. One said it was plica syndrom and that I needed surgery. I opted for surgery last October 2004. He told me to do lots of leg extensions to work my VMO, i noticed that this made my knee hurt pretty bad for 2-3 days following, and I wasnt getting any stronger. I started learning about muscle balance and began with trying to balance out my adductors and abductors. Then I did hamstring work to balance that out. Most recently in May I emailed you and as per your suggestion did some glute work, and more hamstring work. I've come a long way from hurting all the time to hurting almost never. I thank you for that.

I still have the thing that started from the beginning though, when I squat down my right knee clicks on the medial side. It isn't a meniscal tear, although I have not had an MRI scan, Ive done all the tests numerous times and nothing seems to show up.

If i put my weight on my heels and keep my toes pointing straight forward, not outward at all and sit back to squat, I rarely if ever have any clicking, but If i put the weight on the balls of my feet the chance increases and if i let my feet point out to the side at all my knee clicks every time. If I let my knee click it will hurt for a while after, and if it happens several times it will hurt bad for a longer time.

I still haven't been able to resume my training (running) since the injury, my knee will ache for a while after I run, although that seems to be getting better over time.. although its been a damn long time.

Anyway i was hoping you could point me in the direction of something new to do, or if the problem is possibly something besides Plica Syndrom or a meniscal tear, and how I would get that checked. I haven't tried ART, but the nearest provider is a 2.5 hour drive each way.

One thing that has been suggested is that it is a medial retinaculum, although I have almost no understanding of what that is. Anyway, thanks in advance Eric - you are, in terms of knowledge, what I want to be very soon (1st year Exersize Science student).

God Bless

Edit:

I was also wondering if there could be a possible link between this and achillies tendionitis. I had that about 4 months before I was hurt, and I know another person who had plica syndrom - he also had achillies tendonitis before getting plica syndrom - could just be coincidence.

Also the other night while lifting I decided to do some bent knee calf raises. My knee hurt more than normal after doing only a couple sets. I stopped rigtht away and realized that I had been doing those around the time I was hurt also, but the actual symptoms and problems came when I was doing the leg press. Maybe this has somethign to do with it?


#6

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#7

Hey Eric,

I have lateral knee pain and very tight ITB's and VL's as well as lateral lower leg tightness. The result is osteoarthritis(diagnosed by a doc who said to just take lots of advil even after I asked him if it was tracking properly) and fluid gathering in my knee.

It looks like my knee cap has been pulled up and left and feels that way too. The past few months I did glute and VMO specific exercises with stretching to some slight avail(step ups, bulgarian split squats, lunges off a box, and top 1/3 leg extensions).

What else can I do to pull the knee cap medially and downwards?

I'm thinking of band pulls accross my body or weighted leg raises with me lying on my back and the toe pointed to my lateral sides. I'm also thinking of some foam roller massage. Could my adductors possibly be weak and it's a case of external as opposed to interal rotation?

My horribly atrophied legs thank you in advance.


#8

Simple rule: if it hurts in a bad way, don't do it!


#9

Check out my response on the article thread; it should answer your question.


#10

I have a question about bench pressing. I have excellent control when I bench if I only retract my shoulders, but if I retract and depress my scapula it feels like my upper arm rotates internally.

This causes the bar to drift towards my feet, then I must abduct my shoulders to pull the bar back in the proper position. This forces my forearms to twist toward my head. None of this is conscious effort, it just happens. Basically my form just goes down the crapper. Only if I retract my scapula.

Am I mistaken in my form? Should I just retract without depressing? I previously "shoulder benched" flat back with flared elbows (stupid), maybe my body is just used to that groove?

I do external rotations movements 2-3x a week, usually 2-4 sets of 8-12 reps.

I am curious if you think this is more of a technical issue, or is it more a muscular imbalance problem. I understand that diagnosing the exact cause is nearly impossible online, but everything in your deadlift article is spot on for me, so that should give you some idea of my build.

Thank you in advance (I won't be at my computer much longer).

Later.


#11

Good Lord, many surgeons don't know much about rehab.

Nice! My pleasure. :slightly_smiling:

Have any of the doctors ever mentioned a condylar lesion? It's a differential diagnosis for a medial meniscal tear. I've had a CL myself for about three years; I'm always a positive McMurray's test, but there's no meniscus tear-like symptoms (clicking, locking).

If there is a lateral patellar tilt, it can lead to traction on the medial retinaculum. A good ortho should have seen that, though.


#12

It very well could be part of the problem.

Increased pronation leads to increased internal tibial rotation, which increases knee valgus. Increased pronation is largely related to calf tightness and decreased dorsiflexion range of motion. Get too much valgus and medial knee pain can kick in pretty quickly (we actually covered a lot of the potential fallout of over-pronation in the NNM series). You might even be dealing with an MCL issue.

Try adding in DB dorsiflexion work (3x20) three times per week and stretch those calves and peroneals out (foam roll them, too, if you can). If you're wearing Nike Shox, take them off and beat yourself with them; shoes with that much heel lift are the worst thing anyone (especially you right now) can have on their feet.

Stay the course on the rest of the stuff; it's working because you're treating what are likely the compensations for the probable cause (the overpronation).

Get in touch with me on Prime Time in a few weeks and we'll see where you stand.


#13

It's important that you do some glute activation work prior to all those other exercises. Otherwise, you'll just want to use your quads to do all the work. I would add in the foam rolling stuff, continue to stretch like crazy, and implement some of the exercises in Mike and my "Get Your Butt in Gear" series. They're really just the tip of the iceberg in terms of what we do with dynamic flexibility and glute activation work, but they'll get you on the right path. Mini-band sidesteps are a definite must.

Also, if you can find a qualified therapist to do some patellar mobilization work, that'll work great, too. They ought to be able to teach you to do it yourself, too.


#14

It's definitely a technique issue. I'm not sure what you mean by "retract the shoulders."

Where is the bar touching? Neck? Nipple line? Slightly below? Belly? My guess is that you aren't tucking your elbows enough.

It could just be that you're so accustomed to benching bodybuilder style that you want to flare the elbows too early and get back to your comfort zone. That would make a lot of sense. If it's the case, I'd drop the weight down, do a ton of technique practice, and try to get around some experienced lifters to set you straight. Where are you located? I'll see if I can hook you up with some good powerlifters.

Another option would be to get a video and post it here; your call.


#15

Eric,

Do you write individualized strength routines?

How would one go about training the deadlift using conjugate periodization without using squats? I know this is not optimal, but the question is for someone with only minimal equipment that wants to train conjugate style.

I am guessing that one day would be ME deadlift day and another day would be DE deadlift day and involve speed deadlifts.


#16

Yes. You can email me at ericcressey@hotmail.com if you're interested. I work with a wide variety of individuals.

That would be my first reaction to the question, although it would be dependent on where one was missing a lift. Many times, one can improve the deadlift more quickly by addressing other needs rather than just by pulling.


#17

What movements, in your opinion, are best for big shoulders?

Thanks.


#18

All other factors aside, it would just be overhead pressing.

If you're talking shoulder health and incorporating overhead pressing into the context of an overall program, though, my answer would be completely different.


#19

I'm talking shoulder health and in the context of a whole program, because I have hurt both shoulders now. And in an earlier article (or post) you mentioned something about direct shoulder work not being necessary, but I can't remember the article.

Again, thanks.


#20

"Debunking Exercise Myths" was the series.

Give me an idea of what's going on with your shoulders and we'll get you fixed up.