Once you have mastered these exercises, keep them in your routine, but add some more challenging work. Activation comes first, we need to isolate the muscle in order for it to get going, but you pretty soon need to move into some more functional movement for the bum. Check out these bum exercises, a post a wrote a while ago that explains and shows you some of the best exercises to get strong glutes. Glute activation is very important for getting stable and strong hips…but we must always remember to progress.

Here is a picture of the lat dorsi.

As you can see it is huge, attaches on various places… Vertebre, pelvis, ribs, scapula and humerus to be exact, which means that it can cause a whole lot more problems than just in the shoulder, but I digress. The movements it performs are extension of the humerus, adduction of the humerus in two planes, and perhaps most importantly internal rotation of the humerus.

Lat dorsi too tight or malfunctioning…means too much internal rotation, which means imbalances, which means many possible shoulder pathologies ouch as impingement. Not only that, the lats have a significant effect on the movement and stability of the scapula. I won’t go into too much detail here as I want to get to the good stuff, the soft tissue work, but the scapula plays an imperative role in shoulder function and stability. Without a nice functioning scap, you’re screwed. On top of all this, simple trigger points in the lat dorsi can refer pain to the front of the shoulder, so you want them out.

I will go into this large muscle more in the future and delve into why it can cause a whole lot of problems, and why a strong and well functioning lat dorsi can actually improve performance in many measures, but for now, we will move onto the soft tissue work, and how to save your shoulder from a lot of pain.

This video explains how to do self myofascial release on the foam roller for your latissimus dorsi. Be aware, and I am not joking, that if you have not done this before… it bloody hurts. It’s a large muscle that does a lot of work and is on most people generally very tight and full of trigger points.

This video shows you how to perform a release on the lats with a lacrosse ball. As you may have seen in my tennis ball series, a lacrosse ball isn’t always necessary. Anything that size is great to get the trigger points…but remember if you think the foam roller hurt, this will at the start be almost unbearable. Helps prevent and cure shoulder pain though, so toughen up.

Heres to a healthy shoulder

Soft tissue work is the best thing for the hip flexors, and combined with stretches it is very effective. If you can get a professional to release them you will get the best results. Not all of us have the opportunity to get a massage as often as we would like or need, so it is important to be able to do your own soft tissue work at home. There are a couple of methods that you can do at home, and they are using a foam roller and also a tennis ball/ massage ball.

Everyone should invest in a foam roller. It’s the easiest method to do your own soft tissue work at home. Check out this foam roller on amazon, comes in different lengths.

Now…as I explained above the Rec Fem, which is a muscle that actually crosses the hip and the knee is part of the hip flexors, and is the first one that you can do work on by yourself with the foam roller. Here are two videos showing you how to do it.

Remember at first that it can be very painful, especially if you have never had anyone do any work on you before. Points that hurt more, stay on them, eventually the pain will start to fade away. These points that you hit may be trigger points, you can hit them even harder later with a tennis ball. Ensure that you do this often, at the start a couple of times a day. The fact is that tight hip flexors are often a result of our lifestyle. A lot of us work sitting down and our hip flexor muscles are in a shortened position all the time, so we need to do regular soft tissue work to counter act the fact that we are tightening the hips daily.

Try to work up as high as you can, you will hit the lower part of the psoas as well. Combine this with the tennis ball work and stretching regularly and you will be well on your way to releasing your hip flexors and reducing your pain.

What Is Wrong With Most Knee Rehabilitation Programs?

Too often they focus on the knee itself. As obvious as it may seem, this usually will not give you the relief you need and is not the cause of the problem. To have a healthy knee as a general rule you will need to have good mobility in the hip and the ankle, a strong knee joint, and have correct biomechanics when moving.

You may have heard about the VMO and it’s role in helping knee pain. That you need to activate the VMO preferentially and get it stronger in order to avoid knee pain. Sure, you may have some imbalances in the knee. but new research has shown that this might not be the case and activating this muscle by itself is extremely difficult.

Often you need to look elsewhere other than the root of the pain to find solutions. Think about patella tendonitis. The tendon is usually inflamed and overused, the tendon attaches to the quads, holy crap we best be fixing those quads then… right? Nope. Why would you do even more quad dominated exercises, try to fix imbalances around the knee if the problem is actually an overuse of the knee? Surely there are some biomechanics issues and weaknesses going on in surrounding joints, putting a whole lot of pressure onto the tendon.

If your hip or your ankle is malfunctioning, tight, immobile or weak you are automatically going to put pressure up or down the chain. Your knee is a significant part of that chain and it is often forced to do a lot more work than necessary.

So How Can I Help My Knee Pain?

Realise that everything that comes next is a general rule to help reduce chronic knee pain, and most of it comes from my own experience. As a volleyball player my knees take a beating, and these things without fail help to reduce my pain every day. Try them all and see what works for you, where you are lacking, and what you need the most.

Strengthen/ Activate

Lets forget the quads for a bit here, sure some of you may suffer from an ‘imbalance’ in the VMO and laterals quads, but I’m pretty sure you suffer from weak or inactive glutes as well. Realise that the glutes themselves may be strong, you just have an inability to get them to fire and activate, and use your quads instead.

People with knee pain often have poor hip control. The knee ends up doing a lot of work that in reality the hip should be doing. In order to take the pressure off the knees it is imperative that you get your glutes strong and functioning. The bridge is a great exercise to start with, do 3 sets of 15 on each leg, I promise you that will be hard. Start double legged if you need.

Check out this video on glute activation I made a while ago.

Last but not least here are 8 exercises that really engage your glutes. Enjoy.

Bum Exercises

Honestly, weak and inactive glutes are a huge contributor to knee pain, and an easy fix. The stronger your glutes are the less your knees are going to have to work.

Calf strength has recently come into play, and Aussie physic Jill Cook has done a lot of research into calf raises and how they can help reduce knee pain in general. Try to add in a couple of sets of body weight calf raises overtime you head to the gym, do a workout or a training session. Strong calves again mean less pressure through the knee, as they do a lot of work in take off and landing and do a lot of work absorbing eccentric forces.

Stretch

Stretching the right places is imperative, as we have discussed before. Stretching the wrong places can sometimes hinder your objective. One place that it is absolutely certain you need to stretch, are the hip flexors. One of the major hip flexors is the Rec Fem. It’s the muscle that attaches from your hip right onto your tendon, it is the most superficial muscle of the quads.

It can often get tight and cause a whole lot of knee pain. So stretch the hip flexors in general. Tight hip flexors will also result in a bum that is not as active, thanks to reciprocal inhibition. Stretch them, tight hip flexors suck and cause a lot of issues.

Self Soft Tissue Work

What is even better than stretching? Soft tissue work. Obviously the best thing you can do is go and get a professional to work out your kinks, but thankfully there is a much cheaper solution, and one that works pretty well. I am constantly using a foam roller and tennis ball/ massage ball to help relieve a lot of my knee pain. Here are the two I use…the thera roll is a crazy invention, hurts like nothing else, but really does give you a good myofascial release. It is better than your average foam roller, but to take it one step further, you should get on the tennis or massage ball.

Key parts to work on should be the…

Rec Fem

It is really important to give your rec fem an absolute beating. Roll it out to start, focus us and down the muscle, but eventually get onto the tennis ball, it will really help your knee pain. Pics and videos to follow, in the meantime lay face down, place the foam roller or tennis ball directly under the middle of your qauds, and move up and down. If you find a sensitive area, or trigger point, start flexing the knee.

Hip Flexors

Glutes

TFL

ITB

All these places, especially the Rec Fem, have the tendency to be tight and overused and with a little releasing will go a long way to relieving your knee pain. Tight glutes transmit onto the TFL and the ITB, a lot of stress on the ITB is a big cause of knee pain. Lets address all of these areas with some soft tissue work. You can see above the pics on how to use a massage or tennis ball, check out this video as well on using a foam roller. Remember that the thera roll gets in a little deeper.

Mobility

Having mobile joints above and below the knee are imperative to knee health. The ankle and the hip need to be mobile and moving correctly in order for your knee to function optimally and take the stress off it.

Here are some videos on exactly how to get that mobility through your ankle and hip.

Ankle

Hip

Check out this hip mobility guide at Volleyball Base.

Here are some more vids to help you.

Like I said guys, all of these things may not work for everyone, and most of them I have come across through experimentation. I help my own pain by continually applying these principles. Try it out, I have no doubt you will be able to reduce your knee pain significantly.

A calf trigger point will mean possible pain in the foot, heel, arch achilles or knee, as well as in the calf area itself. They can be the cause and aggravator of the painful syndrome plantar fasciitis. The point is, you want to get these trigger points out of your calf muscles, as they can lie dormant for a while and bite you in the bum when you don’t even know it.

Here is a picture of where you can locate some common calf trigger points both in the gastrocnemius, which is the more superficial muscle, and the soleus, the deeper muscle. Keep in mind when you are doing your therapy the way I describe, you don’t need to just focus on these areas, you might have some other tight areas that are or are close to trigger points that you can get some relief from working out.

Common calf trigger points

Middle pic is gastrocnemius, right pic is soleus.

How To Release Calf Trigger Points

OK now the how to. Here is an excerpt from my post on lower body trigger points. Remember that you can try to target the areas you see in the above picture, but a little bit of all round massage won’t hurt you either.

How To:
Start on your bum, raise yourself a little (the more of your body that is raised off the ground, the more pressure you can put through the ball…) and place the ball underneath your calves. Roll right from the Achilles up to under the knee. Slowly. Stop on any tender points and hold. As the calf is pretty wide, you might need to try a few lines, i.e medial, middle and lateral. See how you go.

The best thing you can do is experimentation, there isn’t one way to do everything, and you might find relief from using a tennis ball and rolling on it as I have shown above, using your own hands, getting someone else to get in there, or seeing a professional. Remember if the pain keeps on going, the latter is necessary.

How To Loosen Hip Flexors?

There are three basic ways that you can do to loosen your hip flexors, and the reality is the best thing to do is do all of them. The three methods are:

• Stretching
• Soft Tissue Therapy
• Active Release

Let’s talk through these a little.

Stretching

This is a reasonably obvious one, but it is important to get the right stretches in. Your hip flexor is made largely up of a lot of fascia. Stretching is important, but you need to do it the right way, and it should be accompanied by other releasing methods. Ensure that you hold stretches for at least 30 seconds so you can start to release the fascia as well. You will actually feel your hip flexors releasing. Here you have an example of a stretch to do by yourself, and a stretch that you can do with a partner.

As you can see in this first stretch, you need to put your arms above your head to stretch out your body, stretch out the fascia. Reaching back behind starts to open up the hip flexors even more. Remember to hold this for at least 30 seconds.

This next stretch is one you can do in partners. Hold your knee whilst lying off a table, butt on the edge. Get the partner to push down onto the leg that is hanging off the table. STretch it for 10 seconds, then get the person on the table to push back up whilst you resist them for 5 seconds. Stretch them again passively for another 10 seconds, and push for more range. Remember the hip flexor is a tough muscle, you need to stretch it hard. This is called PNF stretching and is a very useful technique for getting range of motion.

Soft Tissue Therapy

Here is an excerpt from the Tennis Ball Therapy article explaining how to do soft tissue work.

This is a tough one to actually get trigger points done with the tennis ball, however this kind of work will give it a good release. The Psoas is often tight from people sitting down at work all day and having it in a shortened position.

How To:
About 2 cm right from your belly button is the initial place you want to put the ball. Lay flat and gradually raise yourself up of the ground. The higher you go the more stretch and consequently more pressure you put through your Psoas. Repeat this with the ball in the same spot a few times, then move it up and down slightly. Test out each area of the Psoas and find where you are tightest. Not everyone will feel something from this exercise, if you are tight in the Psoas I find the best way to get nice and deep where you need is some hands on active release work or acupuncture. However this is a good, cheap and convenient start!

Active Release

There is a phenomenon called reciprocal inhibition. Basically muscles work in pairs, and when one muscle in that pair is active and working, the other one will release and relax. Your glutes and your hip flexor experience this phenomenon. So what am I saying? Well, working your glutes will help to release your hip flexors, but even more so, working your glutes in exercises that stretch your hip flexors are even better. Lunges are a great exercise for this, but here is a picture of another great one. It’s called the bridge and it basically works your glutes and puts your hip flexor on stretch at the same time. Ensure that you feel your glutes working and contracting. Do it 10 to 15 times and 2 to 3 sets of it.

So here you have three methods to release your hip flexors, try them all and you will feel a difference.

Now you will see two videos that I checked out and liked, that give you some great tips on how to begin exercising your back. Although at the end of the day you definitely need to see a practitioner, and get an individual exercise plan, these videos take you through some exercises you can do safely at home to help you reduce your pain and hopefully heal your bulging disc. If you have any pain, simply stop. We don’t want to work through pain when we are on our own.

Now, obviously seeing your practitioner is the best way to get some more exercises, but the following video outlines a couple of hip bursitis exercises that will really help you to reduce your pain and strengthen your hips. When you think about it, stronger muscles will lead to a more balanced capsule, and there will be less pressure placed on the bursa. You will be helping to reduce your pain and rehabilitate your injury, as well as ensuring that you are preventing further problems.