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Sunday, 5 February 2012

REVIEW: Secrets of the Hip and Knee - Gray Cook, Brett Jones

This will get a few people in a tizzy I know.  The whole 'does the FMS work at all?' argument that has sprung up.  So, let's cover that first.  The FMS (functional movement screen) is at its heart a series of 7 movements using bodyweight & a few tools like a height adjustable hurdle, a measuring rod & a board.  I won't go on to describe every movement involved, but if you are interested pop over to the Functional movement website & check it out (& buy the book called movement if you want a real close look at it).  So, let's cut to the chase.  Looking at the research it does not look like the FMS does a good job of predicting short term injury, if you want references I've got quite a few & the consensus seems to be that for short term injury prediction this isn't an accurate tool, it is very bad at picking up on previous injury (the single biggest indicator of injury is previous injury, if it can't spot that, then it's in trouble when it comes to short term injury prediction).  So, the FMS is worthless right?  Well, no, I don't think so.  A huge factor of the FMS is finding asymmetry & correcting these as much as possible & creating a minimum acceptable movement pattern.  For some things this will be useless or even counter productive, so asymmetrical sports like throwing, fighting etc may actually suffer from symmetry!  But symmetrical sports like swimming, running etc or your average gym-rat may not gain short term injury prevention, but may gain longevity in an activity if they remain more symmetrical & keep decent range of motion.  My personal view is the FMS does a fair job of that, well part of it, I have seen people who can breeze a lot of the FMS tests, but load them & suddenly their squat looks REALLY ugly, so assessing under load is as vital as unloaded to get a full picture as well as previous injury history & many other bits before you can really understand a persons needs.
I haven't referenced the above as I just wanted to give a brief snippet of the arguments raging right now, if you want a piece specifically about the whole FMS debate post below & I'll do a fully referenced blog on that as it would take some time to take you through the whole thing covering all the issues.
So back to the DVD.  Whether you accept the FMS or not this video has some useful exercises you could incorporate into your training & shows you how many knee & lower back issues can be traced back to the hip (the ankle being another major cause of issues elsewhere too), so although the DVD says it's about knees & hips, it actually focusses on the hip as the major player in the whole knee problem arena.  As long time readers will know I have had a few back issues in the past & a couple of the things mentioned on this DVD showed I was definitely lacking in some core stability (especially when loaded across the body - so for example loading the right arm while on the left leg), I cannot hold this stable when moving - for some reason I've never thought to load up like this before, so for example a one leg deadlift with the left arm picking up the weight, while the right leg stays down on the ground & I look like I'm tightrope walking (all wibble-wobble), so that's got to get included.  I do regularly foam roll & as a massage therapist I obviously agree with soft tissue work (nothing beats hands-on, but a roller can get done everyday, so use both!), so I'll be doing the one leg deadlift & I'll be including a split squat progression that isn't exactly the way these guys suggested it, it was something I coincidently had planned for this cycle anyway, but watching this I'm going to load only the opposite shoulder with a kettlebell (you can use a dumbbell just as easily).  So, remember when the weight bearing leg is the right, hold the kettlebell or dumbbell in the left hand at the shoulder, like you are about to press it). My progression ideas for this are as follows:

Stage 1/ Static split squat
Stage 2/ Rear foot elevated split squat
Stage 3/ Forward, backward, lateral lunging

Each stage will be worked until total stability is achieved.  These are not going to be my 'strength moves' as such, I still have to keep my big 3 lifts going the right way (barbell back squat, Barbell deadlift & bench), so I'm keeping them in & working these in around that - that probably wouldn't be to the authors of these DVDs liking as they believe in dropping exercises & focussing in on issues, fixing them & then reintroducing other exercises, but for now I'm trying it this way, if that fails to correct things then I'll think about dropping the big movements, but for now they are staying - as they say, we learn best by doing, so I'm doing this, I may learn it won't work this way..or I may learn that in some situations it does, either way I'll learn another lesson.  By now you probably know I don't always just follow what people say, I tend to tweak & see if I prefer another path, sometimes I've really gone wrong, but on others I've found new ways of doing things that I've included into my bag of tricks.
So DVD, worth the cost or not?  I'd say yes.  If you are new the whole corrective idea it is a good place to start.  If you've had bad knees, hips or lower back in the past (this includes runners, not just lifters), then I'd say yes get it.  Please don't follow the whole 'corrective exercise' thing right down the rabbit hole (Alison in wonderland reference), please do not end up on tip toe balanced on a bosu ball, juggling oranges while pressing a pink dumbbell.  Most dysfunction is fixed by lifting heavy & getting a decent mix of strength, power & muscular endurance, going unilateral where necessary & finding the issues, the whole squatting on a stability ball is just a short cut to an injury in my view.  If you want instability, add chains, add weights from the bar hanging from bands.  These add instability without the injury risk.  If you are not spending at least some of most sessions going heavy (heavy for you that is) then you are doing something very, very wrong.  So, yes do any correctives you need, but do not fall into the 'corrective trap' or you'll waste years doing all sorts of nonsense when you should have been gaining strength! ...ok rant over.

If you want to get hold of the DVD pop over to dragondoor

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