Q: Are there any stretches that are good for knee pain? I've tried rest, ice, and all the normal training suggestions but everytime I start to train with any intensity my knees start to bother me. I'm wondering if it's not a flexibility problem?

Well a lot of knee pain is caused by overactive and tight quadriceps. It's pretty common. Turns out the number one correlation with knee pain are tight quads along with weak glutes and gluteus minimus (the small muscles that move your legs away from your body to the side). Try testing your quadricep flexibility. Can you bring your heel up near your butt without too much trouble? If you can't your quads might be tight.

I think a lot of coaches and athletes neglect stretching of the quads. People are on the right track with regards to placing emphasis on the backside of the body (ie. hips and hamstrings), but that's only part of the equation. In order to help fire up the backside it helps if you loosen up the frontside a bit.

This is my favorite quadricep stretch. It's not uncommon for it to not only have an immediate effect on knee pain but also on a person's gait and stride. Do it a couple of times per day for a week or so and see what happens. It has the added benefit of being a phenomenol hip flexor stretch.

Face away from a bench with one foot up on the bench behind you. The knee of the other leg is at a 45-degree angle with the sole of the foot planted firmly on the ground in front of you.

The first position requires you to take your bum towards the stretch side heel. If this is easy, add the "pelvic tilt" i.e. suck the top of the pelvis in or backwards, and push the bottom end of the pelvis forward. Now take the foot of the non-stretch leg out further away from the bench and lower your pelvis down as low as it can go (your stretch side foot is still up on the bench behind.)

There's a picture on this page:

Quad and hip flexor stretch

Q: Do you recommend the hi-low method of combining training where a person always rests 48 hours between bouts of high intensity training (weights, maximum speed, plyometric work etc.)?

It's an excellent way to organize training. As I'll explain in a minute, I feel it's particularly effective the more lifting an athlete does. This makes it particularly effective for bodybuilders, powerlifters and the like. Having said that, I feel when taken as gospel it's a bit restrictive and could use some clarification. Here's how I would adjust it. First lets give a few examples as to what constitutes "high intensity" and "low intensity" respectively.

High Intensity

1. strength work (anything above 80% +of 1rm for lower body and "whole body" movements such as deadlifts, cleans etc.)
2. maximum effort bodybuilding work (mainly lower body)
3. maximum speed work with full recovery between reps
4. maximum effort plyometric work
5. maximum effort agility and deceleration work
6. maximum effort conditioning work (ie. Timed max effort intervals)
7. martial arts or boxing fighting, sparring, or heavy bag
9. any activity performed with heightened and competitive emotional intensity (competitions)
10. any activity performed under the influence of artificial stimulants
(ephedrine, various energizing supplements) 11. for advanced athletes - any activity involving PR type performances

Low intensity

1. aerobic work
2. submaximal conditioning work
3. dynamic warmups
4. submaximal bodybuilding or upper body isolation bodybuilding work
5. submaximal speed work
6. easy plyometric work (basic unilateral and bilateral hops etc.)
7. footwork drills
8. jump rope
9. martial arts or boxing kata, mitt work, or shadowboxing

The basic rule is that high intensity activities deplete the central nervous system. Obviously, muscles can become fatigued locally from activity, yet central fatigue affects your entire human organism. That's why a particularly grueling bout of exercise restricted to one area of your body can leave you performing less then adequately in other parts of your body the next day. It's also why activities performed with heightened mental and emotional intensity, such as a few seconds of activity at a track meet or a PR performance in the weight room, can sometimes leave a person fatigued for days.

The CNS - Your Powerplant

Think of your "central" nervous system just like a central powerplant for an entire city. The CNS is your powerplant and it resides in the middle. The job of a powerplant is to provide electricity to the entire city that it controls. Without enough electricity the city can't operate efficiently. Now, think of your external musculature as the city. Your central powerplant has to provide the electricity for your muscles and there's only has so much available energy. Every time you perform high intensity activities you use up available electricity from your powerplant. Since you don't have the option of buying a bigger powerplant, you have to organize your training in such a way that your powerplant does not become overextended. Anytime you stress the capacity of your powerplant via engaging in high intensity training, you stress the powerplant and have to let it build back it's energy reserves.

Your Powerplant Needs Time To Recharge

Now, it takes your central nervous system approximately 48 hours to recover from those high intensity activities. The basic tenet is that to foster consistent performance and recovery, high intensity activities should be placed on the same days with other high intensity activites and those "high intensity days" should be alternated with "low intensity" days.

Therefore, in a weekly schedule you might have strength work, plyometrics, and maximum speed work placed on mon, wed, and friday while aerobic and conditioning work would be placed on tuesday thursday.

OK, my personal feeling is that abiding 100% by this rule is much more important when the high intensity elements provoke muscle injury. What is muscle injury? Nothing more then protein breakdown caused by eccentric contractions. What mainly stimulates it? Strength and bodybuilding work. That doesn't mean the other high intensity elements such as sprinting, plyometrics, and agility work can't stimulate muscle injury because they can, particularly when really pushing it to the maximum or setting PRs - this is particularly true the more advanced the athlete is, which is why more advanced athletes get more out of this type of setup then beginners. For example, agility and deceleration work are known as 2 of the elements that "beat people up" the most. Yet it should be no surprise that this (muscle injury) occurs more with weight training when one of the basic goals of most weight training is muscle breakdown. when a muscle is injured (damaged), inflammatory messengers are stimulated which spread and dock in areas throughout the body including the brain and really promote the systemic fatigue and prolonged recovery time that most people refer to when they talk about "CNS" fatigue. Muscle injury to the human CNS is kind've like a tree falling on a power line - It causes transformers to blow out and a city's power supply is disrupted.

So, in my opinion the main point to pay attention to when organizing your training is to make sure you always follow up high demanding "muscle injury" type days with a lower intensity day. Most people can tolerate multiple consecutive days of "high intensity" activities so long as they pay attention to the stress induced in those sessions and hard weight training days are followed by easier days. Therefore, provided you pay attention to the level of emotional intensity you perform under, and phsyical stress (soreness) generated by your non weight training high intensity elements, it's normally Ok to perform plyometrics one day and sprinting the next, maximum speed one day and lift the next, or linear speed and plyo one day and agility the next, -or any combination thereof. But as soon as you throw lifting and strength work into the equation everything needs to be looked at a little more closely. If you have a hard lifting session one day and try to sprint or do anything else high intensity the next, don't expect to be very successful at it simply because that lifting is probably going to provoke more muscle injury.

I hope that makes sense.

Q: I just have a couple of quick questions for you. I have just found the Inno-sport site and I have read most of the sites articles (even yours on there too.) I found that they really emphasized plantar flexion. Is plantar flexion strengthened sufficiently through plyometrics and playing the game (basketball) or do I need to do more specific things?

A: Well in my opinion the importance of the plantar flexors (calves) is not so much a matter of "strength" as it is having "good feet" or "bad feet". You hear this a lot amongst football scouts - So and so has "good feet" and so and so has "bad feet". What's meant by good feet and bad feet? It's really nothing more complicated then having good footwork and being light on the feet vs having bad footwork and being heavy on the feet. It's the ability to quickly and efficiently control the body while transferring forces from the hips through the feet and down into the ground. If you got a broken foot or bad ankle you can generate as much force from the hips and thighs as you want but you ain't going anywhere in a hurry because what transfers those forces to the ground (the feet) aren't working right! In much the same way, many athletes have "broken feet" even though their feet ain't broken!

Strength "can" be a limiting factor but is not often the case. One thing you can do to prove this to yourself is try and jump from a standstill with completely straight legs. Regardless of how strong your calves are or how strong they get, you aren't gonna go very high! Along that same line, it's easy enough to pull up all kinds of studies that demonstrate the forces generated by the plantar flexors pale in comparison to those generated by the hips and thighs in sporting movements, but a couple of real life examples will probably work better, so here goes. If you watch little kids run around on the playground many move better on there feet then a lot of high school athletes despite being relatively much weaker. Additionally, if plantar flexor strength were so important, a surefire method to improve footwork would be to put someone in a calf raise machine and have them do negative accentuated single leg calf raises. That will quickly and impressively improve strength, yet it won't do much of anything for performance.

It's all a matter of movement proficiency. Obviously, before you can increase the amplitude of force that you generate behind a movement pattern, you have to be able to perform the movement pattern effectively and proficiently to begin with. Having good feet is key to that. The more efficiently you move, the less effort you move with, and the more things you can do on your feet, the better off you are. For that reason I like to incorporate an assortment of various footwork drills for athletes. This can involve ladder drills, linear, lateral, and backwards agility drills, multidirectional drills, and an assortment of basic and advanced plyometric drills emphasizing proper position up on the balls of the feet with quick and efficient change of direction etc.

Here's an example of a very basic "dot" drill used for this purpose.

Dot Drill

Developing "good feet" should be the very first step on the path towards athletic prowess. It's one that can be developed even in very young athletes. Some people do have advantages in this department, and those advantages are often apparent from a very early age, but any healthy athlete can immensely improve this ability. Now, the problem is, many athletes of today have been deconditioned to the point where many, if not most, are way behind where they could or should be as far as simple movement efficiency. Not only do they have inferior movement mechanics and "heavy feet" to begin with, but instead of improving that capacity, they spend the majority of their time improving their ability to put out force (weight training and advanced plyometrics). Those methods surely work to improve their ability to develop force but since their movement efficiency is faulty, they aren't able to utilize the improvements they make in those areas. Thus, sometimes it's necessary to really emphasize "good feet" even with mature athletes.

-Kelly

Q: How would any of you suggest a waveloaded workout structure for acquiring basketball skills similar to what you wrote in the "Visualization" article.

A: Here's an example I gave someone who runs a basketball skill development school.

Here are the modules

1. Stationary and moving ballhandling drills with incorporation of basic in and out, in and out cross, hesitation moves. Session time is approx 30-40 minutes.

2.Triple threat play. This starts with movement with out the ball, proper one two or jump stop movements and then receiving the basketball. Dynamic triple threat movements and finishes. This session is heavy on one two footwork drills.

3. Shooting spotup, off the dribble, off of motion cuts etc. We also incorporate step back moves off the dribble, pump fake-one dribble shots etc. But basic mid to long range shooting.

4. Post Moves This includes footwork drills, Miken drills etc. We then have about 4-5 core moves and 3-4 advanced moves.

5. Advanced ballhandling and one on one play. This series incorporates difficult movements of the upper extremity and quite a bit of street flare. Most moves would not be used often but the degree of difficulty for most of my players builds nicely on session 1.

Something like this would be an example. Not perfect but it oughta give you an idea.

Each column is a day.

1234
1234
1234
1234
1234
off
off
24
15
24
15
24
15
3
off
12345
off
12345
off
12345
off
12345
off
153
153
153
153
153
off
off

etc.

Basically you start off general with a mix of everything. Then you isolate a skill and really hammer it hard, then once again integrate it with the others. While you're concentrating on a skill do enough of the others to maintain. Then back off on the focus and integrate/consolidate it. You stabilize a skill by increasing first and then backing off the volume. I'd consider ballhandling to be at the foundation of everything else, meaning if you could only choose one thing to work on then that would carry over better into everything else but that's just my opinion.

-Kelly