What do you think most of that comes
think the biggest joint responsible for this is going to be? Hip, right. Yeah. We've
got a couple things going on at the hip. This one gets a little complicated. I'm
going to be honest with you, we'll start with the easy one. Knees moving
inward is what joint action? Adduction.
What muscles adduct my hip?
The adductors. Right? You knew that right? Sometimes we get a "give me" in the
whole functional anatomy game. You know, it's like, what is the levator scapulae
do? Uh, elevate the scapula? Sometimes we get "give me"s. Adductors.
However, here's where things get a little confusing. The other part that's causing
the knees to buckle in, and this is where it's also related to lower leg
dysfunction, is what my friend Rick likes to call the bowstring effect. The same
muscles that pull on the lateral knee, will also duck the knees in. You
kind of follow me? Here's the easy visual. So if these muscles right here
pull down this way, like the string on a bow and arrow, if these are on the
outside and I shorten that string, what's going to happen to the bow? It's
going to go that way, right? Can you kind of see that? If I drew my knee this
way, this is my femur, this is my knee, and this is my tibia.
I drew a little string right here.
I'm dramatizing. If I shorten this string, what happens to my knee? Can you see
that? What muscles pull on the outside of my knee? TFL. You're not done yet.
Short head of the biceps femoris. Why not the long head?
It's actually a little bit more complicated than that. So what ends up
happening is it's hip adduction and
This is where things get even more complicated. Femoral internal rotation,
this is my femur, this is my tibia, this is my knee, if I have femoral internal
rotation, it is the same thing as tibial external rotation. So all of the muscles
that we listed for externally rotating the tibia, will also turn the femur
inward causing this. Are you with me there? So we did TFL, biceps femoris. The
reason why it's only the short head of the biceps femoris, is the long head of
the biceps femoris crosses the hip, right? Connects into my ischium.
What is my the long head of my biceps femoris do as a joint action at
the hip? It extends the hip and externally rotates. Are you with me
there? So the long head is actually long, and the short head is short. Darn, crazy
muscles. Make up your mind! One head's short, one head's long. But it's true.
So TFL, biceps femoris, possibly even what was the other external rotator of our knee?
Lateral gastroc, right? We could even, it's not on the next slide,
but we could even put lateral gastroc.
Just gets wilder and wilder. So, if this is the case, adduction internal rotation,
what would our long muscles be?
My abductors and external rotators which are going to be, you already hit it,
who are my big abductor and external rotator? Glute what? Yes. My favorite
muscles. They are. They're my favorite muscles. Not saying necessarily visually,
although that's not bad either, but they do have extremely important functions. As
we start tracking up all of our dysfunctions, you will see the glute
max and glute med are almost always weak. And then we wonder why so many
people have droopy glute syndrome. You know droopy glute syndrome, right? No?
I know a couple of people in here are going, "uhg, droopy glute syndrome". So, what
would we do to these muscles? Activate, and then we would try to integrate. Okay.
One thing I need to
specify: we have to activate, and we have to isolate
and activate as much as we can. If you go, 'well I need stronger glutes', and you
decide that you don't do corrective exercise, you decide you're just going to
do squats to try to strengthen your glutes, is that going to work? Why isn't
it going to work?
You're going to continue using the compensation pattern you've always had.
You with me there? You can't control that. If your glute max and glute medius
is shut down because your knees duck in, your biceps femoris is going to take
over, this is something called synergistic dominance.
I don't care how many times you do squats, your glutes aren't
all of a sudden on your 15th squat going to go, "oh yeah I'm supposed to work now."
You've learned to this compensation pattern until you release and stretch
the short muscles, and activate these guys, they're not going to get involved.