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