I recently posted this great article on the MDSoF FB page by Dr. Kathy Dooley regarding gluteus maximus and the knee. As you read in the article, there is a great description about the mechanics of a very common movement issue, “corkscrewing” of the knee, but not what you can do to address the issue. Since this is something we deal with on a daily basis, below is a quick summary of the some of the things our coaches can help you with to address the issue.
Let’s take a step back and talk little bit about why you would want to address the common issue of “corkscrewing” your knee on knee flexion. At MDSoF, we love working out at the the gym, but our training reflects that our passion is getting out of the gym and out into the woods, mountains and/or beach, building a deck or just playing with your children or grandchildren. We want your fitness to support doing something that you are passionate about and recharges you. This corkscrewing or instability of the knee can cause pain in the knee and/or back on a long downhill hike/run or when training heavier or faster (like sprinting or Olympic lifting). A stable knee is the foundation of safe, healthy training.
The most important thing you can do to make a change in movement is to find a test that you can use to measure improvement on a daily basis. My personal favorite is Single Leg Stance (SLS) with eyes closed, but other people have had success with single leg squat to a box or a box step down. What is important about the box step down is that it is assessing the eccentric, or the lowering, component of the movement not the concentric or raising component of the lift. What we have found over the years is that many people lack motor control/stability with eccentric part of the lift and that is where they seem to have injuries/pain most often. Start with something static like the SLS and then move towards something more dynamic so you don’t miss anything. Having an easy, fast and accurate test is the most crucial component to improving any movement issue.
Remember, most of the time, if you have a movement issue, you’ll have a movement pattern that is compensating for the correct movement pattern so your job is to stop the compensatory pattern and re-activate the correct pattern. Usually, the first thing an athlete will do is release a muscle, or group of muscles, by either a manual release (like a foam roll or a ball) or a stretch. The release is a signal to your body to stop using a pattern, For instance, only using the Tensor Fascia Lata (TFL) to “provide lateral control of internal knee rotation” instead of using both the TFL and the Gluteus Maximus (G Max). The TFL is often tight on athletes who have to sit at a desk for work. Try this to address muscle tissue skankiness in the TFL region. Most of the time, releasing the TFL will make changes to the SLS right away, but there are other releases below if this doesn’t make a change.
While releasing a muscle with ball work and/or stretching often relieves pain and/or increases mobility, you need to figure out a way to “make it stick.” The second critical part of addressing a movement issue is to retrain the correct moment pattern. The G Max, most of the time doesn’t fire precisely nor accurately or as Dr Dooley says, it is “…also one of the most functionally inhibited muscles even with its power potential.” Start with TGU to elbow (see 1:20 of this video – weight is not necessary to practice the correct movement pattern) to confirm your G Max works like it’s supposed to. This TGU pattern is awesome because it addresses both fore-aft (sagittal plane) and side-to-side (lateral) function of the hip. You can also use a hinge movement to train the G Max but because it is, most of the time, a standing movement, it might be too much too soon. Start on the ground and work towards standing. Something in between might be the Elevated Roll. While the Monster Walk is a standing exercise is also a great G Max/G Med activator (there is more to this exercise than is shown here, ask a coach how to do this properly).
After you have done one of the above release and the movement re-patterning go back and do your test. If you haven’t made a change with the above, as mentioned in the article, consider the following mechanisms (provided by Dr Dooley) and exercises. Because this piece is meant for future and/or current Mad Dawg athletes, so please ask a coach if you need help with any of the exercises or ask your coach in your Get Started appointment.
Overactive knee internal rotators (e.g., semitendinosus, gracilis, sartorius, popliteus)
The fastest way to see if this is the cause of your corkscrewing issue is to just use a foam roller above and inside the knee to release the overactive knee internal rotators. The barbell in KStarr’s video might work in the upper, more meaty, parts of the leg but start with the foam roll first. Again, re-pattern the G Max with any of the exercises above.
Overactive foot pronators
Here’s another good use for the foam roll or even better a Tiger Tail. Most these foot pronators are on the outside of the lower leg and are pretty small muscles so be gentle here. You can put a lot of pressure on these really easily using your body weight. Here is another guiding principle to how we train here at MDSoF, pain doesn’t mean you are getting a better release or a better workout or really a better anything. That is not to say that we avoid discomfort, it just means that pain is not a very accurate metric. Re-pattern the G Max with any of the exercises above.
Dominant hamstrings and calves, especially in sagittal plane movement
This is a tricky one as the dominant hamstrings could be a deep core issue. That is another guiding principle that we use at MDSoF, start from the inside and work out. There is almost no one who can’t use a little more functional core exercises and this is a better place to start than rolling the hamstrings and the calves as it will lead you to a deeper solution (no pun intended). Seriously, if you suspect tight hamstrings or tight calves, confirm with a few seconds of foam roll, then do some Original Strength exercise and then re-foam roll. Many times the athlete will feel a change in the tissue quality of the hamstrings and calves. It is always great for an athlete to see how connected the body really is.
As always, coaches get the big bucks for helping you sort through these kinds of issues. We think this is a good start, but always ask a coach if you are confused or need more information.