How to Prevent a Career Ending Knee Injury

When it comes to fitness, some people need research to vindicate their beliefs.  With the gimmicks out there, it’s easy to understand why.  But I’ll admit that a lot of my beliefs aren't shrouded in research.  Let that be a little disclaimer before reading this post as it is nothing but a meandering thought that I had while rehabbing my foot.

HOMUNCULUS PEOPLE

I have a love-hate relationship with the Gait Guys.  Sometimes they change my life, sometimes they destroy it.  One thing they taught me about was the importance of the foot in movement.  Considering it was all squats and deadlifts prior to that, I have to thank them.

A main premise that I learned was that propulsion happens off of the second and big toe. If we assume that you have an even weight distribution over the forefoot of your foot’s tripod (which most people don’t have, but were assuming here so don’t judge me) you would have 50% of your weight on each point.  But with propulsion, it’s more like 60 or 70% on the medial point (nearest the big toe).  This requires to foot to evert somewhat — you can try it out yourself.

 

An even weight distribution over the forefoot of the foot's tripod.

Carrying more weight on the point nearest the big toe. There is a reason it's the "big" toe and the highest point of the foot is there.

As mentioned in a previous article, I trained isometric holds after breaking my foot.  To prepare myself for explosive movements, I did holds in the slightly everted 60/40 position.

You have to remember that when I first started rehab, I couldn’t even balance on one leg, let alone on the tip toes of one leg.  So when I tried to progress to the 60/40 position my knee was wobbling all over the place and when I lost balance to the outside (if you’re balancing on your right leg, your body tips over to the right) my knee would jerk inward to get my balance towards the mid line, trying to not fall over.

No big deal when we’re talking about a half crippled guy relearning how to balance on one leg.  But if you think in terms of cutting, when higher forces are involved, it’s the same mechanism that causes ACL/MCL injuries.  We see a lot of guys go down with knee injuries with NO CONTACT.  The two that come to mind are Terrell Owns and Rod Woodson in the NFL, but there are many more beyond my memory.

It used to baffle me how these things happened.  But taking what happened to me, I created a little theory.  Knowing that propulsion happens off of the medial point of the forefoot (remember the 60/40 relationship), WHAT IF your ankle rolls to the outside (same motion as a traditional ankle sprain) when you're trying to cut?  If the knee spasms inward as it did with me, it makes sense that an internal knee injury will occur.

 

My hypothetical "cut." The foot plants strongly and everything is aligned, ready to propel upwards.

Hypothetical bad cut. Ankle rolls outward and the knee collapses inward in what you would call a "knee jerk reaction." Although my knee isn't collapsing inward in this picture, I was trying to make it. It physically hurt my knee, making me believe this theory even more.

The big picture is that our ankle stability during cutting is largely dependent on isometric strength because we have to absorb a lot of force in a small time and spit it back out quickly.  The range of motion is small.  If you look at the video below, when Powell’s foot strikes the ground it stays at a relatively constant angle until propulsion occurs.

httpv://www.youtube.com/watch?v=KRZvlQTTCMg

What if non-contact knee injuries are an overreaction of the knee trying to correct balance issues that are caused by a foot that isn’t doing the “right” thing?